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VOLUME 9 NUMBER 1 • MARCH 2012
15
SA JOURNAL OF DIABETES & VASCULAR DISEASE
RESEARCH ARTICLE
Study outomes
The pattern of cardiovascular disease risk factors used in the 30-year
risk calculator is shown in Table 1. It was found that risk of diabetes,
hypertension and cardiovascular disease generally increased with
age. In this study, diabetic subjects were at significantly higher risk
for cardiovascular disease. Significant differences were observed
between the estimated cardiovascular disease risk in non-diabetic,
normal-weight and obese subjects, with high risk scores still evi-
dent in the normal-weight, normoglycaemic individuals.
The criticism that 10-year models underestimate cardiovascular
disease risk by allowing for continued progression of sub-clinical
atherosclerosis was evident in this study where more than 20% of
young, normoglycaemic subjects presented a high risk score. Intra-
class correlation between lipid- and body mass index (BMI)-based
equations showed that either method could be used for cardio-
vascular disease risk estimation. The study also observed a strong
association between HbA
1c
level and cardiovascular disease risk.
Application in practice
Results from this study have important public health implications,
as cardiovascular disease is often underestimated in the young.
Cardiovascular disease risk can easily be estimated in a primary
healthcare setting due to inter-convertibility of lipids and BMI in risk
estimation. Interestingly, a significant number of participants were
unaware of their diabetic status. So, in addition to improving the
primary healthcare system towards a chronic disease management
approach, the inclusion of education on cardiovascular disease in
school and university curricula may assist in reducing the preva-
lence of obesity and the metabolic syndrome.
G Hardy
Reference
Matsha TE, Hassan MS, Kidd M, Erasmus RT. The 30-year cardiovascular risk profile
1.
of South Africans with diagnosed diabetes, undiagnosed diabetes, pre-diabetes
or normoglycaemia: the Belville, South Africa pilot study.
Cardiovasc J Afr
2012;
23
(1): 5–11.
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