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Cardiovascular diseases deaths are on the rise in South Africa

23 August 2022 | Story André Damons | Photo Supplied

Dr Walter Janse van Rensburg, Senior Lecturer in the Human Molecular Biology Unit, Department of Haematology and Cell Biology in the UFS School of Biomedical Sciences, says new research found that men of European descent over the age of 50 are the most vulnerable for the development of atherosclerosis.

A new study by researchers in the Human Molecular Biology Unit in the School of Biomedical Sciences at the University of the Free State (UFS) into atherosclerosis in the South African population found that men of European descent over the age of 50 are the most vulnerable for the development of atherosclerosis – the most common disorder associated with cardiovascular diseases (CVDs). Nearly half of men in this group had visible signs of atherosclerosis in the coronary arteries of the heart.

This was in contrast to the only roughly one-tenth of the African-descent males and females in the same age bracket. More than a third of women of European descent over 50 had visible atherosclerosis in their coronary arteries. One hypothesis regarding a possible explanation for this discrepancy is based on the theory that socioeconomic status may be a driving force behind CVD.

Risks factor for cardiovascular diseases

Dr Walter Janse van Rensburg, Senior Lecturer in the Human Molecular Biology Unit at the School of Biomedical Sciences, UFS, and principal researcher, says the study was conceptualised during 2020s COVID-19 pandemic, due to reports of excessive blood clots associated with both acute COVID-19 infection and some of the SARS-CoV2 vaccines. However, limited data existed in our region regarding the other underlying causes for blood clot formation, such as atherosclerotic plaque rupture. The data was collected during a couple of months in 2021. The data was collected out of more than 10,000 case files spanning 10 years. The study is still ongoing.

“Atherosclerosis remains a major risk factor for CVD, and thus, believed to be a good indicator of the CVD profile in a population, yet little is known on its prevalence in sub-Saharan African populations. We aimed to determine the prevalence of atherosclerosis in a diverse South African population as found in post-mortem investigations. A retrospective file audit was done on 10,240 forensic post-mortem reports done at a forensic pathology mortuary in South Africa, over 10 years,” writes Dr Janse van Rensburg in the Abstract of the research article.

According to him, cardiovascular diseases are reportedly the No 1 cause of mortality worldwide. According to the latest report from Stats SA, diseases of the circulatory system account for nearly a fifth of all deaths in South Africa.

“CVD is a multifactorial disorder, however, the presence of atherosclerosis (an inflammatory condition of artery walls) is the most common disorder associated with CVD. In order to assist in the prevention of the formation and progression of atherosclerosis, one can manage factors that have been associated with a higher risk for atherosclerosis, such as the use of tobacco, hypertension, elevated cholesterol, obesity, HIV infection and diabetes,” says Dr Janse van Rensburg.

Reasons behind different population’s mortality rate

It has been proposed, says Dr Janse van Rensburg, that socioeconomic status is possibly one of the essential roleplayers in CVD aetiology. The socioeconomic inequality in South Africa is well known, with an economic inequality Gini coefficient of 0.63 (the highest in the world). One study reported that in the Free State province, in the non-agricultural sector, the average household income for a European-descent household is roughly 4.35-times higher than the average African-descent household income.

“Therefore, it is postulated that wealthier people, in the South African context, historically people of European descent, have the means to afford and adopt lifestyles that contribute to the increased risk of lifestyle diseases such as obesity, hypercholesterolaemia and diabetes, which are associated with a higher risk to develop CVD.

“We postulate that CVD-related deaths are traditionally lower among South Africans of African descent compared to the other ethnic populations due to the historical socioeconomic discrepancy between people of African descent and other population groups in higher-income countries.”

The study also found that the prevalence of CVDs and the incidence of premature CVD-related deaths are steadily increasing in both rural and urban communities and across the socioeconomic spectrum. The theory of epidemiological transition says that in populations with improved living conditions and better access to healthcare, the proportion of deaths caused by infectious diseases will decrease, and the proportion of deaths due to more chronic “man-made” lifestyle-related diseases, such as CVD, will increase.

However, our population’s socioeconomic status is not the only driving force behind CVD. Therefore, we theorise there has been an upward trend in South Africa across all regions to improve the access to better food and better healthcare, consequently resulting in an increase in CVD-related morbidity and mortality statistics.

“For all population groups, males are more affected than females within their demographic group. This may also be possibly attributed to the socioeconomic status and access to the healthcare gender-gap differential in the country.”

Studies are vital in raising public awareness

Dr Janse van Rensburg says that studies such as this are vital in raising public awareness regarding disorders associated with the lifestyle choices people make. However, a multidisciplinary approach is needed to ultimately create a lasting impact.

“We hope that our findings will assist in identifying specific groups with a possible increased risk for CVD, and that we will inspire more focused research to identify potential high-risk behaviours within these groups that may eventually result in the enhancement of public health policies and awareness campaigns in our region.

“Recently, another article has been accepted for publication regarding the prevalence of excessive blood clots (thrombosis) as the underlying cause of death in our study cohort, further contributing to our understanding of the origins and contributory factors of CVDs in our region.”

News Archive

UV vestig hom afgelope eeu as leier op verskeie terreine

2004-05-11

Michelle O'Connor - Volksblad - 11 Mei 2004

Ondank terugslae nou 'n 'gesonde volwassene'

HOEWEL die Universiteit van die Vrystaat (UV) vanjaar sy eeufees vier en met 23 000 studente die grootste universiteit in die sentrale deel van die land is, was dié instelling se geboorte glad nie maklik nie. MICHELÉ O'CONNOR het met prof. Frederick Fourie, rektor, oor die nederige begin van dié instelling gesels.

DIE behoefte aan 'n eie universiteit in die Vrystaat het reeds in 1855, kort ná die stigting van Grey-kollege, kop uitgesteek.

Grey se manne het hulleself teen 1890 begin voorberei om die intermediêre B.A.-eksamens af te lê. Dié eksamen het hulle toegang gegee tot die tweede jaar van 'n B.A.-graad aan die destydse University of the Cape Good Hope, nou die Universiteit van Kaapstad.

"Presidente F.W. Reitz en M.T. Steyn het destyds albei die stigting van 'n universiteit hier bepleit. Die grootste rede was sodat die seuns van die Vrystaat nie weggestuur word nie.

"Dié twee se droom is op 28 Januarie 1904 bewaarheid toe ses studente hulle onder dr. Johannes Bril, as hoof/rektor van Grey-kollege, vir die graad B.A. ingeskryf het. Dié graad is aanvanklik deur die Kaapse universiteit toegeken.

"Net die klassieke tale soos Latyns en Grieks, die moderne tale, Nederlands, Duits en Engels, filosofie, geskiedenis, wiskunde, fisika, chemie, plant- en dierkunde is aanvanklik aangebied.

"Die UV se geboue het gegroei van 'n klein tweevertrek-geboutjie wat nou naby Huis Abraham Fischer staan, en verblyf in die Grey-kollege se seunskoshuis," sê Fourie.

Volgens hom is die universiteit se eerste raad en senaat tussen 1904 en 1920 saamgestel. Die eerste dosente is aangestel en die eerste geboue opgerig. "Dié tyd was egter baie moeilik.

"Die instelling het teen 1920 net 100 studente gehad en was geldelik in die knyp. Daar was geen vaste rektor nie en geen vooruitgang nie. Vrystaatse kinders is steeds na ander universiteite gestuur.

"Ds. J.D. Kestell, rektor van 1920 tot 1927, het egter dié instelling finaal gevestig.

"Hy het self studente van oor die hele Vrystaat gewerf en geld by onder meer kerke en banke ingesamel. Kestell het selfs Engelse ouers oortuig om hul kinders na die Greyuniversiteitskollege (GUK) te stuur en teen 1927 het dié instelling met 400 studente gespog.

"In die tydperk tussen 1927 en 1950 het die GUK weer verskeie terugslae beleef.

"In dié tyd was dit onder meer die Groot Depressie en die Tweede Wêreldoorlog. Die armblanke-vraagstuk het regstreeks op studente en dosente ingewerk en die politieke onderstrominge van dié tyd het die instelling ontwrig.

"Die GUK het egter oorleef en die Universiteitskollege van die Oranje-Vrystaat (UKOVS) is in 1935 gebore," sê Fourie.

Hy sê in dié tyd is verskeie fakulteite gevestig en teen 1950 het die UKOVS met 1 000 studente gespog.

Teen 1950 het dit 'n onafhanklike universiteit geword en die naam is verander na die Universiteit van die OranjeVrystaat (UOVS).

Dié tydperk is gekenmerk deur Afrikaner- en blanke selfvertroue en heerskappy. Studentegetalle het tot 7 000 in 1975 gegroei en heelwat vooruitgang het in dié tyd plaasgevind.

"Tussen 1976 en 1989 sukkel dieuniversiteit weer met onder meer ekonomiese krisisse, die land se politieke onstabiliteit en word die UOVS geï soleer.

"Een ligpunt in dié tyd is die toelating van die eerste swart studente, die nuwe Sasol-biblioteek en die fakulteit teologie wat die lig sien.

"Tussen 1990 en vanjaar het die UOVS verskeie op- en afdraandes beleef. Die universiteit doen nie net die eerste stappe van transformasie nie, maar begin ook aan 'n beleid van multikulturaliteit werk.

"Die UOVS se naam verander in 1996 na die Universiteit van die Vrystaat/University of the Free State en in 2001 word die Sotho-vertaling bygevoeg.

"Geldelike druk en probleme neem drasties toe en personeel word gerasionaliseer.

"Teen 2000 begin die UV met 'n draaistrategie en studentegetalle neem tot meer as 23 000 toe," sê Fourie.

Hy sê die UV het die afgelope eeu nie net verskeie terugslae oorleef nie, maar homself ook op verskeie gebiede as 'n leier gevestig.

Die universiteit behaal sy eie geldelike mikpunte, neem 'n nuwe taalbeleid van veeltaligheid aan en herbelê in personeel.

Die instelling inkorporeer die kampusse van die Vista- en Qwaqwa-universiteit en groei internasionaal.

Die UV vestig ook fondamente van 'n institusionele kultuur van verdraagsaamheid, geregtigheid en diversiteit.

"Die baba het in die afgelope eeu 'n gesonde volwassene geword."

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