TY - JOUR
T1 - The clinical consequences and challenges of hypertension in urban-dwelling black Africans
T2 - Insights from the Heart of Soweto Study
AU - Stewart, Simon
AU - Libhaber, Elena
AU - Carrington, Melinda
AU - Damasceno, Albertino
AU - Abbasi, Haroon
AU - Hansen, Craig
AU - Wilkinson, David
AU - Sliwa, Karen
PY - 2011/1/7
Y1 - 2011/1/7
N2 - Background: There is a paucity of data to describe advanced forms of cardiovascular disease (CVD) in urban black Africans with hypertension (HT). Methods: Chris Hani Baragwanath Hospital services the black African community of 1.1 million people in Soweto, South Africa. We prospectively collected detailed demographic and clinical data from all de novo presentations to the hospital's Cardiology Unit in 2006. Results: Overall, 761 black African patients (56% of de novo cases) presented with a diagnosis of HT with more women (63%, aged 58.5 ± 14.9 years) than men (aged 58.0 ± 15.6 years). On presentation, 396 women (82%) versus 187 men (67%) had dizziness, palpitations and/or chest pain (OR 1.23, 95% 1.12-1.34: p < 0.0001). HT was the primary diagnosis in 266 cases (35%). In the rest (n = 495), non-ischaemic forms of heart failure were common (54% of total) while only 6.2% had coronary artery disease. Concurrent left ventricular hypertrophy, renal dysfunction and anaemia were present in 39%, 24% and 11% of cases, respectively, with a similar age-adjusted pattern of co-morbidity according to sex. However, men were more likely to present with impaired systolic function (OR 2.13, 95% CI 1.50 to 3.00; p < 0.0001). Conclusions: In the absence of effective primary and secondary prevention strategies, these unique data highlight the potentially devastating impact of advanced forms of hypertensive heart disease in urban black African communities with more women than men affected.
AB - Background: There is a paucity of data to describe advanced forms of cardiovascular disease (CVD) in urban black Africans with hypertension (HT). Methods: Chris Hani Baragwanath Hospital services the black African community of 1.1 million people in Soweto, South Africa. We prospectively collected detailed demographic and clinical data from all de novo presentations to the hospital's Cardiology Unit in 2006. Results: Overall, 761 black African patients (56% of de novo cases) presented with a diagnosis of HT with more women (63%, aged 58.5 ± 14.9 years) than men (aged 58.0 ± 15.6 years). On presentation, 396 women (82%) versus 187 men (67%) had dizziness, palpitations and/or chest pain (OR 1.23, 95% 1.12-1.34: p < 0.0001). HT was the primary diagnosis in 266 cases (35%). In the rest (n = 495), non-ischaemic forms of heart failure were common (54% of total) while only 6.2% had coronary artery disease. Concurrent left ventricular hypertrophy, renal dysfunction and anaemia were present in 39%, 24% and 11% of cases, respectively, with a similar age-adjusted pattern of co-morbidity according to sex. However, men were more likely to present with impaired systolic function (OR 2.13, 95% CI 1.50 to 3.00; p < 0.0001). Conclusions: In the absence of effective primary and secondary prevention strategies, these unique data highlight the potentially devastating impact of advanced forms of hypertensive heart disease in urban black African communities with more women than men affected.
KW - Africa
KW - Epidemiological transition
KW - Heart failure
KW - Hypertension
KW - Hypertensive heart disease
UR - http://www.scopus.com/inward/record.url?scp=78650840371&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2009.05.061
DO - 10.1016/j.ijcard.2009.05.061
M3 - Article
C2 - 19560221
AN - SCOPUS:78650840371
VL - 146
SP - 22
EP - 27
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 1
ER -