The clinical consequences and challenges of hypertension in urban-dwelling black Africans: Insights from the Heart of Soweto Study

Stewart, S., Libhaber, E., Carrington, M., Damasceno, A., Abbasi, H., Hansen, C., Wilkinson, D. and Sliwa, K. (2011) The clinical consequences and challenges of hypertension in urban-dwelling black Africans: Insights from the Heart of Soweto Study. International Journal of Cardiology, 146 1: 22-27. doi:10.1016/j.ijcard.2009.05.061


Author Stewart, S.
Libhaber, E.
Carrington, M.
Damasceno, A.
Abbasi, H.
Hansen, C.
Wilkinson, D.
Sliwa, K.
Title The clinical consequences and challenges of hypertension in urban-dwelling black Africans: Insights from the Heart of Soweto Study
Journal name International Journal of Cardiology   Check publisher's open access policy
ISSN 0167-5273
Publication date 2011-01-01
Year available 2009
Sub-type Article (original research)
DOI 10.1016/j.ijcard.2009.05.061
Open Access Status Not yet assessed
Volume 146
Issue 1
Start page 22
End page 27
Total pages 6
Place of publication Shannon, Co. Clare, Ireland
Publisher Elsevier Ireland Ltd
Language eng
Subject 2700 Medicine
2705 Cardiology and Cardiovascular Medicine
Abstract Background: There is a paucity of data to describe advanced forms of cardiovascular disease (CVD) in urban black Africans with hypertension (HT). Methods: Chris Hani Baragwanath Hospital services the black African community of 1.1 million people in Soweto, South Africa. We prospectively collected detailed demographic and clinical data from all de novo presentations to the hospital's Cardiology Unit in 2006. Results: Overall, 761 black African patients (56% of de novo cases) presented with a diagnosis of HT with more women (63%, aged 58.5 ± 14.9 years) than men (aged 58.0 ± 15.6 years). On presentation, 396 women (82%) versus 187 men (67%) had dizziness, palpitations and/or chest pain (OR 1.23, 95% 1.12-1.34: p < 0.0001). HT was the primary diagnosis in 266 cases (35%). In the rest (n = 495), non-ischaemic forms of heart failure were common (54% of total) while only 6.2% had coronary artery disease. Concurrent left ventricular hypertrophy, renal dysfunction and anaemia were present in 39%, 24% and 11% of cases, respectively, with a similar age-adjusted pattern of co-morbidity according to sex. However, men were more likely to present with impaired systolic function (OR 2.13, 95% CI 1.50 to 3.00; p < 0.0001). Conclusions: In the absence of effective primary and secondary prevention strategies, these unique data highlight the potentially devastating impact of advanced forms of hypertensive heart disease in urban black African communities with more women than men affected.
Keyword Hypertension
Africa
Epidemiological transition
Heart failure
Hypertensive heart disease
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
 
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Created: Sun, 06 Feb 2011, 10:08:39 EST