Abstract
The aim of this pilot study was to assess the 30-year risk for cardiovascular disease (CVD) in the South Africa population of mixed-ancestry in individuals with non-diabetic hyperglycaemia, and undiagnosed and self-reported diabetes. Participants were drawn from an urban community of the Bellville South suburb of Cape Town. In total, 583 subjects without a history of CVD were eligible for lifetime CVD risk estimation. Gender-specific prediction for CVD risk was calculated using the 30-year CVD interactive risk calculator. High CVD risk (> 20%) was evident in normoglycaemic and younger subjects (under 35 years). The significant predictors of CVD were sibling history of diabetes, and triglyceride, low-density lipoprotein cholesterol and glycated haemoglobin levels (p < 0.001). The high lifetime risk in normoglycaemic and younger subjects may be considered a warning that CVD might take on epidemic proportions in the near future in this country. We recommend the inclusion of education on CVD in school and university curricula.
Highlights
The aim of this pilot study was to assess the 30-year risk for cardiovascular disease (CVD) in the South Africa population of mixed-ancestry in individuals with non-diabetic hyperglycaemia, and undiagnosed and self-reported diabetes
Fasting glucose levels compared to postprandial glucose concentration were found not to be the strongest determinants of intima–media thickness (IMT) or death associated with hyperglycaemia,[7,9] the DECODE study group[7] did find an increased risk of mortality for individuals with impaired fasting glucose (IFG) compared to those with normoglycaemia
This is evident in our study in which we present evidence of a high risk score (> 20%) in young individuals and in those subjects with normoglycaemia (Figs 2, 3)
Summary
The aim of this pilot study was to assess the 30-year risk for cardiovascular disease (CVD) in the South Africa population of mixed-ancestry in individuals with non-diabetic hyperglycaemia, and undiagnosed and self-reported diabetes. Various mathematical equations that incorporate the major risk factors (age, gender, high blood pressure, smoking, dyslipidaemia and diabetes) have been developed for the assessment of CVD risk over a 10-year period in general populations.[11,12,13,14] The performance of the two frequently used models, the Framingham Heart Study[13] and the UK Prospective Diabetes Study risk engine (UKPDS), version 3,14 have been evaluated in individuals with diabetes, hyperglycaemia and normoglycaemia.[15] The Framingham Heart Study performed better at classifying subjects with a net gain in correct classification of –14 and –12.4% for non-diabetic hyperglycaemia and normoglycaemia, respectively.[15] the 10-year time frame of these models has been criticised because an individual’s lifetime risk may be high while the 10-year risk prediction may be low, delaying efforts to modify that risk
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