Why South African heart failure patients are young and female

December 9, 2008 by  

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Young and female – this is the typical demographic profile of heart failure patients in South Africa. “Heart failure patients in Soweto, South Africa, are more likely to be middle-aged and female compared to patients in Western nations.” according to a recent study.

So why the difference compared to Western countries? According to the study, the contributing factors are probably the following:

  • increased incidence of hypertension
  • heart valve disorders
  • increasing urbanization

Urbanization is especially of significance because increase in heart problems has also been observed in urbanized parts of more affluent countries. This suggests that with economic development and affluence come lifestyle changes in the population – e.g. eating more processed less nutritious food and decreased physical activity – that is unfortunately unhealthy. However, unlike in developed countries, the health care system of developing countries like South Africa is not ready to handle the problems. However, there is more to South Africa’s heart problems that initially thought.

The South African report published in Circulation: Journal of the American Heart Association gives the following figures:

Eighty-eight percent of the new heart failure patients were black Africans.

Their average age was 55, and 57 percent were women.

About 90 percent had at least one cardiovascular risk factor – with hypertension being the most common (60 percent).

Twenty-seven percent of patients had right heart failure (reduced pumping ability in the right heart chambers).

The high percentage of isolated right heart failure – 27% – surprised the authors. Usually right heart failure which occurs as a consequence of left heart failure. The incidence of isolated heart failure in the South Africana population studied is 10 times more than what has been observed in western countries where left heart failure is more prevalent. Right heart failure is associated to damage to the lungs and pulmonary vessels usually seem is smokers.The authors speculate that air pollution – both environmental and occupation – may be a major factor. Pollution, of course, especially traffic-generated fine particle pollution, is another price of urbanization.

Another interesting finding of the study is the fac t that new cases of heart failure involved women who were on the average, 3 years younger than men. Most of these women are of reproductive age, thus indicating “pregnancy-related heart failure, as post-partum cardiomyopathy occurs more frequently in black African women.”

The study authors went on to say that is clearly a need for gender-specific programs for prevention, screening and management of heart failure in South Africa.

Photo credit: stock.xchng

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