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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

Twenty years of the constitution of South Africa – cause for celebration and reflection
2016-05-11

Description: Judge Azar Cachalia Tags: Judge Azar Cachalia

Judge Azar Cachalia

The University of the Free State’s Centre for Human Rights and the Faculty of Law held the celebration of the twentieth anniversary of the adoption of the South African Constitution on 11 May 2016 on the Bloemfontein Campus.  Students and faculty members celebrated and reflected on not only the achievements of the constitution but also on perspectives regarding its relevance in modern society, and to what extent it has upheld the human rights of all citizens of South Africa.

The panel discussion started with a presentation on the pre-1996 perspective by Judge Azar Cachalia of the Supreme Court of Appeal.  Judge Cachalia reflected on his role in the realisation and upholding of the constitution, from his days as a student activist, then as an attorney representing detainees during political turmoil, and currently as a judge: “My role as an attorney was to defend people arrested for public violence. My role as a judge today is to uphold the constitution.”  He stressed the importance of the constitution today, and the responsibility institutions such as the police service have in upholding human rights.  Judge Cachalia played a significant role in drafting the new Police Act around 1990, an Act which was to ensure that the offences perpetrated by the police during apartheid did not continue in the current democratic era. Further, he pointed out that societal turmoil has the potential to make society forget about the hard work that was put into structures upholding human rights. “Constitutions are drafted in moments of calm.  It is a living document, and we hope it is not torn up when we go through social conflict, such as we are experiencing at present.”

Thobeka Dywili, a Law student at the UFS, presented her views from the new generation’s perspective.  She relayed her experience as a student teaching human rights at schools in disadvantaged communities. She realised that, although the youth are quite aware of their basic human rights, after so many years of democracy, “women and children are still seen as previously disadvantaged when they should be equal”. She pointed out that, with the changing times, the constitution needs to be looked at with a new set of eyes, suggesting more robust youth engagement on topics that affect them, using technology to facilitate discussions. She said with the help of social media, it is possible for a simple discussion to become a revolution; #feesmustfall was a case in point.

Critical perspectives on the constitution were presented by Tsepo Madlingozi of University of Pretoria and University of London. In his view, the constitution has not affected policy to the extent that it should, with great disparities in our society and glaring issues, such as lack of housing for the majority of the poor.  “Celebration of the constitution should be muted, as the constitution is based on a decolonisation approach, and does not directly address the needs of the poor. The Constitutional Court is not pro-poor.”  He posed the question of whether twenty years on, the present government has crafted a new society successfully.  “We have moved from apartheid to neo-apartheid, as black elites assimilate into the white world, and the two worlds that exist have not been able to stand together as a reflection of what the constitution stands for.”

Prof Caroline Nicholson, Dean of the Faculty of Law, encouraged more open discussions, saying such dialogues are exactly what was intended by the Centre for Human Rights. She emphasised the importance of exchanging ideas, of allowing people to speak freely, and of sharing perspectives on important issues such as the constitution and human rights.

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