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VOLUME 12 NUMBER 1 • JULY 2015
RESEARCH ARTICLE
SA JOURNAL OF DIABETES & VASCULAR DISEASE
The on-treatment lipid and FG values are listed in Table 3. Overall,
patients of African ancestry had lower TC, LDL-C, and non-HDL-C
levels and higher FG levels than subjects of other ethnic groups. In
the cohort with DM (Table 2), the African-ancestry patients had the
highest levels of HbA
1c
, both for males and females.
The primary outcome or percentage of patients reaching LDL-C
targets is given in Table 4. Overall 60.5% of patients reached goal
as per the NCEP ATP II guidelines and 52.3% according to the JETF
guidelines. Differences in attainment of goal were noted. Patients
of mixed ancestry were less likely to get to either of the two goals,
with the exception of mixed-ancestry males, who had similar not-
at-goal percentages as the male patients of Asian ancestry. Females
subjects were less likely to get to goal, both for the NCEP ATP III [OR
0.65 (CI 0.54–0.77),
p
< 0.001] and JETF [OR 0.76 (CI 0.64–0.91),
p
< 0.003] guidelines. This difference was maintained across the
various ethnic groups.
The secondary outcomes or percentages of patients receiving
LLDs with the metabolic syndrome, and the breakdown of those
receiving LLDs for primary versus secondary prevention is given in
Table 5.
Discussion
The World Health Organisation has indicated that cardiovascular
disease will be the number one cause of mortality in the
developing world by 2020.
15
Subjects with cardiovascular disease
in underdeveloped countries tend to exhibit mortality 10 or more
Table 2.
Laboratory results
Entire study
Caucasian
African
Mixed ancestry
Asian
Laboratory parameters
Male Female Male Female Male Female Male Female Male Female
Total cholesterol (mmol/l)
4.72
5.06
4.75
5.26
4.44
4.57
4.78
5.20
4.75
5.13
LDL cholesterol (mmol/l)
2.63
2.85
2.62
2.93
2.44
2.55
2.65
3.01
2.72
2.91
HDL cholesterol (mmol/l)
1.21
1.41
1.25
1.53
1.19
1.31
1.15
1.36
1.19
1.33
Triglycerides (mmol/l)
2.01
1.79
2.03
1.80
1.83
1.55
2.31
1.83
1.88
1.99
Non-HDL cholesterol (mmol/l)
3.51
3.65
3.51
3.73
3.25
3.26
3.63
3.84
3.56
3.80
Glucose (mmol/l)
6.52
6.76
6.0
5.8
7.2
8.1
6.8
6.7
7.1
7.0
Glycosylated haemoglobin (%)
7.34
638
6.31
8.74
7.48
7.91
Table 3.
Control of diabetes and hypertension
Entire study
Caucasian
African
Mixed ancestry
Asian
Condition
Male Female Male Female Male Female Male Female Male Female
Diabetic patients
Number
718
690
279
152
118
256
120
139
200
141
Glucose (mmol/l)
7.93
8.44
7.46
8.08
8.12
9.12
8.17
7.86
8.24
8.19
HbA
1c
(%)
7.94
8.73
7.33
7.64
8.66
9.60
8.19
8.52
8.26
8.57
Hypertensive patients
Number
1081
1063
529
367
142
304
170
218
240
174
Systolic blood pressure (mmHg)
134.9 137.3 135.6 135.6 137.3 137.1 136.6 141.9 130.6 135.3
Diastolic blood pressure (mmHg)
81.7
80.8
82.2
79.3
83.8
81.5
81.3
81.2
79.8
80.0
Table 4.
Attainment of primary goal (%)
Entire study
Caucasian
African
Mixed ancestry
Asian
Guidelines
Male Female Male Female Male Female Male Female Male Female
NCEP ATP III
63.4
56.8
67.3
61.5
68.4
60.8
61.0
41.7
58.7
52.7
EAS/ESC
55.0
49.3
57.5
50.1
62.3
55.8
44.3
42.0
51.6
48.0
Table 5.
Secondary outcome variables
Entire study
Caucasian
African
Mixed ancestry
Asian
Variables
Male Female Male Female Male Female Male Female Male Female
Metabolic syndrome (%)
65.2
71.5
62.8
55.7
72.6
88.0
71.2
77.6
63.7
78.1
Primary prevention (%)
40.3
48.7
47.4
66.7
32.7
24.9
32.4
44.0
34.1
45.7
Secondary prevention (including DM) (%)
59.7
51.3
52.6
33.3
67.3
75.1
67.6
56.0
65.9
54.3