Coronary Heart Disease in South African

Background:
Coronary heart disease (CHD) is a disease in which there is a narrowing or blockage of the coronary arteries (blood vessels that carry blood and oxygen to the heart). This disease is the number 2 leading cause of death in South Africa. Before 1960 CHD is uncommon especially in black people, since then CHD risk factor levels have increased.

Objective:
This study aims to assess the relationship between CHD and known risk factors which contributes to the rise of CHD causes death in the region.

Overview:

In the 1960s in sub-Saharan Africa, coronary heart disease (CHD) is near absent in rural areas and very uncommon in urban centers, where many Africans are in an advanced stage of transition. Among town dwellers intakes of food, especially fat, have risen and intakes of fiber-containing foods have fallen. The prevalence of hypertension exceeds that of the white population. The same applies to the practice of smoking in males, but not in females. The level of physical activity has fallen generally. With these increases in risk factors, we can expect urban Africans to attain a high mortality rate for CHD. However, as long as Africa remains poor, a major rise in CHD is unlikely.

According to the latest WHO data published in 2017 Coronary Heart Disease Deaths in South Africa reached 40,729 or 8.12% of total deaths. The age-adjusted Death Rate is 114.02 per 100,000 of population ranks South Africa number 95 in the world. CHD is the second leading cause of death after HIV in southern Africa.

Causes of CHD:

•Smoke •High blood pressure •High cholesterol •have high levels of lipoprotein (a) •Not exercise regularly •have high levels of lipoprotein etc.

Risk factors which included in this sample are:

sbp: systolic blood pressure, tobacco: cumulative tobacco (kg), ldl: low density lipoprotein cholesterol, adiposity, famhist: family history of heart disease (Present, Absent), typea: type-A behavior, obesity, alcohol: current alcohol consumption, age: age at on set

The correlation between risk factors and CHD:

Calculating the correlation coefficient for each risk factor, I learn that the maximum has is 0.3 and the minimum is 0. Using the correlation coefficient we select the first five highest value of the risk factors.

The value of correlation coefficient of Risk factors with CHD

Age group: r=0.31, Tobacco group: r=0.25, Family history: r=0.27, Low density lipoprotein: r=0.24 , Adiposity: r=0.21, Systolic blood pressure: r=0.16, Obesity: r=0.10, Alcohol consumption: r=0.06 and Age onset: r=0

Age:

Lifestyle factors cause plaque to build up in your arteries as you age. In men, the risk for coronary heart disease starts to increase around age 40–45. Before menopause, women have a lower risk of coronary heart disease than men. After around age 55, women’s risk goes up. From the 462 samples, 45.7% of them are under age 42, 3.5% is the age between 42 and 45, and the rest 50.8% are age 45+.

Tobacco:

Smoking tobacco or long-term exposure to secondhand smoke, which can damage the blood vessels. From the sample cumulative tobacco consumption in kg, 59.7% are smoking below the lower bound confidence interval(95%), 6.1% between the confidence interval and 34.2% are above the upper bound of the confidence interval.

Family history:

A family history of early heart disease is a risk factor for coronary heart disease. This is especially true if your father or brother was diagnosed before age 55, or if your mother or sister was diagnosed before age 65. Research shows that some genes are linked with a higher risk of coronary heart disease. From the sample, 41.6% have the family history the rest 58.4% don’t have a family history of any heart disease. From the sample who doesn’t have a family history of heart disease 24.8% are positive and for the sample who have a family history of heart disease 48.9% are positive for CHD.

Low-density lipoprotein:

LDL (low-density lipoprotein), sometimes called “bad” cholesterol, makes up most of your body’s cholesterol. High levels of LDL cholesterol raise your risk for heart disease and stroke. From the sample, 11.3% are below the normal value and the rest 88.7% are above the normal figure.

Adiposity:

Adiposity is a condition of being severely overweight, or obese. The term “obesity” more frequently is used for this condition in the U.S. where obesity is usually defined by measuring a person’s body mass index (BMI). From the sample, 14.3% are over the average sample BMI and the rest 85.7% are below the average.

CHD sample statistical taste

From the 462 samples, 34.6% or 160 patients are positive and the rest 302 or 65.4% are negative for having CHD.

From the risk factors, age under 42 years old contributes 45.7 % and age over 42 years old are 54.3%. The patients who smoke more than the sample average are 37.1%, the rest 62.9% are nonsmokers and who smoke under the sample average. On the other hand, the patients who have family history 31.8% the rest 68.2% doesn’t have a family history. The patients who have less than the normal Low-density lipoprotein 15.2% and over the normal point are 84.8%. Finally, the patients whose adiposity is less than the normal are 75.8% and the rest have 24.2%.

CHD Positive

The patients who are positive for CHD are 160, the patients under age 42 are 25%, between age 42 and 44 are 2.5% and over age 44 are 72.5%. The patients who smoke less than the sample average cumulative tobacco in kg or nonsmokers are 50% and the others are 50%. The patients with less than sample avrage low lipoprotein are 28.1% the others with higher than the sample mean value is 71.9%. The patient who has a family history of heart disease is 40% the others who don’t have are 60%. The patients with less than normal BMI are 60% and over the normal BMI are 40%.

CHD Negative

The patients who are negative for CHD are 302, the patients under age 42 are 56.6%, between age 42 and 44 are 4.0% and over age 44 are 39.4%. The patients who smoke less than the sample average or nonsmokers are 74.2% and the others are 25.8%. The patients with less than the sample mean low lipoprotein is 52.3% the others with high value are 47.7%. The patient who has a family history of heart disease is 68.2% the others who don’t have are 31.8%. The patients with less than the normal BMI are 75.8% and over the normal BMI are 24.2%.

Conclusion:

Coronary heart disease (CHD) is the second leading cause of South Africa, as we have seen the proportions are more than enough for the government to take action some measures to save people’s life. On the other hand, everyone has to take counteraction to prevent himself from CHD. Most of the preventive action suggested are:

Quit smoking, Control conditions such as high blood pressure, high cholesterol, and diabetes, Stay physically active, eat a low-fat, low-salt diet that’s rich in fruits, vegetables, and whole grains, Maintain a healthy weight, Reduce and manage stress and lead a healthy lifestyle.