title: Differential associations of cardiovascular disease risk factors with relative wealth in urban-dwelling South Africans.
abstract: To examine the associations of cardiovascular disease risk factors (CVDRF) with wealth, defined by the asset index, in 25- to 74-year-old black Africans in Cape Town.
  
  
  
  Assets, including consumer durable goods, and CVDRF were determined in a randomly selected cross-sectional sample. A principal component analysis of the pooled data, based on assets that defined wealth, was used to develop an asset index. Ordinal logistic regression analyses assessed the independent associations of CVDRF with wealth tertiles.
  
  
  
  Among the 1099 participants, the least poor compared with the poorest tertile had significantly higher prevalence of diabetes (16.3 versus 9.6%), hypercholesterolaemia (33.9 versus 21.4%), obesity (45.4 versus 26.3%) and fat intake ≥30% of diet (44.2 versus 29.3%). Daily smoking was highest in the poorest (35.8%) versus the least poor (26.4%). Psychosocial stress (low sense of coherence or locus of control) was significantly higher in poorer participants. In the regression analyses, wealth was associated with male gender [odds ratio (OR): 1.89, 95% confidence interval (CI): 1.37-2.60], urbanization (OR: 1.02, 95% CI: 1.01-1.02), high fat intake, obesity and hypercholesterolaemia. Daily smoking, problematic alcohol use (OR: 0.70, 95% CI: 0.52-0.94) and psychosocial stress were inversely related to wealth.
  
  
  
  Differential distribution of CVDRF by wealth mandates incorporating equity components when developing tailored interventions.
authors.affiliation: Non-communicable Diseases Research Unit, South African Medical Research Council (SAMRC), 491 Ridge Road, Overport, Durban 4001, South Africa Department of Medicine, University of Cape Town (UCT), Cape Town 8001, South Africa.
authors.forename: N
authors.initials: N
authors.lastname: Peer
authors.affiliation: Biostatistics Unit, SAMRC, Cape Town 8001, South Africa.
authors.forename: C
authors.initials: C
authors.lastname: Lombard
authors.affiliation: Chronic Disease Initiative for Africa, Department of Medicine, UCT, Cape Town 8001, South Africa.
authors.forename: K
authors.initials: K
authors.lastname: Steyn
authors.affiliation: Chronic Disease Initiative for Africa, Department of Medicine, UCT, Cape Town 8001, South Africa Division of Diabetic Medicine and Endocrinology, Department of Medicine, UCT, Cape Town 8001, South Africa.
authors.forename: N
authors.initials: N
authors.lastname: Levitt
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D004041:Dietary Fats / Q000008:administration & dosage; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*
chemical_list: D004041:Dietary Fats
keywords: South Africa; asset index; black; cardiovascular disease risk factors; socioeconomic status