Medics sound heart disease alarm for coloured Capetonians

28 March 2018 - 12:31 By Serena Hawkey
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Capetonians are getting heart disease earlier than people from the developed world — and young coloured people are affected worst of all.

This is the finding of a new study by University of Cape Town researchers working at Groote Schuur Hospital‚ which showed that local heart sufferers were on average 20 years younger than their counterparts elsewhere – affecting a cohort that the researchers called the “breadwinner generation”.

The study‚ which tracked 119 patients over two years‚ found that the coloured community was affected by more severe and pre-existing cases of heart failure than other groups.

The mean age of patients with acute heart failure was 49.9‚compared with 70 in Europe and North America.

In particular‚ the study it noted high rates of heart disease caused by narrowing of the arteries — the highest in Sub-Saharan Africa — which the researchers suggested might be linked to urbanisation.

“It has been shown that movement of people from rural areas to urban centres results in a change in diet and lifestyle‚ predisposing to the development of ischaemic heart disease‚” they write in the South African Medical Journal.

The study flags concerns about the high local death rate from heart disease as well as the high number of heart patients who are readmitted to hospital. It found that patients were being discharged with inadequate medication and without proper medical follow-up to ensure compliance with prescriptions.

The researchers note that “these high mortality rates may be due to the different aetiological [causes of disease] pattern in Cape Town‚ with a significant contribution of ischaemic heart disease and a lower prevalence of hypertension as the primary cause of acute heart failure.”

The medical school study‚ by Patryk Szymanski‚ Motasim Badri and Bongani Mayosi‚ also found that far fewer prescriptions were given to discharged patients compared with elsewhere in Sub-Saharan Africa. For example‚ only 26% of the study cohort were prescribed aldosterone antagonists (diuretics)‚ while elsewhere in Sub-Saharan Africa the rate is 60%-75%.

The researchers suggested that the high rate of readmission to hospital — over 25% within 180 days of initial discharge — might be attributable to several factors‚ including patients not sticking to their treatment regimes‚ and lacking understanding of the disease and the need to manage their lifestyles.

They also questioned whether the pressure for hospital beds might have led to the premature discharge of patients.

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