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VOLUME 8 NUMBER 2 • JUNE 2011
97
SA JOURNAL OF DIABETES & VASCULAR DISEASE
REPORTS
tiveness-based guidelines for the prevention
of cardiovascular disease in women, which has
lowered the threshold for ‘high risk’ to equal
to or more than a 10% risk of dying from any
cardiovascular event in the next 10 years.
The ‘at-risk’ classification for women is as
before, except that the presence of systemic
lupus erythrematosus and rheumatoid arthritis
are added as significantly increasing the rela-
tive risk of cardiovascular disease and rank as
cardiovascular risk factors. Also, a history of
pre-eclampsia, gestational diabetes or preg-
nancy-induced hypertension also ranks as a
cardiovascular risk in the ‘at risk’ population.
‘These new guidelines mean that more
women will qualify for therapy, including
statins, as we apply these new standards to our
population’, Dr Rapeport stressed.
‘With regard to lipid therapy in the high-
risk women, it would be reasonable to target
2.6 mmol/l, although in patients who have
had a recent acute coronary syndrome event,
a target of 1.8 mmol/l would be justified. This
may well imply the use of statin combination
therapy’, Dr Rapeport noted.
‘In the at-risk population, women should
be treated with statins to a target LDL choles-
terol level of 3.4 mmol/l. It is important to note
that in modern statin trials, such as JUPITER,
women benefited as much as men.’
The difference between previous guide-
lines and the new AHA guidelines is that cost
effectiveness with regard to gender is also
considered. Antihypertensive therapy, aspirin
in women over 65 years of age with moder-
ate to severe cardiovascular disease risk, and
smoking cessation treatments appear to be
cost effective for women. Other therapies such
as weight management and gastric bypass sur-
gery require further gender-focused cost stud-
ies.
J Aalbers, Special Assignments Editor
Take-home message
• There is a strong association between
NAFLD and cardiovascular disease.
• Careful monitoring and aggressive man-
agement of risk factors is key.
• It is not known whether ameliorating
NAFLD will ultimately prevent or slow
progression of cardiovascular disease
(likely to be shown in the next three to
five years).
• Do not avoid statins in patients with
moderately elevated ALT/AST as they are
likely to benefit most.
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Bongi Ngema-Zuma Foundation and Novo Nordisk (Pty) Ltd bring diabetes screening to the 12th annual
conference of the Apostolic Church
The Bongi Ngema-Zuma Foundation and Novo Nordisk participated in the gathering of over 12 000 women from the Apostolic
Church on 25–26 May 2011 at the Ntabazwe Township in Harrismith. The goal was to raise awareness, provide education on
diabetes, and screen for diabetes. Novo Nordisk took their Changing Diabetes bus to Harrismith in order to facilitate the screening
of the many volunteers attending the conference.
Ms Ngema-Zuma delivered a talk on her personal
experience with diabetes. Martin Salkow from Novo
Nordisk also addressed the group of women, emphasising
the importance of taking one’s medication, and informing
others that education is key in families, i.e. teaching them
to recognise the signs and symptoms of diabetes.
Educational material was handed out in both English
and Zulu to all members and Novo Nordisk screened a
total of 1 625 volunteers for blood glucose levels, blood
pressure, weight and waist circumference.
The event was a humbling experience as women from all
over South Africa gathered together, some with newborn
babies and older children, in order to participate.
