SAJDVD: VOLUME 16, ISSUE
1, JULY
2019
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- From the Editor’s Desk
Authors: Mahomed, FA
From: South African Journal of Diabetes and Vascular Disease, Vol 16, Issue 1, July 2019
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- Hypertensive disorders of pregnancy:
what the physician needs to know
Authors: John Ant hony , Albertino Damasceno , Dike Ojjii
From: South African Journal of Diabetes and Vascular Disease, Vol 16, Issue 1, July 2019
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Abstract: Hypertension developing during pregnancy may be caused by a variety of different pathophysiological mechanisms. The occurrence of proteinuric hypertension during the second half of pregnancy identifies a group of women whose hypertensive disorder is most likely to be caused by the pregnancy itself and for whom the risk of complications, including maternal mortality, is highest. Physicians identifying patients with hypertension in pregnancy need to discriminate between pre-eclampsia and other forms of hypertensive disease. Pre-eclamptic disease requires obstetric intervention before it will resolve and it must be managed in a multidisciplinary environment. The principles of diagnosis and management of these different entities are outlined in this review.
- A survey of non-communicable diseases and their risk factors among
university employees: a single institutional study
Authors: Emmanuel I Agaba , Maxwell O Akanbi , Patricia A Agaba , Ama ka N Ocheke, Zumnan M Gimba , Steve DaniyamANIYAM, Edit h N Okeke
From: South African Journal of Diabetes and Vascular Disease, Vol 16, Issue 1, July 2019 2019Full text: Click here to order »
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Background: The incidence of non-communicable diseases (NCDs) is rising globally, with its attendant morbidity and mortality, especially in developing countries. This study evaluated the prevalence of NCDs and their risk factors among members of a university community.
Methods: All employees of the university were invited to the University health clinic for screening, using the World Health Organisation’s STEPwise approach to NCDs.
Results: A total of 883 (521; 59.0% males) employees with a
mean age of 44 ± 10 years were studied. The median (IQR) number of NCD risk factors was three (two to three) per participant. The most common NCD risk factors were inadequate intake of fruit and vegetables (94.6%; 95% CI: 92.8–95.9), physical inactivity (77.8%; 95% CI: 74.9–80.5%) and dyslipidaemia (51.8%; 95% CI: 48.4–51.6%). Others included obesity (26.7%; 95% CI: 23.9–29.8%), alcohol use (24.0%; 95% CI: 21.3–27.0%) and cigarette smoking (2.9%; 95% CI: 2.0–4.3). Hypertension was the most common NCD (48.5%; 95% CI: 45.1–51.8%), followed by chronic kidney disease (13.6%; 95% CI: 11.4–16.1) and diabetes mellitus (8.0%; 95% CI: 6.4–10.1). There was no gender-specific difference in the prevalence of NCDs.
Conclusion: This study identified that NCDs and their modifiable risk factors are highly prevalent in this community. Workplace policy to support the adoption of healthy living is needed.
- Ellisras Longitudinal Study 2017: The relationship between dietary
intake and body mass index among young rural adults in South Africa aged 18 to
30 years (ELS 18)
Authors: Julia TM Mas hiane , Kotsedi D Monye ki, Andre P Kengne , Nkwana M Rosina , Mafoloa S Monye ki
From: South African Journal of Diabetes and Vascular Disease, Vol 16, Issue 1, July 2019
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Aim: To assess the relationship between dietary intake and adiposity in young rural South African adults.
Methods: A total of 728 young adults participated and dietary intake was assessed using the 24-hour recall method. Linear regression models were used to determine the association between dietary intake and body mass index (BMI) before and after adjustment for age and gender.
Results: Females showed higher mean BMI values than males in all age groups. An age group of 27- to 30-year-old females had a mean value of 28.1 kg/m2 while males had a mean value of 21.9 kg/m2. The distribution of BMI categories (underweight, normal weight, overweight, obese) was 20.5, 61.7, 9.3 and 3.1% in males, and 8.6, 42.5, 23.1 and 25.8% in females (p ≤ 0.05). Cholesterol intake was significantly (p ≤ 0.05) associated with BMI (beta = 0.002, 95% CI: 0.00–0.004) as well as overweight and obesity (odds ratio = 1.734; 95% CI: –1.09–2.75) after adjustment for age and gender.
Conclusion: There was a high prevalence of overweight and obesity among rural Ellisras females. Moreover, increasing cholesterol intake was associated with overweight and obesity in the overall sample.
- Prevalence and sociodemographic correlates of cardiovascular risk
factors among patients with hypertension in South African primary care
Authors: JM Ngango , OB Omole
From: South African Journal of Diabetes and Vascular Disease, Vol 16, Issue 1, July 2019
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Objective: To determine the prevalence and sociodemographic correlates of cardiovascular risk factors among patients with hypertension at Johan Heyns Community Health Centre, Sedibeng district, South Africa.
Methods: A total of 328 participants were systematically sampled. A researcher-administered questionnaire collected information on: socio-demography, presence of diabetes, family history of hypercholesterolaemia, family history of fatal cardiovascular (CV) events, and engagement in physical activities. Other measurements included: blood pressure (BP), weight, height, abdominal circumference and electrocardiography (ECG). Data analysis included descriptive statistics, chi-squared test and regression analysis. Main outcome measures included the proportions of participants with each CV risk and their significant sociodemographic determinants.
Results: Participants’ mean age was 57.7 years. Most participants were black (86.0%), female (79%) and pensioners (43.6%). The mean BP was 139/84 mmHg, and 60.7% had their BP controlled to targets. There was an average of 3.7 CV risk factors per participant and the prevalence of CV risk factors was: abdominal obesity (80.8%), physical inactivity (73.2%), diabetes (30.2%), alcohol use (28.0%), hypercholesterolaemia (26.5%), smoking (11.9%), past family history of fatal CV event (14.9%), and left ventricular hypertrophy (5.2%). Sociodemographic factors significantly associated with each CV risk factor were: obesity and being female (p = 0.00); alcohol use and young age (p = 0.00); smoking, being male and race other than black (p = 0.00 and p = 0.00, respectively); physical inactivity, being a pensioner and male (p = 0.02 and p = 0.02, respectively); diabetes and being male (p = 0.03); hypercholesterolaemia and race other than black (p = 0.03); family history of hypercholesterolaemia and race other than black (p = 0.00); and family history of fatal CV event and race other than black (p = 0.00).
Conclusion: There is a high burden of CV risk factors among patients with hypertension in South African primary care, signifying a substantial risk of cardiovascular disease (CVD) in this setting. Interventions aimed at CVD risk reduction need to take cognisance of the sociodemographic correlates of CV risk factors.
- Ellisras Longitudinal Study 2017: The relationship between waist
circumference, waist-to-hip ratio, skinfolds and blood pressure among young
adults in Ellisras, South Africa (ELS 14)
Authors: RB Sebati, Kotsedi D Monye ki, MS Monye ki, B Motloutsi , AL Toriola , MJL Monye ki
From: South African Journal of Diabetes and Vascular Disease, Vol 16, Issue 1, July 2019
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Background: Obesity and hypertension are major risk factors for non-communicable diseases in the world today. The relationship between indicators of obesity and blood pressure needs attention in the rural South African population.
Aim: This study examined the relationship between anthro-pometric parameters and blood pressure (BP) among young adults in the Ellisras rural area of South Africa.
Methods: A total of 742 (365 females and 377 males) young adults aged 22 to 30 years, who were part of the Ellisras Longitudinal Study (ELS), participated in the research. Anthropometric and BP measurements were taken using the protocol of the International Society for the Advancement of Kinanthropometry (ISAK). Linear regression was used to determine the relationship between anthropometric parameters and BP. The risk of developing hypertension among young Elisras adults was evaluated using logistic regression.
Results: The results indicted a higher but non-significant prevalence of hypertension in men (2.7%) than women (2.4%). Linear regression showed a significant positive (p < 0.05) association between waist circumference and systolic BP (beta = 0.273, 95% CI: 0.160–0.386), even after being adjusted for age and gender (beta = 253, 95% CI: 0.127–0.343). The risk for developing hypertension was significant (p < 0.05) for waist circumference (OR = 2.091, 95% CI: 1.129–3.871) after adjustment for age and gender.
Conclusion: Of all anthropometric parameters, waist circumference was most significantly associated with BP
(p < 0.05). Anthropometric indicators of obesity were strong predictors of hypertension among young adults in the Ellisras rural area.
- Cardiovascular risk factors among
people living with HIV in rural Kenya: a
clinic-based study
Authors: Kennet h Juma , Roseanne Nyabera, Mbugua , George ODINYA, James Jowi , Mzee Ngunga , David Zakus , Gerald Yonga
From: South African Journal of Diabetes and Vascular Disease, Vol 16, Issue 1, July 2019
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Objectives: To determine the prevalence of cardiovascular risk factors and their association with antiretroviral therapy (ART) among HIV-infected adults in a rural sub-county hospital in Kenya.
Methods: This was a descriptive survey of patient charts characterising cardiovascular risk among adult patients (> 18 years) at Ukwala sub-county hospital between June 2013 and January 2015. Post-stratification survey weights were applied to obtain prevalence levels. Adjusted odds ratios (AOR) for each variable related to cardiovascular risk factors were calculated using logistic regression models.
Results: Overall, the prevalence of diabetes mellitus was 0.4%, 0.3% of patients had had a previous cardiovascular event (heart attack or stroke), 40.4% had pre-hypertension, while 10.4% had stage 1 and 2.9% stage 2 hypertension. Up to 14% of patients had elevated non-fasting total cholesterol levels. Factors associated with hypertension were male gender (AOR 1.59, p = 0.0001), being over 40 years of age (AOR 1.78, p = 0.0001) and having an increased waist circumference (OR 2.56, p = 0.0014). Raised total cholesterol was more likely in those on tenofovir disoproxil fumarate (TDF) (AOR 2.2, p = 0.0042), azidothymidine (AZT) (AOR 2.5, p = 0.0004) and stavudine (D4T)-containing regimens (AOR 3.13, p = 0.0002).
Conclusions: An elevated prevalence of undiagnosed cardiovascular risk factors such as hypertension and raised total cholesterol levels was found among people living with HIV. There was an association between raised total cholesterol and nucleoside reverse-transcriptase inhibitor (NRTI)-based ART regimens. Our findings provide further rationale for integrating routine cardiovascular risk-factor screening into HIV-care services.
- The effect of exercise on diabetes management
Authors: TJ Ellapen , A Broodryk, Y Paul , P Buys
From: South African Journal of Diabetes and Vascular Disease, Vol 16, Issue 1, July 2019
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Abstract: Regular exercise is a fundamental component of any strategic diabetes-management plan. Habitual exercise provides numerous physiological benefits to diabetic patients. It is however naïve to believe that exercise does not induce risk factors that may adversely impact on the health of a diabetic patient. The objective of this clinical commentary is to increase awareness of both the benefits and risks induced by exercise among diabetic patients.
- New technologies launched to protect insulin from temperature
fluctuations
From: South African Journal of Diabetes and Vascular Disease, Vol 16, Issue 1, July 2019
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LATEST EDITORS' CHOICE
Interesting
features, including:
- Cardiometabolic risk factors in male long-distance bus drivers
- Endothelial dysfunction in patients with hyperlipidaemia
- Hypertension in newly diagnosed diabetic patients in Uganda
- Microalbuminuria and left ventricular dysfunction in type 2 diabetes
- SGLT-2 inhibitors in type 2 diabetes: protecting kidney and heart
- African roadmap: 25% hypertension control in Africa by 2025
RELIABLE EXPERT INFORMATION
The SAJDVD’s main focus is
providing new and relevant information for doctors,
nurses and allied professionals involved in caring
for the diabetes patient.
But as we are part of the larger Diabetes team, we would like to reach out to all patients with relevant information. So here it is!
But as we are part of the larger Diabetes team, we would like to reach out to all patients with relevant information. So here it is!
