A Broad Spectrum of Heart Disease and Risk Factors in a Black Urban Population in South Africa: The...
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ABSTRACTS S22 Abstracts Heart, Lung and Circulation 2008;17S:S1–S209 Conclusions: These unique data confirm the importance of HT as a precursor to advanced forms of HD in urban black Africans. doi:10.1016/j.hlc.2008.05.050 50 Prevalence of Obesity and Hypertension in Urban and Rural Communities: A Comparison of South African and Australian Risk Factor Prevalence Data Melinda Carrington 1,2,∗ , Simon Stewart 1,2 , Kemi Tibazarwa 1,2 , Karen Sliwa 1,2 1 Baker Heart Research Institute, Melbourne, Australia; 2 University of the Witwatersrand, Johannedsburg, South Africa Purpose: The same key risk factors have driven an epi- demic of cardiovascular disease (CVD) in “developed” countries and will likely drive a future epidemic of CVD in “developing” countries undergoing epidemiologic transi- tion. Methods: We recently screened a total of 1127 black Africans in urban Soweto (Urban-RSA) for common risk factors for CVD. Using the same methods in Australia as part of a National Blood Pressure Screening Day, we recently screened 10,649 and 3038 participants in urban (Urban-Aus) and rural (Rural-Aus) communities (pre- dominantly Caucasian) for the same risk factors. Results: Median (IQR) age of participants in Urban-RSA, Urban-Aus, and Rural-Aus was 45 (IQR 34–55) years, 48 (36–59) years and 51 (39–62) years. The proportion of women in Urban-RSA, Urban-Aus, and Rural-Aus was 63%, 55% and 57%, respectively. In Urban-RSA, 23% of men and 51% of women were obese (BMI ≥ 30 kg/m 2 ) versus 25% and 26%, and 33% and 33% of men and women respectively living in Urban-Aus and Rural-Aus. Overall, 30% of men (median BP 130/80 mmHg) and 31% of women (BP 130/81) in Urban-RSA were hypertensive (systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg) compared to 41% of men (134/81 mmHg) and 25% of women (125/77 mmHg) in Urban-Aus and 49% of men (137/82 mmHg) and 34% of women (130/79 mmHg) in Rural-Aus. Summary: These data confirm high levels of risk in all three target communities with some potentially important differences that will require potentially different public health initiatives. doi:10.1016/j.hlc.2008.05.051 51 A Broad Spectrum of Heart Disease and Risk Factors in a Black Urban Population in South Africa: The Heart of Soweto Study Simon Stewart 1,2,∗ , Lucas Ntyintyane 1,2 , Kemi Tibazarwa 1,2 , Anthony Becker 1,2 , Karen Sliwa 1,2 1 Baker Heart Research Institute, Melbourne, Australia; 2 University of Witwatersrand, Johannesburg, South Africa Background: The Heart of Soweto Study is the largest study of emergent heart disease in Africa to date. Methods: Baragwanath Hospital in Soweto provides health care to a population of 1.1 million mainly black Africans. We registered detailed demographic, clinical and diagnostic data from all de novo presentations of heart disease (HD) in 2006. Results: There were 1593 de novo presentations for mainly advanced HD. Black Africans (85%) and women predom- inated (60%); being slightly younger than men (53 ± 16 years vs. 55 ± 15 years: p = 0.031). Risk factor prevalence was high (56% had hypertension) with >60% having mul- tiple risks. Heart failure (HF) was the most common primary diagnosis (44%) with systolic dysfunction evident in 53% of cases and 66% attributable to dilated cardiomy- opathy and/or hypertensive HD. Other common primary diagnoses were hypertension (19%), valvular HD (17%) and coronary artery disease (CAD, 10%). Within a large infective component, comorbity included anaemia (13%), diabetes (10%) and renal dysfunction (10%). More black Africans presented in HF (54% vs. 45% – OR 2.36, 95% CI 1.74–3.21: p < 0.0001); alternatively, less presented with CAD (6% vs. 38% – OR 0.10, 95% CI 0.07–0.14: p < 0.0001). Similarly, women were more likely to present with valvu- lar HD than men (26% vs. 18% – OR 1.30, 95% CI 1.11–1.52: p = 0.0001). Summary: We found multiple threats to the current and future heart health of Soweto, South Africa. doi:10.1016/j.hlc.2008.05.052 52 Hospital Length of Stay in Patients Undergoing Percuta- neous Coronary Intervention Nick Andrianopoulos 1,∗ , Stephen J. Duffy 2 , Angela L. Brennan 1 , Gishel New 3 , Andrew E. Ajani 4 , David J. Clark 5 , Nino Hay 1 , Douglas Wong 1 , Zahide Yildirim 1 , Christopher Reid 1 1 Monash Centre of Cardiovascular Research & Education in Therapeutics, Monash University, Melbourne, Australia; 2 Alfred Hospital, Melbourne, Australia; 3 Box Hill Hospital, Melbourne, Australia; 4 Royal Melbourne Hospital, Melbourne, Australia; 5 Austin Hospital, Melbourne, Australia Background: Coronary heart disease treatment results in the highest direct expenditure on any individual disease in Australia (2000-2001 AIHW data), and over 70% of this budget is spent on inpatient hospital care. An apprecia- ble proportion of this is due to percutaneous coronary intervention (PCI), and the length of stay (LOS) for these
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S22 Abstracts Heart, Lung and Circulation2008;17S:S1–S209
Conclusions: These unique data confirm the importanceof HT as a precursor to advanced forms of HD in urbanblack Africans.
doi:10.1016/j.hlc.2008.05.050
50Prevalence of Obesity and Hypertension in Urban andRural Communities: A Comparison of South African andAustralian Risk Factor Prevalence Data
Melinda Carrington 1,2,∗, Simon Stewart 1,2, KemiTibazarwa 1,2, Karen Sliwa 1,2
1 Baker Heart Research Institute, Melbourne, Australia;2 University of the Witwatersrand, Johannedsburg, South Africa
Purpose: The same key risk factors have driven an epi-demic of cardiovascular disease (CVD) in “developed”countries and will likely drive a future epidemic of CVD in“developing” countries undergoing epidemiologic transi-tion.Methods: We recently screened a total of 1127 blackAfricans in urban Soweto (Urban-RSA) for common riskfactors for CVD. Using the same methods in Australiaas part of a National Blood Pressure Screening Day, werecently screened 10,649 and 3038 participants in urban(Urban-Aus) and rural (Rural-Aus) communities (pre-dominantly Caucasian) for the same risk factors.
51A Broad Spectrum of Heart Disease and Risk Factors ina Black Urban Population in South Africa: The Heart ofSoweto Study
Simon Stewart 1,2,∗, Lucas Ntyintyane 1,2, KemiTibazarwa 1,2, Anthony Becker 1,2, Karen Sliwa 1,2
1 Baker Heart Research Institute, Melbourne, Australia;2 University of Witwatersrand, Johannesburg, South Africa
Background: The Heart of Soweto Study is the largeststudy of emergent heart disease in Africa to date.Methods: Baragwanath Hospital in Soweto provideshealth care to a population of 1.1 million mainly blackAfricans. We registered detailed demographic, clinicaland diagnostic data from all de novo presentations of heartdisease (HD) in 2006.Results: There were 1593 de novo presentations for mainlyadvanced HD. Black Africans (85%) and women predom-inated (60%); being slightly younger than men (53 ± 16years vs. 55 ± 15 years: p = 0.031). Risk factor prevalencewas high (56% had hypertension) with >60% having mul-tiple risks. Heart failure (HF) was the most commonprimary diagnosis (44%) with systolic dysfunction evidentin 53% of cases and 66% attributable to dilated cardiomy-opathy and/or hypertensive HD. Other common primarydiagnoses were hypertension (19%), valvular HD (17%)and coronary artery disease (CAD, 10%). Within a large
Results: Median (IQR) age of participants in Urban-RSA,Urban-Aus, and Rural-Aus was 45 (IQR 34–55) years, 48(36–59) years and 51 (39–62) years. The proportion ofwomen in Urban-RSA, Urban-Aus, and Rural-Aus was63%, 55% and 57%, respectively. In Urban-RSA, 23% ofmen and 51% of women were obese (BMI ≥ 30 kg/m2)versus 25% and 26%, and 33% and 33% of men andwomen respectively living in Urban-Aus and Rural-Aus.Overall, 30% of men (median BP 130/80 mmHg) and 31%of women (BP 130/81) in Urban-RSA were hypertensive(systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg)compared to 41% of men (134/81 mmHg) and 25% ofwomen (125/77 mmHg) in Urban-Aus and 49% of men(137/82 mmHg) and 34% of women (130/79 mmHg) inRural-Aus.Summary: These data confirm high levels of risk in allthree target communities with some potentially importantdifferences that will require potentially different publichealth initiatives.
doi:10.1016/j.hlc.2008.05.051
infective component, comorbity included anaemia (13%),diabetes (10%) and renal dysfunction (10%). More blackAfricans presented in HF (54% vs. 45% – OR 2.36, 95%CI 1.74–3.21: p < 0.0001); alternatively, less presented withCAD (6% vs. 38% – OR 0.10, 95% CI 0.07–0.14: p < 0.0001).Similarly, women were more likely to present with valvu-lar HD than men (26% vs. 18% – OR 1.30, 95% CI 1.11–1.52:p = 0.0001).Summary: We found multiple threats to the current andfuture heart health of Soweto, South Africa.
doi:10.1016/j.hlc.2008.05.052
52Hospital Length of Stay in Patients Undergoing Percuta-neous Coronary Intervention
Nick Andrianopoulos 1,∗, Stephen J. Duffy 2, Angela L.Brennan 1, Gishel New 3, Andrew E. Ajani 4, David J.Clark 5, Nino Hay 1, Douglas Wong 1, Zahide Yildirim 1,Christopher Reid 1
1 Monash Centre of Cardiovascular Research & Educationin Therapeutics, Monash University, Melbourne, Australia;2 Alfred Hospital, Melbourne, Australia; 3 Box Hill Hospital,Melbourne, Australia; 4 Royal Melbourne Hospital, Melbourne,Australia; 5 Austin Hospital, Melbourne, Australia
Background: Coronary heart disease treatment results inthe highest direct expenditure on any individual diseasein Australia (2000-2001 AIHW data), and over 70% of thisbudget is spent on inpatient hospital care. An apprecia-ble proportion of this is due to percutaneous coronaryintervention (PCI), and the length of stay (LOS) for these
