South Africa faces a looming health crisis as increased wealth, poor eating habits and sedentary behaviour point to an ”epidemic” of heart disease, especially among the black population.
”We are sitting on a time bomb,” said professor Anthony MBewu, interim president of the Medical Research Council (MRC).
However, hope was on the horizon, as the MRC finalises two research protocols which will go a long way to identifying and managing the risks of heart disease.
MBewu said the first protocol consisted of a three-to-six month pilot study, to test the feasibility of evaluating risk factors for heart disease among black, coloured and Indian South Africans.
”The second study, a three-year study, would look at a much bigger sample and would hopefully be funded by the National Institute of Health. It will be the most comprehensive heart disease study in the country. We are hoping this study would commence early next year.”
MBewu, a cardiologist who is to be the lead investigator of the study, said a multi-disciplinary approach would be followed.
Laboratory scientists, clinicians, public health and health policy researchers would be involved.
The three proposed sites for the study were the University of Limpopo (formerly Medunsa), the Chris Hani-Baragwanath Hospital in Soweto, Gauteng, and the Albert Luthuli Hospital in KwaZulu-Natal.
MBewu said South Africa had one of the highest rates of heart disease in the world and had experienced an ”epidemic of heart disease” among the Indian population in the 1970s and 80s, among coloured population during the 1980s and 90s, and now among black Africans.
”There are increased rates of atherosclerosis, a hardening of the arteries, [which is] actually a degenerative and inflammatory disease of the blood vessels. It is no longer only associated with middle-aged white males.”
MBewu atherosclerosis took off in early adulthood and reached a peak in the 50s and 60s, although it sometimes occured in children.
He said during 2000, 12% of the 500 000 deaths recorded in the country were from heart disease.
Another eight percent of deaths in the same year were caused by strokes, which are closely aligned to heart disease.
”The research to be conducted is important because the best way to reduce heart disease is by preventing the heart attacks and strokes rather than treating them,” said MBewu.
He said there were several contributing factors to heart disease and strokes, including smoking, high blood pressure, diet, a lack of exercise, obesity and diabetes.
All of these contributory factors were prevalent in present day South Africa, with about 25% of the population suffering from hypertension and about 20% at risk of being obese.
”The nation is in poor health, with just as many, if not more deaths from heart disease and strokes than Aids … Aids is a major global problem, but heart disease and strokes is much bigger.”
MBewu said even worse was the fact that most people who suffered from heart disease or had a stroke, did not die, but were disabled or required expensive medical treatment.
This had a massive impact on the health system and the economy. A study conducted a decade ago estimated that it then cost the country R4-billion per year.
Estimates have doubled now to about R10-billion per year, said MBewu.
Evidence gathered at Chris Hani-Baragwanath Hospital suggested that over half of the patients who now experienced heart attacks were black Africans, when the number would have been very few 10 to 20 years ago.
The Heart Foundation said it now focused on the majority of the urbanising population.
”The most important thing is to create awareness, and undertaking to do more risk factor screening, for example, blood pressure and diabetes,” said Shan Biesman-Simons, director of nutrition and education at the foundation.
She said the organisation’s education programme targeted pre-school and primary school pupils in previously disadvantaged areas in a bid to create awareness. – Sapa