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23 August 2022 | Story André Damons | Photo Supplied
Dr Walter Janse van Rensburg
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

Conference: Expanded ARV treatment
2005-03-02

VENUE: University of the Free State, Bloemfontein, South Africa
DATE: 30 March 2005 - 1 April 2005

  • ARV Programme as on 24Feb Download Word document
     
  • Programme Special events Download Word document


    Official web site www.fshealth.gov.za/subsites/arvc

     


    Rationale for the Conference
    At the time of the planned Conference, much ground would have been covered, both in the Free State and in South Africa, in respect of the expanded public sector ARV treatment programme in respect of research, experiences in practice, training of staff, treatment of patients, lessons learned, successes and failures, etc. The time would then be quite opportune to share these in a systematic manner with other provinces and countries, as well as with the large variety of stakeholders and role players in the ARV and related domains, be they academics and researchers, policy makers and service/facility managers, the variety of caregivers, and the community organisations and affected patients.

The Conference and current research
The proposed Conference is, firstly, directly linked to the current research on the public sector roll-out of ARV treatment in the Free State conducted by several research institutions (e.g. CIET, CHSR&D, UCT Lung Institute). Secondly, the Conference could and would serve as a forum for other research groups in the country and further a field to report and share knowledge and experiences on ARV treatment and related initiatives. Lastly, the Conference will stage a golden opportunity for researchers and scientists, on the one hand, and policy makers, managers, and caregivers (as knowledge users), on the other hand, to engage in cross-disciplinary discourse on this mutual and topical theme.

Theme of Conference
Expanded ARV treatment in the Free State: sharing experiences

Focus
The focus is primarily on public sector ARV treatment in the Free State, but also initiatives/activities/perspectives of relevance to the Free State elsewhere in the country at large and further a field, as well as relevant ARV initiatives in the public, private, NGO and FBO sectors. Bear in mind, however, that ARV treatment is but part of a much more comprehensive approach to HIV and AIDS. The Conference will, therefore, not narrowly focus on the ARV treatment programme only. The broader context, other relevant dimensions, and a comprehensive approach to the challenges of HIV, AIDS and TB are of equal importance.

The purpose of the Conference
Enhance meaningful exchange, mutual understanding and collaboration among researchers, scientists, policy makers, managers and practitioners in the field of ARV treatment and related fields.

Share experiences in the various spheres of ARV treatment and related spheres (policy, management, practice, research, training, public-private-civil society sectors).

Record, reflect and report on the establishment of the ARV treatment programme in the Free State, and in within the context of the comprehensive HIV/AIDS programme.

Disseminate important research results on ARV treatment and related themes to health policy makers, managers, practitioners, communities and to the research community.

Stimulate discourse among various disciplines and various stakeholders/role players involved in ARV treatment and related programmes.

Sensitise and acquaint researchers to the requirements of policy makers, managers and practitioners in respect of ARV treatment and related fields.

Facilitate the implementation of research results in ARV treatment policy, programmes and practice.

Dissemination of Conference-related information
Information generated during the Conference could feed into policy, management and practice of ARV treatment, the training accompanying such programme, and the existing body of knowledge. After the Conference the information will be disseminated via the Internet and by scientific and popular publications.

Date and duration
Set for 30 & 31 March & 1 April 2005; to commence at 09:00 on the first day (30 March) and to end at 16:30 (1 April) the third day.

Format and scope of Conference
Alternating plenary, parallel sessions and debates focused on topical issues and interest groups. The Conference will strive to be maximally interactive and participative.

Themes and topics to cover:

  • Policy, management and health services/practice (various levels and contexts – clinical treatment, information, IT systems, pharmacy, laboratories, nutrition)
     
  • Research covering all relevant disciplines and diverse dimensions of ARV treatment and related themes
  • Training and evaluation of training
  • Patients, communities and civil society organisations
  • Public, private, NGO, FBO initiatives and partnerships

Emphasis will be on the Free State, however, with of significant involvement from other provinces, SADC countries, and countries further a field. The thrust will be to export lessons and experiences from the Free State, but also to import lessons and experiences from other provinces, countries and sectors.

Presenters
Key presenters from the Free State, other provinces, South Africa, from the private, FBO and NGO sectors, and from several other countries

Delegates
About half of the delegates will be Free State stakeholders and role players (all levels and all contexts). The other half will be role players and stakeholders in the ARV and related fields from other provinces, the national level, and other countries, as well as from the private, public and non-governmental sectors.

Focused workshops
Provision will be made for half-a-day or one-day workshop initiatives on the third day (1 April 2005).

Enquiries
For more information please contact:

Prof Dingie van Rensburg
Centre for Health Systems Research & Development
University of the Free State
PO Box 339
Bloenfontein
SOUTH AFRICA
9300

Contact:
Carin van Vuuren
Conference Organiser
Centre for Health Systems Research & Development
University of the Free State
P.O.Box 339
Bloemfontein
South Africa
9300
Tel +27 (0) 51 401 2181
Fax +27 (0) 51 4480370
Cell 0832932890
e-mail: arvconference.hum@mail.uovs.ac.za

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