South African Coronary Heart Disease

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 #95 in the world. CHD is the second leading cause of death after HIV in South 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 the 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

qalcohol: current alcohol consumption

age: age at onset

What is the correlation between risk factors and CHD?

Calculating the correlation coefficient for each risk factor, I learn that the maximum has is 0.4. and the minimum is 0.1.

Using the correlation coefficient we select the first five highest value of the risk factors

Selected Risk factors correlation coefficient values:

Age: r=0.37

Tobacco: r=0.3

Family history: r=0.27

Low density lipoprotein: r=0.26

Adiposity: r=0.25

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 sample 38% of them are under age 40, the rest 62% are age 40+.

Tobacco:

Smoking tobacco or long-term exposure to secondhand smoke, which can damage the blood vessels. From the sample, 62.8% are smoking less than the sample average tobacco cumulative the rest 37.2% of smokers take higher than the sample average which has high risk.

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.

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 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 40 years contributes 49%, over 40 years are 51%. 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 are less than the normal are 75.8% and the rest have 24.2%

CHD positive

The patients who have a positive CHD are 160, the patients under age 40 are 17.5% and over age 40 are 82.5%. The patients who smoke less than the sample average or nonsmokers are 62.5% and the others are 31.5%. The patients with less than normal low lipoprotein are 3.8% the others with high value are 96.2%. The patient who has a family history is 40% the others who don’t have are 60%. The patients with less than the normal BMI are 60% and over the normal BMI are 40%

CHD negative

The patients who have a negative CHD are 302, the patients under age 40 are 49% and over age 40 are 51%. The patients who smoke less than the sample average or nonsmokers are 62.9% and the others are 37.1%. The patients with less than normal low lipoprotein are 15.2% the others with high value are 84.8%. The patient who has a family history 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

-Lead a healthy lifestyle