Prevalence of cardiovascular diseases and associated risk factors in a rural black population of South Africa
Identifieur interne : 004B17 ( Istex/Corpus ); précédent : 004B16; suivant : 004B18Prevalence of cardiovascular diseases and associated risk factors in a rural black population of South Africa
Auteurs : Marianne Alberts ; Petter Urdal ; Krisela Steyn ; Inger Stensvold ; Aage Tverdal ; Johanna H. Nel ; Nelia P. SteynSource :
- European journal of preventive cardiology [ 2047-4873 ] ; 2005.
English descriptors
- KwdEn :
- Africa alberts, Alanine aminotransferase, Alcohol consumption, American diabetes association criteria, Black africans, Black communities, Black community, Black women, Blood pressure, Body mass index, Brisk study, Cape peninsula, Cape town, Cardiology, Cardiovasc risk, Cardiovascular, Cardiovascular disease, Cardiovascular diseases, Cardiovascular prevention, Central obesity, Chronic disease risk factors, Chronic diseases, Chronic diseases risk factors, Clin nutr, Copyright, Copyright european society, Cutoff points, Diabetes, Diabetes care, Diabetes mellitus, European journal, European society, Expert panel, Fasting blood sugar, Framingham, Framingham equations, Gamma glutamyltransferase, Glucose, Health survey, High blood cholesterol, High levels, High prevalence, Higher risk, Hypertension, Hypertension society, Limpopo, Limpopo province, Lipid profile, Medical research council, Obese, Obese women, Obesity, Participant, Peripheral obesity, Physical activity, Poor community, Prevalence, Response rate, Risk factors, Risk profile, Risk score, Smokeless tobacco, Sociodemographic data, Southern africa, Steyn, Study population, Unauthorized, Unauthorized reproduction, Waist circumference, World health organization, World population.
- Teeft :
- Africa alberts, Alanine aminotransferase, Alcohol consumption, American diabetes association criteria, Black africans, Black communities, Black community, Black women, Blood pressure, Body mass index, Brisk study, Cape peninsula, Cape town, Cardiology, Cardiovasc risk, Cardiovascular, Cardiovascular disease, Cardiovascular diseases, Cardiovascular prevention, Central obesity, Chronic disease risk factors, Chronic diseases, Chronic diseases risk factors, Clin nutr, Copyright, Copyright european society, Cutoff points, Diabetes, Diabetes care, Diabetes mellitus, European journal, European society, Expert panel, Fasting blood sugar, Framingham, Framingham equations, Gamma glutamyltransferase, Glucose, Health survey, High blood cholesterol, High levels, High prevalence, Higher risk, Hypertension, Hypertension society, Limpopo, Limpopo province, Lipid profile, Medical research council, Obese, Obese women, Obesity, Participant, Peripheral obesity, Physical activity, Poor community, Prevalence, Response rate, Risk factors, Risk profile, Risk score, Smokeless tobacco, Sociodemographic data, Southern africa, Steyn, Study population, Unauthorized, Unauthorized reproduction, Waist circumference, World health organization, World population.
Abstract
Background To determine the prevalence and associated risk factors of cardiovascular diseases in a rural adult black population from Limpopo Province in South Africa. Design A cross-sectional study. Methods A sample of 1608 women and 498 men aged 30 years and above participated in the study. Sociodemographic data, anthropometric measures (body mass index, waist/hip ratio), blood pressure and biochemical risk factors were measured. A global cardiovascular disease (CVD) risk profile was developed. Results There was a high prevalence of tobacco use for men (57%) and women (35.4%), with women (28.1%) predominantly using smokeless tobacco. Alcohol use was very common in men (57.2%). Women weighed a great deal more than men, and 51.7% were either overweight or obese. Diabetes was diagnosed in 8.8 and 8.5% of women and men, respectively. High-density lipoprotein-cholesterol was relatively high, whereas 42.3% of women and 28.5% of men had low-density lipoprotein-cholesterol levels of 3 mmol/l or more. Hypertension (blood pressure ≥ 140/90 mmHg) was found in 25.5% of women and 21.6% of men. According to the Framingham formulae, 18.9% of women and 32.1% of men had a 20% or higher chance of having a CVD event in the next 10 years. Conclusions There was a high prevalence of chronic disease risk factors in the rural, poor black community in Limpopo, South Africa. Consequently, the population had a higher than expected risk of developing a CVD event in the following 10 years when compared with similar studies in black Africans.
Url:
DOI: 10.1097/01.hjr.0000174792.24188.8e
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ISTEX:E6B8B14569ACDE4516A22E2CA1EA131942E83F70Le document en format XML
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first="Aage" last="Tverdal">Aage Tverdal</name><affiliation><mods:affiliation></mods:affiliation></affiliation><affiliation><mods:affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</mods:affiliation></affiliation><affiliation><mods:affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</mods:affiliation></affiliation><affiliation><mods:affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>fDepartment of Logistics, University of Stellenbosch, 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South Africa.</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:E6B8B14569ACDE4516A22E2CA1EA131942E83F70</idno><date when="2005" year="2005">2005</date><idno type="doi">10.1097/01.hjr.0000174792.24188.8e</idno><idno type="url">https://api.istex.fr/document/E6B8B14569ACDE4516A22E2CA1EA131942E83F70/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">004B17</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">004B17</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Prevalence of cardiovascular diseases and associated risk factors in a rural black population of South Africa</title><author><name sortKey="Alberts, Marianne" sort="Alberts, Marianne" uniqKey="Alberts M" first="Marianne" last="Alberts">Marianne Alberts</name><affiliation><mods:affiliation></mods:affiliation></affiliation><affiliation><mods:affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</mods:affiliation></affiliation><affiliation><mods:affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</mods:affiliation></affiliation><affiliation><mods:affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</mods:affiliation></affiliation></author><author><name sortKey="Urdal, Petter" sort="Urdal, Petter" uniqKey="Urdal P" first="Petter" last="Urdal">Petter Urdal</name><affiliation><mods:affiliation></mods:affiliation></affiliation><affiliation><mods:affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</mods:affiliation></affiliation><affiliation><mods:affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</mods:affiliation></affiliation><affiliation><mods:affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</mods:affiliation></affiliation></author><author><name sortKey="Steyn, Krisela" sort="Steyn, Krisela" uniqKey="Steyn K" first="Krisela" last="Steyn">Krisela Steyn</name><affiliation><mods:affiliation></mods:affiliation></affiliation><affiliation><mods:affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</mods:affiliation></affiliation><affiliation><mods:affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</mods:affiliation></affiliation><affiliation><mods:affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</mods:affiliation></affiliation></author><author><name sortKey="Stensvold, Inger" sort="Stensvold, Inger" uniqKey="Stensvold I" first="Inger" last="Stensvold">Inger Stensvold</name><affiliation><mods:affiliation></mods:affiliation></affiliation><affiliation><mods:affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</mods:affiliation></affiliation><affiliation><mods:affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</mods:affiliation></affiliation><affiliation><mods:affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</mods:affiliation></affiliation></author><author><name sortKey="Tverdal, Aage" sort="Tverdal, Aage" uniqKey="Tverdal A" first="Aage" last="Tverdal">Aage Tverdal</name><affiliation><mods:affiliation></mods:affiliation></affiliation><affiliation><mods:affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</mods:affiliation></affiliation><affiliation><mods:affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</mods:affiliation></affiliation><affiliation><mods:affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</mods:affiliation></affiliation></author><author><name sortKey="Nel, Johanna H" sort="Nel, Johanna H" uniqKey="Nel J" first="Johanna H." last="Nel">Johanna H. Nel</name><affiliation><mods:affiliation></mods:affiliation></affiliation><affiliation><mods:affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</mods:affiliation></affiliation><affiliation><mods:affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</mods:affiliation></affiliation><affiliation><mods:affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</mods:affiliation></affiliation></author><author><name sortKey="Steyn, Nelia P" sort="Steyn, Nelia P" uniqKey="Steyn N" first="Nelia P." last="Steyn">Nelia P. Steyn</name><affiliation><mods:affiliation></mods:affiliation></affiliation><affiliation><mods:affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</mods:affiliation></affiliation><affiliation><mods:affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</mods:affiliation></affiliation><affiliation><mods:affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">European journal of preventive cardiology</title><title level="j" type="abbrev">Eur J Cardiovasc Prev Rehabil</title><idno type="ISSN">2047-4873</idno><idno type="eISSN">2047-4881</idno><imprint><publisher>SAGE Publications</publisher><pubPlace>Sage UK: London, England</pubPlace><date type="published" when="2005">2005</date><biblScope unit="volume">12</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="347">347</biblScope><biblScope unit="page" to="354">354</biblScope></imprint><idno type="ISSN">2047-4873</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">2047-4873</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Africa alberts</term><term>Alanine aminotransferase</term><term>Alcohol consumption</term><term>American diabetes association criteria</term><term>Black africans</term><term>Black communities</term><term>Black community</term><term>Black women</term><term>Blood pressure</term><term>Body mass index</term><term>Brisk study</term><term>Cape peninsula</term><term>Cape town</term><term>Cardiology</term><term>Cardiovasc risk</term><term>Cardiovascular</term><term>Cardiovascular disease</term><term>Cardiovascular diseases</term><term>Cardiovascular prevention</term><term>Central obesity</term><term>Chronic disease risk factors</term><term>Chronic diseases</term><term>Chronic diseases risk factors</term><term>Clin nutr</term><term>Copyright</term><term>Copyright european society</term><term>Cutoff points</term><term>Diabetes</term><term>Diabetes care</term><term>Diabetes mellitus</term><term>European journal</term><term>European society</term><term>Expert panel</term><term>Fasting blood sugar</term><term>Framingham</term><term>Framingham equations</term><term>Gamma glutamyltransferase</term><term>Glucose</term><term>Health survey</term><term>High blood cholesterol</term><term>High levels</term><term>High prevalence</term><term>Higher risk</term><term>Hypertension</term><term>Hypertension society</term><term>Limpopo</term><term>Limpopo province</term><term>Lipid profile</term><term>Medical research council</term><term>Obese</term><term>Obese women</term><term>Obesity</term><term>Participant</term><term>Peripheral obesity</term><term>Physical activity</term><term>Poor community</term><term>Prevalence</term><term>Response rate</term><term>Risk factors</term><term>Risk profile</term><term>Risk score</term><term>Smokeless tobacco</term><term>Sociodemographic data</term><term>Southern africa</term><term>Steyn</term><term>Study population</term><term>Unauthorized</term><term>Unauthorized reproduction</term><term>Waist circumference</term><term>World health organization</term><term>World population</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Africa alberts</term><term>Alanine aminotransferase</term><term>Alcohol consumption</term><term>American diabetes association criteria</term><term>Black africans</term><term>Black communities</term><term>Black community</term><term>Black women</term><term>Blood pressure</term><term>Body mass index</term><term>Brisk study</term><term>Cape peninsula</term><term>Cape town</term><term>Cardiology</term><term>Cardiovasc risk</term><term>Cardiovascular</term><term>Cardiovascular disease</term><term>Cardiovascular diseases</term><term>Cardiovascular prevention</term><term>Central obesity</term><term>Chronic disease risk factors</term><term>Chronic diseases</term><term>Chronic diseases risk factors</term><term>Clin nutr</term><term>Copyright</term><term>Copyright european society</term><term>Cutoff points</term><term>Diabetes</term><term>Diabetes care</term><term>Diabetes mellitus</term><term>European journal</term><term>European society</term><term>Expert panel</term><term>Fasting blood sugar</term><term>Framingham</term><term>Framingham equations</term><term>Gamma glutamyltransferase</term><term>Glucose</term><term>Health survey</term><term>High blood cholesterol</term><term>High levels</term><term>High prevalence</term><term>Higher risk</term><term>Hypertension</term><term>Hypertension society</term><term>Limpopo</term><term>Limpopo province</term><term>Lipid profile</term><term>Medical research council</term><term>Obese</term><term>Obese women</term><term>Obesity</term><term>Participant</term><term>Peripheral obesity</term><term>Physical activity</term><term>Poor community</term><term>Prevalence</term><term>Response rate</term><term>Risk factors</term><term>Risk profile</term><term>Risk score</term><term>Smokeless tobacco</term><term>Sociodemographic data</term><term>Southern africa</term><term>Steyn</term><term>Study population</term><term>Unauthorized</term><term>Unauthorized reproduction</term><term>Waist circumference</term><term>World health organization</term><term>World population</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background To determine the prevalence and associated risk factors of cardiovascular diseases in a rural adult black population from Limpopo Province in South Africa. Design A cross-sectional study. Methods A sample of 1608 women and 498 men aged 30 years and above participated in the study. Sociodemographic data, anthropometric measures (body mass index, waist/hip ratio), blood pressure and biochemical risk factors were measured. A global cardiovascular disease (CVD) risk profile was developed. Results There was a high prevalence of tobacco use for men (57%) and women (35.4%), with women (28.1%) predominantly using smokeless tobacco. Alcohol use was very common in men (57.2%). Women weighed a great deal more than men, and 51.7% were either overweight or obese. Diabetes was diagnosed in 8.8 and 8.5% of women and men, respectively. High-density lipoprotein-cholesterol was relatively high, whereas 42.3% of women and 28.5% of men had low-density lipoprotein-cholesterol levels of 3 mmol/l or more. Hypertension (blood pressure ≥ 140/90 mmHg) was found in 25.5% of women and 21.6% of men. According to the Framingham formulae, 18.9% of women and 32.1% of men had a 20% or higher chance of having a CVD event in the next 10 years. Conclusions There was a high prevalence of chronic disease risk factors in the rural, poor black community in Limpopo, South Africa. Consequently, the population had a higher than expected risk of developing a CVD event in the following 10 years when compared with similar studies in black Africans.</div></front></TEI><istex><corpusName>sage</corpusName><keywords><teeft><json:string>hypertension</json:string><json:string>risk factors</json:string><json:string>limpopo</json:string><json:string>cardiology</json:string><json:string>obese</json:string><json:string>unauthorized reproduction</json:string><json:string>framingham</json:string><json:string>copyright</json:string><json:string>glucose</json:string><json:string>copyright european society</json:string><json:string>world population</json:string><json:string>steyn</json:string><json:string>chronic diseases</json:string><json:string>cardiovascular</json:string><json:string>central obesity</json:string><json:string>study population</json:string><json:string>waist circumference</json:string><json:string>cardiovascular 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communities</json:string><json:string>diabetes care</json:string><json:string>response rate</json:string><json:string>cape peninsula</json:string><json:string>brisk study</json:string><json:string>european society</json:string><json:string>unauthorized</json:string><json:string>obesity</json:string><json:string>prevalence</json:string><json:string>participant</json:string></teeft></keywords><author><json:item><name>Marianne Alberts</name><affiliations><json:null></json:null><json:null></json:null><json:string>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</json:string><json:string>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</json:string><json:string>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</json:string><json:string>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</json:string><json:string>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</json:string><json:string>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</json:string></affiliations></json:item><json:item><name>Petter Urdal</name><affiliations><json:null></json:null><json:null></json:null><json:string>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</json:string><json:string>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</json:string><json:string>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</json:string><json:string>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</json:string><json:string>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</json:string><json:string>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</json:string></affiliations></json:item><json:item><name>Krisela Steyn</name><affiliations><json:null></json:null><json:null></json:null><json:string>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</json:string><json:string>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</json:string><json:string>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</json:string><json:string>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</json:string><json:string>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</json:string><json:string>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</json:string></affiliations></json:item><json:item><name>Inger Stensvold</name><affiliations><json:null></json:null><json:null></json:null><json:string>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</json:string><json:string>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</json:string><json:string>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</json:string><json:string>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</json:string><json:string>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</json:string><json:string>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</json:string></affiliations></json:item><json:item><name>Aage Tverdal</name><affiliations><json:null></json:null><json:null></json:null><json:string>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</json:string><json:string>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</json:string><json:string>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</json:string><json:string>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</json:string><json:string>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</json:string><json:string>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</json:string></affiliations></json:item><json:item><name>Johanna H. Nel</name><affiliations><json:null></json:null><json:null></json:null><json:string>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</json:string><json:string>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</json:string><json:string>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</json:string><json:string>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</json:string><json:string>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</json:string><json:string>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</json:string></affiliations></json:item><json:item><name>Nelia P. Steyn</name><affiliations><json:null></json:null><json:null></json:null><json:string>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</json:string><json:string>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</json:string><json:string>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</json:string><json:string>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</json:string><json:string>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</json:string><json:string>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>chronic diseases</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>cross-sectional studies</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>diabetes mellitus</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>ethnicity</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>hyperlipidaemia</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>hypertension</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>obesity</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>risk factors</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>rural population</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>tobacco</value></json:item></subject><articleId><json:string>10.1097_01.hjr.0000174792.24188.8e</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>Background To determine the prevalence and associated risk factors of cardiovascular diseases in a rural adult black population from Limpopo Province in South Africa. Design A cross-sectional study. Methods A sample of 1608 women and 498 men aged 30 years and above participated in the study. Sociodemographic data, anthropometric measures (body mass index, waist/hip ratio), blood pressure and biochemical risk factors were measured. A global cardiovascular disease (CVD) risk profile was developed. Results There was a high prevalence of tobacco use for men (57%) and women (35.4%), with women (28.1%) predominantly using smokeless tobacco. Alcohol use was very common in men (57.2%). Women weighed a great deal more than men, and 51.7% were either overweight or obese. Diabetes was diagnosed in 8.8 and 8.5% of women and men, respectively. High-density lipoprotein-cholesterol was relatively high, whereas 42.3% of women and 28.5% of men had low-density lipoprotein-cholesterol levels of 3 mmol/l or more. Hypertension (blood pressure ≥ 140/90 mmHg) was found in 25.5% of women and 21.6% of men. According to the Framingham formulae, 18.9% of women and 32.1% of men had a 20% or higher chance of having a CVD event in the next 10 years. Conclusions There was a high prevalence of chronic disease risk factors in the rural, poor black community in Limpopo, South Africa. Consequently, the population had a higher than expected risk of developing a CVD event in the following 10 years when compared with similar studies in black Africans.</abstract><qualityIndicators><score>7.449</score><pdfVersion>1.4</pdfVersion><pdfPageSize>587 x 782 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>1539</abstractCharCount><pdfWordCount>4033</pdfWordCount><pdfCharCount>29064</pdfCharCount><pdfPageCount>8</pdfPageCount><abstractWordCount>243</abstractWordCount></qualityIndicators><title>Prevalence of cardiovascular diseases and associated risk factors in a rural black population of South Africa</title><genre><json:string>research-article</json:string></genre><host><title>European Journal of Preventive Cardiology</title><language><json:string>unknown</json:string></language><issn><json:string>2047-4873</json:string></issn><eissn><json:string>2047-4881</json:string></eissn><publisherId><json:string>CPR</json:string></publisherId><volume>12</volume><issue>4</issue><pages><first>347</first><last>354</last></pages><genre><json:string>journal</json:string></genre></host><categories><wos><json:string>science</json:string><json:string>cardiac & cardiovascular systems</json:string></wos><scienceMetrix></scienceMetrix><inist><json:string>sciences appliquees, technologies et medecines</json:string><json:string>sciences biologiques et medicales</json:string><json:string>sciences medicales</json:string></inist></categories><publicationDate>2005</publicationDate><copyrightDate>2005</copyrightDate><doi><json:string>10.1097/01.hjr.0000174792.24188.8e</json:string></doi><id>E6B8B14569ACDE4516A22E2CA1EA131942E83F70</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/E6B8B14569ACDE4516A22E2CA1EA131942E83F70/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/E6B8B14569ACDE4516A22E2CA1EA131942E83F70/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/E6B8B14569ACDE4516A22E2CA1EA131942E83F70/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Prevalence of cardiovascular diseases and associated risk factors in a rural black population of South Africa</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher scheme="https://publisher-list.data.istex.fr">SAGE Publications</publisher><pubPlace>Sage UK: London, England</pubPlace><availability><licence><p>© 2005 European Society of Cardiology</p></licence><p scheme="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-0J1N7DQT-B">sage</p></availability><date>2005</date></publicationStmt><notesStmt><note type="research-article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</note><note type="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note><note>Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Prevalence of cardiovascular diseases and associated risk factors in a rural black population of South Africa</title><author xml:id="author-0000"><persName><forename type="first">Marianne</forename><surname>Alberts</surname></persName><note type="biography">Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</note><affiliation>Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</affiliation><affiliation></affiliation><affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</affiliation><affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</affiliation><affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</affiliation><affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Petter</forename><surname>Urdal</surname></persName><note type="biography">Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</note><affiliation>Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</affiliation><affiliation></affiliation><affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</affiliation><affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</affiliation><affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</affiliation><affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</affiliation></author><author xml:id="author-0002"><persName><forename type="first">Krisela</forename><surname>Steyn</surname></persName><note type="biography">Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</note><affiliation>Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</affiliation><affiliation></affiliation><affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</affiliation><affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</affiliation><affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</affiliation><affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Inger</forename><surname>Stensvold</surname></persName><note type="biography">Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</note><affiliation>Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</affiliation><affiliation></affiliation><affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</affiliation><affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</affiliation><affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</affiliation><affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</affiliation></author><author xml:id="author-0004"><persName><forename type="first">Aage</forename><surname>Tverdal</surname></persName><note type="biography">Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</note><affiliation>Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</affiliation><affiliation></affiliation><affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</affiliation><affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</affiliation><affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</affiliation><affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</affiliation></author><author xml:id="author-0005"><persName><forename type="first">Johanna H.</forename><surname>Nel</surname></persName><note type="biography">Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</note><affiliation>Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</affiliation><affiliation></affiliation><affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</affiliation><affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</affiliation><affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</affiliation><affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</affiliation></author><author xml:id="author-0006"><persName><forename type="first">Nelia P.</forename><surname>Steyn</surname></persName><note type="biography">Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</note><affiliation>Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</affiliation><affiliation></affiliation><affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</affiliation><affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</affiliation><affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</affiliation><affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</affiliation></author><idno type="istex">E6B8B14569ACDE4516A22E2CA1EA131942E83F70</idno><idno type="ark">ark:/67375/M70-W1L85N76-L</idno><idno type="DOI">10.1097/01.hjr.0000174792.24188.8e</idno><idno type="article-id">10.1097_01.hjr.0000174792.24188.8e</idno></analytic><monogr><title level="j">European journal of preventive cardiology</title><title level="j" type="abbrev">Eur J Cardiovasc Prev Rehabil</title><idno type="pISSN">2047-4873</idno><idno type="eISSN">2047-4881</idno><idno type="publisher-id">CPR</idno><idno type="PublisherID-hwp">spcpr</idno><idno type="PublisherID-nlm-ta">Eur J Cardiovasc Prev Rehabil</idno><imprint><publisher>SAGE Publications</publisher><pubPlace>Sage UK: London, England</pubPlace><date type="published" when="2005"></date><biblScope unit="volume">12</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="347">347</biblScope><biblScope unit="page" to="354">354</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2005</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Background To determine the prevalence and associated risk factors of cardiovascular diseases in a rural adult black population from Limpopo Province in South Africa. Design A cross-sectional study. Methods A sample of 1608 women and 498 men aged 30 years and above participated in the study. Sociodemographic data, anthropometric measures (body mass index, waist/hip ratio), blood pressure and biochemical risk factors were measured. A global cardiovascular disease (CVD) risk profile was developed. Results There was a high prevalence of tobacco use for men (57%) and women (35.4%), with women (28.1%) predominantly using smokeless tobacco. Alcohol use was very common in men (57.2%). Women weighed a great deal more than men, and 51.7% were either overweight or obese. Diabetes was diagnosed in 8.8 and 8.5% of women and men, respectively. High-density lipoprotein-cholesterol was relatively high, whereas 42.3% of women and 28.5% of men had low-density lipoprotein-cholesterol levels of 3 mmol/l or more. Hypertension (blood pressure ≥ 140/90 mmHg) was found in 25.5% of women and 21.6% of men. According to the Framingham formulae, 18.9% of women and 32.1% of men had a 20% or higher chance of having a CVD event in the next 10 years. Conclusions There was a high prevalence of chronic disease risk factors in the rural, poor black community in Limpopo, South Africa. Consequently, the population had a higher than expected risk of developing a CVD event in the following 10 years when compared with similar studies in black Africans.</p></abstract><textClass><keywords scheme="keyword"><list><head>keywords</head><item><term>chronic diseases</term></item><item><term>cross-sectional studies</term></item><item><term>diabetes mellitus</term></item><item><term>ethnicity</term></item><item><term>hyperlipidaemia</term></item><item><term>hypertension</term></item><item><term>obesity</term></item><item><term>risk factors</term></item><item><term>rural population</term></item><item><term>tobacco</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2005">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/E6B8B14569ACDE4516A22E2CA1EA131942E83F70/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus sage not found" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" URI="journalpublishing.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article" dtd-version="2.3" xml:lang="EN"><front><journal-meta><journal-id journal-id-type="publisher-id">CPR</journal-id><journal-id journal-id-type="hwp">spcpr</journal-id><journal-id journal-id-type="nlm-ta">Eur J Cardiovasc Prev Rehabil</journal-id><journal-title>European Journal of Preventive Cardiology</journal-title><issn pub-type="ppub">2047-4873</issn><issn pub-type="epub">2047-4881</issn><publisher><publisher-name>SAGE Publications</publisher-name><publisher-loc>Sage UK: London, England</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.1097/01.hjr.0000174792.24188.8e</article-id><article-id pub-id-type="publisher-id">10.1097_01.hjr.0000174792.24188.8e</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Scientific Paper</subject></subj-group></article-categories><title-group><article-title>Prevalence of cardiovascular diseases and associated risk factors in a rural black population of South Africa</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Alberts</surname><given-names>Marianne</given-names></name><xref ref-type="aff" rid="aff1-01.hjr.0000174792.24188.8e">a</xref><xref ref-type="corresp" rid="corresp1-01.hjr.0000174792.24188.8e"></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Urdal</surname><given-names>Petter</given-names></name><xref ref-type="aff" rid="aff2-01.hjr.0000174792.24188.8e">b</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Steyn</surname><given-names>Krisela</given-names></name><xref ref-type="aff" rid="aff3-01.hjr.0000174792.24188.8e">c</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Stensvold</surname><given-names>Inger</given-names></name><xref ref-type="aff" rid="aff4-01.hjr.0000174792.24188.8e">d</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Tverdal</surname><given-names>Aage</given-names></name><xref ref-type="aff" rid="aff5-01.hjr.0000174792.24188.8e">e</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Nel</surname><given-names>Johanna H.</given-names></name><xref ref-type="aff" rid="aff6-01.hjr.0000174792.24188.8e">f</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Steyn</surname><given-names>Nelia P.</given-names></name><xref ref-type="aff" rid="aff3-01.hjr.0000174792.24188.8e">c</xref></contrib></contrib-group><aff id="aff1-01.hjr.0000174792.24188.8e"><label>a</label>School of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</aff><aff id="aff2-01.hjr.0000174792.24188.8e"><label>b</label>Department of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</aff><aff id="aff3-01.hjr.0000174792.24188.8e"><label>c</label>Chronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</aff><aff id="aff4-01.hjr.0000174792.24188.8e"><label>d</label>National Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</aff><aff id="aff5-01.hjr.0000174792.24188.8e"><label>e</label>National Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</aff><aff id="aff6-01.hjr.0000174792.24188.8e"><label>f</label>Department of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</aff><author-notes><corresp id="corresp1-01.hjr.0000174792.24188.8e">Correspondence and requests for reprints to Marianne Alberts, PO Box 3760, Polokwane 0700, South Africa. Tel: + 27 15 2683398; fax: + 27 15 2682205; e-mail: <email xlink:href="ma15@pixie.co.za" xlink:type="simple">ma15@pixie.co.za</email></corresp><fn fn-type="other" id="fn1-01.hjr.0000174792.24188.8e"><p>Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</p></fn></author-notes><pub-date pub-type="epub-ppub"><month>8</month><year>2005</year></pub-date><volume>12</volume><issue>4</issue><fpage>347</fpage><lpage>354</lpage><history><date date-type="accepted"><day>10</day><month>5</month><year>2005</year></date><date date-type="received"><day>12</day><month>10</month><year>2004</year></date></history><permissions><copyright-statement>© 2005 European Society of Cardiology</copyright-statement><copyright-year>2005</copyright-year><copyright-holder content-type="other">European Society of Cardiology</copyright-holder></permissions><abstract><p><italic>Background</italic> To determine the prevalence and associated risk factors of cardiovascular diseases in a rural adult black population from Limpopo Province in South Africa.</p><p><italic>Design</italic> A cross-sectional study.</p><p><italic>Methods</italic> A sample of 1608 women and 498 men aged 30 years and above participated in the study. Sociodemographic data, anthropometric measures (body mass index, waist/hip ratio), blood pressure and biochemical risk factors were measured. A global cardiovascular disease (CVD) risk profile was developed.</p><p><italic>Results</italic> There was a high prevalence of tobacco use for men (57%) and women (35.4%), with women (28.1%) predominantly using smokeless tobacco. Alcohol use was very common in men (57.2%). Women weighed a great deal more than men, and 51.7% were either overweight or obese. Diabetes was diagnosed in 8.8 and 8.5% of women and men, respectively. High-density lipoprotein-cholesterol was relatively high, whereas 42.3% of women and 28.5% of men had low-density lipoprotein-cholesterol levels of 3 mmol/l or more. Hypertension (blood pressure ≥ 140/90 mmHg) was found in 25.5% of women and 21.6% of men. According to the Framingham formulae, 18.9% of women and 32.1% of men had a 20% or higher chance of having a CVD event in the next 10 years.</p><p><italic>Conclusions</italic> There was a high prevalence of chronic disease risk factors in the rural, poor black community in Limpopo, South Africa. Consequently, the population had a higher than expected risk of developing a CVD event in the following 10 years when compared with similar studies in black Africans.</p></abstract><kwd-group><kwd>chronic diseases</kwd><kwd>cross-sectional studies</kwd><kwd>diabetes mellitus</kwd><kwd>ethnicity</kwd><kwd>hyperlipidaemia</kwd><kwd>hypertension</kwd><kwd>obesity</kwd><kwd>risk factors</kwd><kwd>rural population</kwd><kwd>tobacco</kwd></kwd-group></article-meta></front><body><sec id="section1-01.hjr.0000174792.24188.8e"><title>Introduction</title><p>Infectious diseases and malnutrition have been the main causes of morbidity and mortality in sub-Saharan Africa up to now [<xref ref-type="bibr" rid="bibr1-01.hjr.0000174792.24188.8e">1</xref>]. However, as a result of dramatic increases in urbanization and the far-reaching effects of globalization in recent decades, non-communicable diseases (NCD) have become more prevalent; and are predicted to increase alarmingly worldwide. Even in low-income countries, such as those in sub-Saharan Africa, this is happening [<xref ref-type="bibr" rid="bibr2-01.hjr.0000174792.24188.8e">2</xref>]. Much of this increase is caused by changes in lifestyle, in particular, dietary changes, increases in weight and obesity, decreases in physical activity, high levels of stress, and increasing tobacco and alcohol consumption. These lifestyle behaviours lead to the emergence of the well-known risk factors for NCD [<xref ref-type="bibr" rid="bibr3-01.hjr.0000174792.24188.8e">3</xref>–<xref ref-type="bibr" rid="bibr6-01.hjr.0000174792.24188.8e">6</xref>].</p><p>The most common morbidity and mortality associated with chronic diseases in the urban black population in South Africa are caused by stroke, hypertension and type 2 diabetes [<xref ref-type="bibr" rid="bibr7-01.hjr.0000174792.24188.8e">7</xref>].</p><p>Until now there has been a paucity of data regarding chronic diseases and associated risk factors in rural black populations in South Africa. Consequently, the aim of this study was to identify specific risk factors for chronic diseases in a rural settlement of the Limpopo province in South Africa.</p></sec><sec id="section2-01.hjr.0000174792.24188.8e"><title>Methods</title><p>Limpopo is the most impoverished region in South Africa, with 4. 5 million inhabitants of whom 96% are black and approximately 91% live in rural or semirural areas. Health facilities in these areas are frequently inadequate or inaccessible [<xref ref-type="bibr" rid="bibr8-01.hjr.0000174792.24188.8e">8</xref>]. The study area is situated 40–50 km northeast of Polokwane, the capital city of Limpopo. The area is estimated to have between 15 000 and 20 000 inhabitants, with 5800 older than 30 years of age. The villages are typical rural settlements where the dwelling units consist of a mix of shacks, traditional mud huts and conventional brick houses. Unemployment is estimated at 50–60%. All inhabitants of this area belong to the Pedi group and are northern Sotho-speaking people [<xref ref-type="bibr" rid="bibr9-01.hjr.0000174792.24188.8e">9</xref>]. Letters with the objectives of the study were sent to all individual households. All participants gave written consent to participate in the study. Ethical approval for the study was obtained from the Ethics Committee at the University of the North.</p><p>Of the possible 5800 adults aged 30 years and older, 2106 participated by completing interviews and having clinical measurements taken. Only 1391 of these participants were willing to undergo a venepuncture to collect a blood sample. Although this makes the response rate less than 40%, which is a limitation of the study, there are certain factors that need to be considered regarding a typical village in this province. First, there is a high rate of migrancy, with a large proportion of men working in the cities and coming home infrequently, thus there was a difficulty in finding eligible men to examine. Second, because of the HIV/AIDS epidemic in South Africa and its social connotations there is a great reluctance for adults to donate blood in surveys of this nature. Secrecy regarding HIV status is still a well-established practice, and many people refuse to have blood drawn because they do not trust the health system. Consequently, our results should be interpreted with caution because selection bias may have played a role.</p><p>Fieldworkers were trained and standardized, and they completed questionnaires by interview in participants’ homes or at a designated place. A questionnaire was developed to elicit information on socio-economic status and risk factors for NCD. Questions on risk factors were related to physical activity, tobacco use, alcohol consumption and the presence of specific diseases.</p><p>Body weight was measured according to standard procedures [<xref ref-type="bibr" rid="bibr10-01.hjr.0000174792.24188.8e">10</xref>] to the nearest 0.1 kg, with the subject in light clothing. Standing height was measured with the subject barefoot to the nearest 0.1 cm using a stadiometer. Body mass index (BMI) was calculated as weight (kg)/[height (m)]<sup>2</sup> [<xref ref-type="bibr" rid="bibr10-01.hjr.0000174792.24188.8e">10</xref>]. Overweight was identified when the BMI was over 25 and below 30, and obesity when the BMI was 30 or greater. A waist measurement was taken around the narrowest part of the waist using a non-stretchable tape. A hip measurement was taken around the widest part of the hips. The waist/hip ratio (WHR) was calculated [<xref ref-type="bibr" rid="bibr11-01.hjr.0000174792.24188.8e">11</xref>], and was considered to be abnormal when the value was 1.0 or greater for men and 0.8 or greater for women. The waist circumference was also used on its own to assess abdominal obesity [<xref ref-type="bibr" rid="bibr12-01.hjr.0000174792.24188.8e">12</xref>]. Its presence was recorded when the waist circumference was 102 cm or greater and 88 cm or greater for men and women, respectively. Study participants were also classified as having central obesity (apple-shaped, defined as a BMI ≥ 30, and a waist circumference above the cutoff points described above) or peripheral obesity (pear-shaped, defined as a BMI ≥ 30, and a waist circumference below the cutoff points).</p><p>Blood pressure (BP) was recorded with a mercury sphygmomanometer according to the guidelines of the Hypertension Society of Southern Africa [<xref ref-type="bibr" rid="bibr13-01.hjr.0000174792.24188.8e">13</xref>]. Three readings were taken, and the mean of the last two was used as a measure of BP. Hypertension was diagnosed as having a BP of 140/90 mmHg or greater.</p><p>A registered nurse collected fasting blood samples. After having been seated for at least 15 min, 30 ml blood was drawn from each subject into either plain tubes or tubes containing ethylenediamine tetraacetic acid or sodium fluoride. The samples were stored in a coolbox and then centrifuged within 5 h to prepare the plasma or serum. Aliquots were frozen at −70°C until analysed.</p><p>The sodium fluoride plasma was used for measuring glucose. Glucose was measured on a Technicon RA-XT, using reagents from Bayer Diagnostica, New York, USA. The diagnosis of diabetes was based on the American Diabetes Association criteria for fasting blood sugar at a level of 7 mmol/l or greater [<xref ref-type="bibr" rid="bibr14-01.hjr.0000174792.24188.8e">14</xref>]. The remaining components were measured using Dimension ES and reagents from Dade Behring, USA. Low-density lipoprotein (LDL)-cholesterol was calculated using the Friedewald equation [<xref ref-type="bibr" rid="bibr15-01.hjr.0000174792.24188.8e">15</xref>]. Lipid profile abnormalities were diagnosed when the total cholesterol level was equal to or above 5 mmol/l and high-density lipoprotein (HDL)-cholesterol was below 1.2 mmol/l. In addition, hypertriglyceridaemia and raised LDL-cholesterol were diagnosed when they were 1.5 and 3 mmol/l or greater, respectively [<xref ref-type="bibr" rid="bibr16-01.hjr.0000174792.24188.8e">16</xref>].</p><table-wrap id="table1-01.hjr.0000174792.24188.8e" position="float"><label>Table 1</label><caption><p>Demographic status of the rural black study population in Limpopo province</p></caption><graphic alternate-form-of="table1-01.hjr.0000174792.24188.8e" position="float" xlink:href="10.1097_01.hjr.0000174792.24188.8e-table1.tif" xlink:type="simple"></graphic><table><colgroup span="1"><col align="left" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col></colgroup><thead><tr><td colspan="1" rowspan="1"></td><td colspan="6" rowspan="1">Women</td><td colspan="6" rowspan="1">Men</td></tr><tr><td colspan="1" rowspan="1">Age group (years)</td><td colspan="1" rowspan="1">30–34</td><td colspan="1" rowspan="1">35–44</td><td colspan="1" rowspan="1">45–54</td><td colspan="1" rowspan="1">55–64</td><td colspan="1" rowspan="1">65+</td><td colspan="1" rowspan="1">Total</td><td colspan="1" rowspan="1">30–34</td><td colspan="1" rowspan="1">35–44</td><td colspan="1" rowspan="1">45–54</td><td colspan="1" rowspan="1">55–64</td><td colspan="1" rowspan="1">65+</td><td colspan="1" rowspan="1">Total</td></tr></thead><tbody><tr><td colspan="1" rowspan="1">Number (max)</td><td colspan="1" rowspan="1">162</td><td colspan="1" rowspan="1">334</td><td colspan="1" rowspan="1">318</td><td colspan="1" rowspan="1">353</td><td colspan="1" rowspan="1">396</td><td colspan="1" rowspan="1">1563</td><td colspan="1" rowspan="1">61</td><td colspan="1" rowspan="1">88</td><td colspan="1" rowspan="1">100</td><td colspan="1" rowspan="1">117</td><td colspan="1" rowspan="1">133</td><td colspan="1" rowspan="1">499</td></tr><tr><td colspan="1" rowspan="1">Level of schooling (%)</td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td></tr><tr><td colspan="1" rowspan="1">Grades 1–6</td><td colspan="1" rowspan="1">16.7</td><td colspan="1" rowspan="1">34.7</td><td colspan="1" rowspan="1">60.1</td><td colspan="1" rowspan="1">67.4</td><td colspan="1" rowspan="1">81.3</td><td colspan="1" rowspan="1">57.2</td><td colspan="1" rowspan="1">29.5</td><td colspan="1" rowspan="1">37.5</td><td colspan="1" rowspan="1">54.0</td><td colspan="1" rowspan="1">59.8</td><td colspan="1" rowspan="1">72.9</td><td colspan="1" rowspan="1">54.5</td></tr><tr><td colspan="1" rowspan="1">Grades 7–10</td><td colspan="1" rowspan="1">46.9</td><td colspan="1" rowspan="1">50.3</td><td colspan="1" rowspan="1">35.3</td><td colspan="1" rowspan="1">30.3</td><td colspan="1" rowspan="1">18.2</td><td colspan="1" rowspan="1">34.3</td><td colspan="1" rowspan="1">29.5</td><td colspan="1" rowspan="1">48.9</td><td colspan="1" rowspan="1">42.0</td><td colspan="1" rowspan="1">34.2</td><td colspan="1" rowspan="1">24.8</td><td colspan="1" rowspan="1">35.3</td></tr><tr><td colspan="1" rowspan="1">Grades 11–12+</td><td colspan="1" rowspan="1">36.4</td><td colspan="1" rowspan="1">15.0</td><td colspan="1" rowspan="1">4.4</td><td colspan="1" rowspan="1">2.3</td><td colspan="1" rowspan="1">0.5</td><td colspan="1" rowspan="1">8.5</td><td colspan="1" rowspan="1">41.0</td><td colspan="1" rowspan="1">13.6</td><td colspan="1" rowspan="1">4.0</td><td colspan="1" rowspan="1">6.0</td><td colspan="1" rowspan="1">2.3</td><td colspan="1" rowspan="1">10.2</td></tr><tr><td colspan="1" rowspan="1">Electricity in house (%)</td><td colspan="1" rowspan="1">24.1</td><td colspan="1" rowspan="1">23.6</td><td colspan="1" rowspan="1">24.5</td><td colspan="1" rowspan="1">18.7</td><td colspan="1" rowspan="1">20.3</td><td colspan="1" rowspan="1">21.9</td><td colspan="1" rowspan="1">12.7</td><td colspan="1" rowspan="1">19.1</td><td colspan="1" rowspan="1">11.8</td><td colspan="1" rowspan="1">24.0</td><td colspan="1" rowspan="1">20.4</td><td colspan="1" rowspan="1">18.4</td></tr><tr><td colspan="1" rowspan="1">Water tap in house (%)</td><td colspan="1" rowspan="1">22.7</td><td colspan="1" rowspan="1">20.9</td><td colspan="1" rowspan="1">22.6</td><td colspan="1" rowspan="1">18.1</td><td colspan="1" rowspan="1">21.5</td><td colspan="1" rowspan="1">20.9</td><td colspan="1" rowspan="1">27.0</td><td colspan="1" rowspan="1">31.9</td><td colspan="1" rowspan="1">20.4</td><td colspan="1" rowspan="1">19.0</td><td colspan="1" rowspan="1">25.4</td><td colspan="1" rowspan="1">24.2</td></tr><tr><td colspan="1" rowspan="1">Radio in house (%)</td><td colspan="1" rowspan="1">87.0</td><td colspan="1" rowspan="1">83.1</td><td colspan="1" rowspan="1">81.3</td><td colspan="1" rowspan="1">78.2</td><td colspan="1" rowspan="1">71.9</td><td colspan="1" rowspan="1">79.1</td><td colspan="1" rowspan="1">92.1</td><td colspan="1" rowspan="1">83.2</td><td colspan="1" rowspan="1">84.5</td><td colspan="1" rowspan="1">80.2</td><td colspan="1" rowspan="1">83.8</td><td colspan="1" rowspan="1">84.0</td></tr></tbody></table></table-wrap><p>The cutoff points used for gamma glutamyltransferase were 80 and 50 U/l for men and women, respectively, and for alanine transferase (ALT) greater than 35 U/l for women and greater than 50 U/l for men [<xref ref-type="bibr" rid="bibr17-01.hjr.0000174792.24188.8e">17</xref>, <xref ref-type="bibr" rid="bibr18-01.hjr.0000174792.24188.8e">18</xref>].</p><p>Data were analysed using SPSS (version 11.0; SPSS Inc., Chicago, Illinois, USA) for Windows. Categorical data are presented as percentages, and continuous data as the mean and standard deviations. For comparison, statistical significance was set at a probability level of 0.05 when using analysis of variance and the Student's <italic>t</italic>-test. The total CVD risk factor burden was calculated using the Framingham risk equations, and the prognosis (expressed as a percentage) of having a CVD event in the next 10 years is reported [<xref ref-type="bibr" rid="bibr19-01.hjr.0000174792.24188.8e">19</xref>]. Although it is realized that the Framingham equations are based on longitudinal data from Caucasians, there are no similar data from cohort studies for black Africans. The crude data (excluding sociodemographic data in <xref ref-type="table" rid="table1-01.hjr.0000174792.24188.8e">Table 1</xref>) for the whole study population were age-standardized to that of the world population [<xref ref-type="bibr" rid="bibr20-01.hjr.0000174792.24188.8e">20</xref>].</p></sec><sec id="section3-01.hjr.0000174792.24188.8e"><title>Results</title><p>A total sample of 2106 participants was entered into the study, with 76.3% women and 23.7% men. <xref ref-type="table" rid="table1-01.hjr.0000174792.24188.8e">Table 1</xref> provides the sociodemographic profile of the participants. This is a poor community with little infrastructure, such as electricity and running water, in their homes. However, most of the participants had radios in their homes. Most of the participants had less than 7 years of schooling.</p><p><xref ref-type="table" rid="table2-01.hjr.0000174792.24188.8e">Table 2</xref> shows the data on the lifestyle-related risk factors. Most participants followed a physically inactive lifestyle, particularly in the work setting. More than half of the men consumed alcohol, whereas very few women did so. Tobacco use was very high in men, but surprisingly, many women also reported using tobacco. Women used smokeless tobacco (mainly snuff) far more frequently than cigarettes. The number of cigarettes smoked per day was very low, with women smoking one to two cigarettes per day, whereas the men smoked approximately five cigarettes per day. Both men and women started using tobacco quite late in life.</p><p><xref ref-type="table" rid="table3-01.hjr.0000174792.24188.8e">Table 3</xref> presents data on the anthropometry and BP of the participants. Although women were found to be shorter than men, they actually weighed more than the men. Approximately 59% of the women were overweight or obese, whereas only 29% of men fell within these categories [<xref ref-type="bibr" rid="bibr9-01.hjr.0000174792.24188.8e">9</xref>] (<xref ref-type="table" rid="table4-01.hjr.0000174792.24188.8e">Table 4</xref>). Further exploration into central obesity showed that 26.9% of the women had apple-shaped obesity whereas only 3.1% had a pear shape. In men, 5% were found to have apple-shaped and 3.3% pear-shaped obesity (<xref ref-type="table" rid="table4-01.hjr.0000174792.24188.8e">Table 4</xref>). Of the apple-shaped obese women 28% had a 20% or higher risk of suffering from a CVD event, according to the Framingham risk tables, within the next 10 years, whereas 67% of pear-shaped men carried this level of risk. In contrast, the pear-shaped obese women and men had 6.3 and 30%, respectively, of a 20% or higher risk of suffering from a CVD event in the next 10 years (data not shown).</p><p>The BP of men and women was higher in the older age groups than in the younger groups. Hypertension was very common in the study population, with approximately 25% of the participants having raised BP (<xref ref-type="table" rid="table3-01.hjr.0000174792.24188.8e">Table 3</xref>).</p><p>The analyses of the blood samples are shown in <xref ref-type="table" rid="table5-01.hjr.0000174792.24188.8e">Table 5</xref>, as well as the total CVD risk score calculated according to the Framingham equations. A reasonably acceptable pattern of the lipid profile, with high HDL-cholesterol and low LDL-cholesterol levels, is shown for these participants. Their fasting blood sugar increased with age, indicating diabetes at a level of more than 7 mmol/l in 10% of the study population (<xref ref-type="table" rid="table5-01.hjr.0000174792.24188.8e">Table 5</xref>). Compared with women, the markedly higher levels of gamma glutamyl-transferase found in men suggest a higher alcohol intake by these men. Similarly, ALT was also found to be higher in men than in women. High ALT values indicative of liver damage were found in 6.5% of men but in very few women (<xref ref-type="table" rid="table5-01.hjr.0000174792.24188.8e">Table 5</xref>).</p><table-wrap id="table2-01.hjr.0000174792.24188.8e" position="float"><label>Table 2</label><caption><p>Lifestyle-related risk factors in the rural black population of Limpopo (age-standardized to the world population [<xref ref-type="bibr" rid="bibr21-01.hjr.0000174792.24188.8e">21</xref>])</p></caption><graphic alternate-form-of="table2-01.hjr.0000174792.24188.8e" position="float" xlink:href="10.1097_01.hjr.0000174792.24188.8e-table2.tif" xlink:type="simple"></graphic><table><colgroup span="1"><col align="left" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col></colgroup><thead><tr><td colspan="1" rowspan="1"></td><td colspan="7" rowspan="1">Women</td><td colspan="7" rowspan="1">Men</td></tr><tr><td colspan="1" rowspan="1">Age group (years)</td><td colspan="1" rowspan="1">30–34</td><td colspan="1" rowspan="1">35–44</td><td colspan="1" rowspan="1">45–54</td><td colspan="1" rowspan="1">55–64</td><td colspan="1" rowspan="1">65+</td><td colspan="1" rowspan="1">≥ 30</td><td colspan="1" rowspan="1">Age-standardized</td><td colspan="1" rowspan="1">30–34</td><td colspan="1" rowspan="1">35–44</td><td colspan="1" rowspan="1">45–54</td><td colspan="1" rowspan="1">55–64</td><td colspan="1" rowspan="1">65+</td><td colspan="1" rowspan="1">≥ 30</td><td colspan="1" rowspan="1">Age-standardized</td></tr></thead><tbody><tr><td colspan="1" rowspan="1">Number</td><td colspan="1" rowspan="1">155</td><td colspan="1" rowspan="1">342</td><td colspan="1" rowspan="1">323</td><td colspan="1" rowspan="1">375</td><td colspan="1" rowspan="1">412</td><td colspan="1" rowspan="1">1608</td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1">59</td><td colspan="1" rowspan="1">87</td><td colspan="1" rowspan="1">101</td><td colspan="1" rowspan="1">117</td><td colspan="1" rowspan="1">134</td><td colspan="1" rowspan="1">498</td><td colspan="1" rowspan="1"></td></tr><tr><td colspan="1" rowspan="1">Physical activity</td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td></tr><tr><td colspan="1" rowspan="1">Home (%)</td><td colspan="1" rowspan="1">63.9</td><td colspan="1" rowspan="1">52.6</td><td colspan="1" rowspan="1">46.8</td><td colspan="1" rowspan="1">36.0</td><td colspan="1" rowspan="1">20.7</td><td colspan="1" rowspan="1">40.8</td><td colspan="1" rowspan="1">45.2</td><td colspan="1" rowspan="1">66.7</td><td colspan="1" rowspan="1">62.0</td><td colspan="1" rowspan="1">45.5</td><td colspan="1" rowspan="1">29.0</td><td colspan="1" rowspan="1">35.0</td><td colspan="1" rowspan="1">43.8</td><td colspan="1" rowspan="1">48.0</td></tr><tr><td colspan="1" rowspan="1">Work</td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td></tr><tr><td colspan="1" rowspan="1">1. Sit/stand (%)</td><td colspan="1" rowspan="1">85.6</td><td colspan="1" rowspan="1">76.4</td><td colspan="1" rowspan="1">79.1</td><td colspan="1" rowspan="1">87.4</td><td colspan="1" rowspan="1">96.4</td><td colspan="1" rowspan="1">85.6</td><td colspan="1" rowspan="1">83.5</td><td colspan="1" rowspan="1">66.7</td><td colspan="1" rowspan="1">66.7</td><td colspan="1" rowspan="1">61.2</td><td colspan="1" rowspan="1">84.8</td><td colspan="1" rowspan="1">95.4</td><td colspan="1" rowspan="1">77.7</td><td colspan="1" rowspan="1">73.3</td></tr><tr><td colspan="1" rowspan="1">2. Walk/active (%)</td><td colspan="1" rowspan="1">14.4</td><td colspan="1" rowspan="1">23.6</td><td colspan="1" rowspan="1">20.9</td><td colspan="1" rowspan="1">12.6</td><td colspan="1" rowspan="1">3.6</td><td colspan="1" rowspan="1">14.4</td><td colspan="1" rowspan="1">16.5</td><td colspan="1" rowspan="1">33.3</td><td colspan="1" rowspan="1">33.3</td><td colspan="1" rowspan="1">38.8</td><td colspan="1" rowspan="1">15.2</td><td colspan="1" rowspan="1">4.6</td><td colspan="1" rowspan="1">22.3</td><td colspan="1" rowspan="1">26.7</td></tr><tr><td colspan="1" rowspan="1">Alcohol (%)</td><td colspan="1" rowspan="1">5.6</td><td colspan="1" rowspan="1">11.2</td><td colspan="1" rowspan="1">19.0</td><td colspan="1" rowspan="1">21.1</td><td colspan="1" rowspan="1">27.2</td><td colspan="1" rowspan="1">18.6</td><td colspan="1" rowspan="1">16.5</td><td colspan="1" rowspan="1">63.5</td><td colspan="1" rowspan="1">51.1</td><td colspan="1" rowspan="1">59.2</td><td colspan="1" rowspan="1">52.9</td><td colspan="1" rowspan="1">59.9</td><td colspan="1" rowspan="1">57.1</td><td colspan="1" rowspan="1">57.2</td></tr><tr><td colspan="1" rowspan="1">Regular tobacco use (%)</td><td colspan="1" rowspan="1">21.2</td><td colspan="1" rowspan="1">26.4</td><td colspan="1" rowspan="1">36.0</td><td colspan="1" rowspan="1">44.3</td><td colspan="1" rowspan="1">53.9</td><td colspan="1" rowspan="1">39.2</td><td colspan="1" rowspan="1">35.4</td><td colspan="1" rowspan="1">62.9</td><td colspan="1" rowspan="1">57.7</td><td colspan="1" rowspan="1">60.6</td><td colspan="1" rowspan="1">48.3</td><td colspan="1" rowspan="1">54.0</td><td colspan="1" rowspan="1">55.7</td><td colspan="1" rowspan="1">57.2</td></tr><tr><td colspan="1" rowspan="1">Smoke cigarettes/pipe (%)</td><td colspan="1" rowspan="1">11.0</td><td colspan="1" rowspan="1">15.8</td><td colspan="1" rowspan="1">17.7</td><td colspan="1" rowspan="1">22.3</td><td colspan="1" rowspan="1">28.0</td><td colspan="1" rowspan="1">20.4</td><td colspan="1" rowspan="1">18.6</td><td colspan="1" rowspan="1">57.1</td><td colspan="1" rowspan="1">51.7</td><td colspan="1" rowspan="1">53.4</td><td colspan="1" rowspan="1">41.3</td><td colspan="1" rowspan="1">46.5</td><td colspan="1" rowspan="1">48.9</td><td colspan="1" rowspan="1">50.4</td></tr><tr><td colspan="1" rowspan="1">Smokeless tobacco (snuff/chew) (%)</td><td colspan="1" rowspan="1">12.9</td><td colspan="1" rowspan="1">20.1</td><td colspan="1" rowspan="1">27.4</td><td colspan="1" rowspan="1">36.7</td><td colspan="1" rowspan="1">48.4</td><td colspan="1" rowspan="1">32.0</td><td colspan="1" rowspan="1">28.1</td><td colspan="1" rowspan="1">1.6</td><td colspan="1" rowspan="1">4.4</td><td colspan="1" rowspan="1">6.8</td><td colspan="1" rowspan="1">7. 4</td><td colspan="1" rowspan="1">11.3</td><td colspan="1" rowspan="1">7. 1</td><td colspan="1" rowspan="1">6.1</td></tr><tr><td colspan="1" rowspan="1">Number of cigarettes used by smokers (SD)</td><td colspan="1" rowspan="1">1.3 (0.9)</td><td colspan="1" rowspan="1">1.5 (1.9)</td><td colspan="1" rowspan="1">2.0 (2.5)</td><td colspan="1" rowspan="1">1.3 (1.0)</td><td colspan="1" rowspan="1">1.7 (2.7)</td><td colspan="1" rowspan="1">1.6 (2.1)</td><td colspan="1" rowspan="1">1.6 (1.9)</td><td colspan="1" rowspan="1">5.5 (3.8)</td><td colspan="1" rowspan="1">6.3 (5.1)</td><td colspan="1" rowspan="1">6.3 (5.8)</td><td colspan="1" rowspan="1">4.5 (6.2)</td><td colspan="1" rowspan="1">3.8 (4.4)</td><td colspan="1" rowspan="1">5.2 (5.2)</td><td colspan="1" rowspan="1">5.5 (5.3)</td></tr><tr><td colspan="1" rowspan="1">Years smoking by smokers (SD)</td><td colspan="1" rowspan="1">6.4 (6.9)</td><td colspan="1" rowspan="1">7. 0 (7.4)</td><td colspan="1" rowspan="1">10.8 (9.6)</td><td colspan="1" rowspan="1">16.4 (13.1)</td><td colspan="1" rowspan="1">21.1 (15.6)</td><td colspan="1" rowspan="1">15.0 (13.6)</td><td colspan="1" rowspan="1">13.1 (12.1)</td><td colspan="1" rowspan="1">14.3 (9.3)</td><td colspan="1" rowspan="1">18.6 (10.6)</td><td colspan="1" rowspan="1">23.4 (10.6)</td><td colspan="1" rowspan="1">27.0 (15.1)</td><td colspan="1" rowspan="1">30.1 (16.3)</td><td colspan="1" rowspan="1">23.3 (13.9)</td><td colspan="1" rowspan="1">21.5 (13.4)</td></tr><tr><td colspan="1" rowspan="1">Age of onset of smoking (SD)</td><td colspan="1" rowspan="1">27.8 (11.8)</td><td colspan="1" rowspan="1">32.8 (8.5)</td><td colspan="1" rowspan="1">36.2 (13.1)</td><td colspan="1" rowspan="1">39.6 (13.9)</td><td colspan="1" rowspan="1">45.3 (18.5)</td><td colspan="1" rowspan="1">39.3 (15.7)</td><td colspan="1" rowspan="1">37.6 (14.1)</td><td colspan="1" rowspan="1">21.7 (5.4)</td><td colspan="1" rowspan="1">22.9 (7.6)</td><td colspan="1" rowspan="1">27.8 (10.4)</td><td colspan="1" rowspan="1">28.1 (13.2)</td><td colspan="1" rowspan="1">33.1 (15.8)</td><td colspan="1" rowspan="1">27.0 (12.0)</td><td colspan="1" rowspan="1">25.8 (11.1)</td></tr></tbody></table></table-wrap><table-wrap id="table3-01.hjr.0000174792.24188.8e" position="float"><label>Table 3</label><caption><p>Chronic diseases risk factors based on measurements [mean (SD)] in rural black population of Limpopo (age-standardized against the world population [<xref ref-type="bibr" rid="bibr21-01.hjr.0000174792.24188.8e">21</xref>])</p></caption><graphic alternate-form-of="table3-01.hjr.0000174792.24188.8e" position="float" xlink:href="10.1097_01.hjr.0000174792.24188.8e-table3.tif" xlink:type="simple"></graphic><table><colgroup span="1"><col align="left" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col></colgroup><thead><tr><td colspan="1" rowspan="1"></td><td colspan="7" rowspan="1">Women</td><td colspan="7" rowspan="1">Men</td></tr><tr><td colspan="1" rowspan="1">Age group (years)</td><td colspan="1" rowspan="1">30–34</td><td colspan="1" rowspan="1">35–44</td><td colspan="1" rowspan="1">45–54</td><td colspan="1" rowspan="1">55–64</td><td colspan="1" rowspan="1">65+</td><td colspan="1" rowspan="1">≥ 30</td><td colspan="1" rowspan="1">Age-standardized</td><td colspan="1" rowspan="1">30–34</td><td colspan="1" rowspan="1">35–44</td><td colspan="1" rowspan="1">45–54</td><td colspan="1" rowspan="1">55–64</td><td colspan="1" rowspan="1">65+</td><td colspan="1" rowspan="1">≥ 30</td><td colspan="1" rowspan="1">Age-standardized</td></tr></thead><tbody><tr><td colspan="1" rowspan="1">Number</td><td colspan="1" rowspan="1">155</td><td colspan="1" rowspan="1">342</td><td colspan="1" rowspan="1">323</td><td colspan="1" rowspan="1">375</td><td colspan="1" rowspan="1">412</td><td colspan="1" rowspan="1">1608</td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1">59</td><td colspan="1" rowspan="1">87</td><td colspan="1" rowspan="1">101</td><td colspan="1" rowspan="1">117</td><td colspan="1" rowspan="1">134</td><td colspan="1" rowspan="1">498</td><td colspan="1" rowspan="1"></td></tr><tr><td colspan="1" rowspan="1">Weight (kg)</td><td colspan="1" rowspan="1">66.3 (15.5)</td><td colspan="1" rowspan="1">69.8 (16.3)</td><td colspan="1" rowspan="1">70.0 (16.7)</td><td colspan="1" rowspan="1">68.1 (15.2)</td><td colspan="1" rowspan="1">62.5 (14.5)</td><td colspan="1" rowspan="1">67.3 (15.9)</td><td colspan="1" rowspan="1">67.9 (16.0)</td><td colspan="1" rowspan="1">61.4 (9.9)</td><td colspan="1" rowspan="1">64.7 (11.9)</td><td colspan="1" rowspan="1">66.7 (15.2)</td><td colspan="1" rowspan="1">66.4 (11.8)</td><td colspan="1" rowspan="1">64.2 (15.5)</td><td colspan="1" rowspan="1">65.0 (13.5)</td><td colspan="1" rowspan="1">64.8 (13.1)</td></tr><tr><td colspan="1" rowspan="1">Height (m)</td><td colspan="1" rowspan="1">1.58 (0.1)</td><td colspan="1" rowspan="1">1.59 (0.1)</td><td colspan="1" rowspan="1">158 (0.1)</td><td colspan="1" rowspan="1">1.56 (0.1)</td><td colspan="1" rowspan="1">1.55 (0.1)</td><td colspan="1" rowspan="1">1.57 (0.1)</td><td colspan="1" rowspan="1">1.58 (0.1)</td><td colspan="1" rowspan="1">1.69 (0.1)</td><td colspan="1" rowspan="1">1.70 (0.1)</td><td colspan="1" rowspan="1">1.67 (0.1)</td><td colspan="1" rowspan="1">1.68 (0.1)</td><td colspan="1" rowspan="1">1.65 (0.1)</td><td colspan="1" rowspan="1">1.67 (0.1)</td><td colspan="1" rowspan="1">1.68 (0.1)</td></tr><tr><td colspan="1" rowspan="1">Waist (cm)</td><td colspan="1" rowspan="1">81.1 (11.5)</td><td colspan="1" rowspan="1">85.4 (13.4)</td><td colspan="1" rowspan="1">88.1 (12.8)</td><td colspan="1" rowspan="1">88.1 (12.9)</td><td colspan="1" rowspan="1">88.2 (11.8)</td><td colspan="1" rowspan="1">86.9 (12.8)</td><td colspan="1" rowspan="1">86.3 (12.9)</td><td colspan="1" rowspan="1">77.7 (8.9)</td><td colspan="1" rowspan="1">81.8 (9.8)</td><td colspan="1" rowspan="1">84.2 (11.8)</td><td colspan="1" rowspan="1">85.6 (10.4)</td><td colspan="1" rowspan="1">85.9 (11.2)</td><td colspan="1" rowspan="1">83.7 (11.0)</td><td colspan="1" rowspan="1">83.0 (10.8)</td></tr><tr><td colspan="1" rowspan="1">BMI</td><td colspan="1" rowspan="1">26.5 (7.0)</td><td colspan="1" rowspan="1">27.6 (6.2)</td><td colspan="1" rowspan="1">27.9 (6.2)</td><td colspan="1" rowspan="1">27.9 (6.0)</td><td colspan="1" rowspan="1">26.0 (6.0)</td><td colspan="1" rowspan="1">27.2 (6.2)</td><td colspan="1" rowspan="1">27.3 (6.3)</td><td colspan="1" rowspan="1">21.5 (3.1)</td><td colspan="1" rowspan="1">22.5 (4.0)</td><td colspan="1" rowspan="1">23.8 (5.1)</td><td colspan="1" rowspan="1">23.8 (4.6)</td><td colspan="1" rowspan="1">23.4 (5.2)</td><td colspan="1" rowspan="1">23.2 (4.7)</td><td colspan="1" rowspan="1">23.0 (4.5)</td></tr><tr><td colspan="1" rowspan="1">WHR</td><td colspan="1" rowspan="1">0.8 (0.1)</td><td colspan="1" rowspan="1">0.8 (0.1)</td><td colspan="1" rowspan="1">0.8 (0.1)</td><td colspan="1" rowspan="1">0.8 (0.1)</td><td colspan="1" rowspan="1">0.9 (0.1)</td><td colspan="1" rowspan="1">0.8 (0.1)</td><td colspan="1" rowspan="1">0.8 (0.1)</td><td colspan="1" rowspan="1">0.8 (0.1)</td><td colspan="1" rowspan="1">0.9 (0.1)</td><td colspan="1" rowspan="1">0.9 (0.1)</td><td colspan="1" rowspan="1">0.9 (0.1)</td><td colspan="1" rowspan="1">0.9 (0.1)</td><td colspan="1" rowspan="1">0.9 (0.1)</td><td colspan="1" rowspan="1">0.9 (0.1)</td></tr><tr><td colspan="1" rowspan="1">Systolic BP (mmHg)</td><td colspan="1" rowspan="1">121.0 (13.4)</td><td colspan="1" rowspan="1">126.1 (16.9)</td><td colspan="1" rowspan="1">133.9 (21.5)</td><td colspan="1" rowspan="1">139.8 (23.3)</td><td colspan="1" rowspan="1">148.8 (25.1)</td><td colspan="1" rowspan="1">136.1 (23.4)</td><td colspan="1" rowspan="1">133.2 (22.2)</td><td colspan="1" rowspan="1">126.1 (13.7)</td><td colspan="1" rowspan="1">128.8 (16.7)</td><td colspan="1" rowspan="1">130.0 (16.7)</td><td colspan="1" rowspan="1">141.2 (24.5)</td><td colspan="1" rowspan="1">140.2 (25.4)</td><td colspan="1" rowspan="1">134.7 (21.8)</td><td colspan="1" rowspan="1">132.7 (20.3)</td></tr><tr><td colspan="1" rowspan="1">Diastolic BP (mmHg)</td><td colspan="1" rowspan="1">79.5 (10.4)</td><td colspan="1" rowspan="1">83.4 (11.1)</td><td colspan="1" rowspan="1">87.4 (12.9)</td><td colspan="1" rowspan="1">88.8 (12.7)</td><td colspan="1" rowspan="1">89.0 (13.1)</td><td colspan="1" rowspan="1">86.5 (12.7)</td><td colspan="1" rowspan="1">85.6 (12.5)</td><td colspan="1" rowspan="1">84.4 (11.8)</td><td colspan="1" rowspan="1">86.0 (13.7)</td><td colspan="1" rowspan="1">86.0 (12.4)</td><td colspan="1" rowspan="1">87.9 (13.7)</td><td colspan="1" rowspan="1">85.8 (12.7)</td><td colspan="1" rowspan="1">86.3 (13.0)</td><td colspan="1" rowspan="1">86.0 (12.9)</td></tr></tbody></table><table-wrap-foot><fn id="table3-fn1-01.hjr.0000174792.24188.8e"><p>BP, Blood pressure; BMI, body mass index (kg/m<sup>2</sup>); WHR, waist/hip ratio.</p></fn></table-wrap-foot></table-wrap><table-wrap id="table4-01.hjr.0000174792.24188.8e" position="float"><label>Table 4</label><caption><p>Prevalence of chronic diseases risk factors in a rural black population of Limpopo (age-standardized to the world population [<xref ref-type="bibr" rid="bibr21-01.hjr.0000174792.24188.8e">21</xref>])</p></caption><graphic alternate-form-of="table4-01.hjr.0000174792.24188.8e" position="float" xlink:href="10.1097_01.hjr.0000174792.24188.8e-table4.tif" xlink:type="simple"></graphic><table><colgroup span="1"><col align="left" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col></colgroup><thead><tr><td colspan="1" rowspan="2">Condition Age group (years)</td><td colspan="1" rowspan="2">Criteria for diagnosis</td><td colspan="1" rowspan="1"></td><td colspan="7" rowspan="1">Women</td><td colspan="7" rowspan="1">Men</td></tr><tr><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1">30–34</td><td colspan="1" rowspan="1">35–44</td><td colspan="1" rowspan="1">45–54</td><td colspan="1" rowspan="1">55–64</td><td colspan="1" rowspan="1">65+</td><td colspan="1" rowspan="1">≥ 30</td><td colspan="1" rowspan="1">Age-standardized</td><td colspan="1" rowspan="1">30–34</td><td colspan="1" rowspan="1">35–44</td><td colspan="1" rowspan="1">45–54</td><td colspan="1" rowspan="1">55–64</td><td colspan="1" rowspan="1">65+</td><td colspan="1" rowspan="1">≥ 30</td><td colspan="1" rowspan="1">Age-standardized</td></tr></thead><tbody><tr><td colspan="1" rowspan="1">Diabetes</td><td colspan="1" rowspan="1">Glucose</td><td colspan="1" rowspan="1">≥ 7.0 mmol/l</td><td colspan="1" rowspan="1">3.3</td><td colspan="1" rowspan="1">4.0</td><td colspan="1" rowspan="1">11.7</td><td colspan="1" rowspan="1">14.3</td><td colspan="1" rowspan="1">12.5</td><td colspan="1" rowspan="1">10.0</td><td colspan="1" rowspan="1">8.8</td><td colspan="1" rowspan="1">2.9</td><td colspan="1" rowspan="1">7.0</td><td colspan="1" rowspan="1">6.3</td><td colspan="1" rowspan="1">12.9</td><td colspan="1" rowspan="1">13.7</td><td colspan="1" rowspan="1">9.9</td><td colspan="1" rowspan="1">8.5</td></tr><tr><td colspan="1" rowspan="1">Alcohol use</td><td colspan="1" rowspan="1">GGT<xref ref-type="table-fn" rid="table4-fn3-01.hjr.0000174792.24188.8e"><sup>∗∗</sup></xref></td><td colspan="1" rowspan="1">>100 U/l</td><td colspan="1" rowspan="1">0.8</td><td colspan="1" rowspan="1">1.9</td><td colspan="1" rowspan="1">5.3</td><td colspan="1" rowspan="1">5.0</td><td colspan="1" rowspan="1">5.6</td><td colspan="1" rowspan="1">4.1</td><td colspan="1" rowspan="1">3.7</td><td colspan="1" rowspan="1">3.2</td><td colspan="1" rowspan="1">13.7</td><td colspan="1" rowspan="1">14.5</td><td colspan="1" rowspan="1">16.7</td><td colspan="1" rowspan="1">21.7</td><td colspan="1" rowspan="1">15.9</td><td colspan="1" rowspan="1">14.3</td></tr><tr><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1">>50 U/l (women) or 80 U/l (men)</td><td colspan="1" rowspan="1">11.8</td><td colspan="1" rowspan="1">9.0</td><td colspan="1" rowspan="1">15.1</td><td colspan="1" rowspan="1">16.6</td><td colspan="1" rowspan="1">17.5</td><td colspan="1" rowspan="1">14.4</td><td colspan="1" rowspan="1">13.5</td><td colspan="1" rowspan="1">3.2</td><td colspan="1" rowspan="1">17.7</td><td colspan="1" rowspan="1">21.0</td><td colspan="1" rowspan="1">22.6</td><td colspan="1" rowspan="1">25.0</td><td colspan="1" rowspan="1">20.3</td><td colspan="1" rowspan="1">18.5</td></tr><tr><td colspan="1" rowspan="1">Liver affected</td><td colspan="1" rowspan="1">ALT<xref ref-type="table-fn" rid="table4-fn3-01.hjr.0000174792.24188.8e"><sup>∗∗</sup></xref></td><td colspan="1" rowspan="1">>80 U/l</td><td colspan="1" rowspan="1">4.4</td><td colspan="1" rowspan="1">1.2</td><td colspan="1" rowspan="1">2.3</td><td colspan="1" rowspan="1">1.0</td><td colspan="1" rowspan="1">0.7</td><td colspan="1" rowspan="1">1.6</td><td colspan="1" rowspan="1">1.8</td><td colspan="1" rowspan="1">3.2</td><td colspan="1" rowspan="1">3.9</td><td colspan="1" rowspan="1">9.5</td><td colspan="1" rowspan="1">8.3</td><td colspan="1" rowspan="1">5.4</td><td colspan="1" rowspan="1">6.5</td><td colspan="1" rowspan="1">6.3</td></tr><tr><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1">>35 U/l (women) or >50 U/l (men)</td><td colspan="1" rowspan="1">45.2</td><td colspan="1" rowspan="1">44.8</td><td colspan="1" rowspan="1">53.1</td><td colspan="1" rowspan="1">60.3</td><td colspan="1" rowspan="1">45.0</td><td colspan="1" rowspan="1">50.5</td><td colspan="1" rowspan="1">49.7</td><td colspan="1" rowspan="1">19.4</td><td colspan="1" rowspan="1">27.5</td><td colspan="1" rowspan="1">34.9</td><td colspan="1" rowspan="1">29.8</td><td colspan="1" rowspan="1">21.7</td><td colspan="1" rowspan="1">27.1</td><td colspan="1" rowspan="1">27.3</td></tr><tr><td colspan="1" rowspan="1">Lipid disorder</td><td colspan="1" rowspan="1">TC<xref ref-type="table-fn" rid="table4-fn2-01.hjr.0000174792.24188.8e"><sup>∗</sup></xref></td><td colspan="1" rowspan="1">>5.0 mmol/l</td><td colspan="1" rowspan="1">16.0</td><td colspan="1" rowspan="1">20.5</td><td colspan="1" rowspan="1">32.2</td><td colspan="1" rowspan="1">39.1</td><td colspan="1" rowspan="1">44.0</td><td colspan="1" rowspan="1">32.4</td><td colspan="1" rowspan="1">29.4</td><td colspan="1" rowspan="1">20.6</td><td colspan="1" rowspan="1">20.0</td><td colspan="1" rowspan="1">26.2</td><td colspan="1" rowspan="1">31.7</td><td colspan="1" rowspan="1">25.5</td><td colspan="1" rowspan="1">25.8</td><td colspan="1" rowspan="1">24.8</td></tr><tr><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1">HDLC</td><td colspan="1" rowspan="1"><1.2 mmol/l</td><td colspan="1" rowspan="1">37.0</td><td colspan="1" rowspan="1">35.0</td><td colspan="1" rowspan="1">37.7</td><td colspan="1" rowspan="1">45.6</td><td colspan="1" rowspan="1">28.4</td><td colspan="1" rowspan="1">36.9</td><td colspan="1" rowspan="1">36.8</td><td colspan="1" rowspan="1">35.5</td><td colspan="1" rowspan="1">41.5</td><td colspan="1" rowspan="1">45.8</td><td colspan="1" rowspan="1">44.6</td><td colspan="1" rowspan="1">41.4</td><td colspan="1" rowspan="1">42.5</td><td colspan="1" rowspan="1">42.0</td></tr><tr><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1">TC/HDLC >5.0</td><td colspan="1" rowspan="1">4.7</td><td colspan="1" rowspan="1">6.9</td><td colspan="1" rowspan="1">14.4</td><td colspan="1" rowspan="1">20.5</td><td colspan="1" rowspan="1">15.5</td></tr><tr><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1">Triglycerides<xref ref-type="table-fn" rid="table4-fn2-01.hjr.0000174792.24188.8e"><sup>∗</sup></xref></td><td colspan="1" rowspan="1">>1.5 mmol/l</td><td colspan="1" rowspan="1">6.8</td><td colspan="1" rowspan="1">8.5</td><td colspan="1" rowspan="1">19.1</td><td colspan="1" rowspan="1">27.3</td><td colspan="1" rowspan="1">30.0</td><td colspan="1" rowspan="1">20.1</td><td colspan="1" rowspan="1">17.3</td><td colspan="1" rowspan="1">11.8</td><td colspan="1" rowspan="1">23.2</td><td colspan="1" rowspan="1">27.0</td><td colspan="1" rowspan="1">31.0</td><td colspan="1" rowspan="1">26.1</td><td colspan="1" rowspan="1">25.5</td><td colspan="1" rowspan="1">24.1</td></tr><tr><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1">LDLC<xref ref-type="table-fn" rid="table4-fn3-01.hjr.0000174792.24188.8e"><sup>∗∗</sup></xref></td><td colspan="1" rowspan="1">>3.0 mmol/l</td><td colspan="1" rowspan="1">30.8</td><td colspan="1" rowspan="1">38.8</td><td colspan="1" rowspan="1">42.5</td><td colspan="1" rowspan="1">49.1</td><td colspan="1" rowspan="1">52.3</td><td colspan="1" rowspan="1">44.5</td><td colspan="1" rowspan="1">42.3</td><td colspan="1" rowspan="1">25.8</td><td colspan="1" rowspan="1">25.0</td><td colspan="1" rowspan="1">30.4</td><td colspan="1" rowspan="1">31.3</td><td colspan="1" rowspan="1">30.1</td><td colspan="1" rowspan="1">29.1</td><td colspan="1" rowspan="1">28.5</td></tr><tr><td colspan="1" rowspan="1">Hypertension</td><td colspan="1" rowspan="1">BP</td><td colspan="1" rowspan="1">>140/90 mmHg</td><td colspan="1" rowspan="1">5.6</td><td colspan="1" rowspan="1">18.1</td><td colspan="1" rowspan="1">23.9</td><td colspan="1" rowspan="1">36.7</td><td colspan="1" rowspan="1">45.4</td><td colspan="1" rowspan="1">29.2</td><td colspan="1" rowspan="1">25.2</td><td colspan="1" rowspan="1">11.5</td><td colspan="1" rowspan="1">12.9</td><td colspan="1" rowspan="1">21.4</td><td colspan="1" rowspan="1">33.9</td><td colspan="1" rowspan="1">31.6</td><td colspan="1" rowspan="1">24.5</td><td colspan="1" rowspan="1">21.6</td></tr><tr><td colspan="1" rowspan="1">Obesity</td><td colspan="1" rowspan="1">BMI kg/m<sup>2∗∗</sup></td><td colspan="1" rowspan="1">≥ 30</td><td colspan="1" rowspan="1">25.8</td><td colspan="1" rowspan="1">31.1</td><td colspan="1" rowspan="1">33.5</td><td colspan="1" rowspan="1">34.6</td><td colspan="1" rowspan="1">21.1</td><td colspan="1" rowspan="1">29.3</td><td colspan="1" rowspan="1">30.0</td><td colspan="1" rowspan="1">1.7</td><td colspan="1" rowspan="1">4.6</td><td colspan="1" rowspan="1">10.9</td><td colspan="1" rowspan="1">11.1</td><td colspan="1" rowspan="1">8.2</td><td colspan="1" rowspan="1">8.0</td><td colspan="1" rowspan="1">7.4</td></tr><tr><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1">≥25 to ≤ 29.9</td><td colspan="1" rowspan="1">22.0</td><td colspan="1" rowspan="1">31.1</td><td colspan="1" rowspan="1">28.3</td><td colspan="1" rowspan="1">30.3</td><td colspan="1" rowspan="1">30.6</td><td colspan="1" rowspan="1">29.4</td><td colspan="1" rowspan="1">28.9</td><td colspan="1" rowspan="1">15.0</td><td colspan="1" rowspan="1">16.1</td><td colspan="1" rowspan="1">22.8</td><td colspan="1" rowspan="1">25.6</td><td colspan="1" rowspan="1">22.2</td><td colspan="1" rowspan="1">21.1</td><td colspan="1" rowspan="1">20.3</td></tr><tr><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1">WHR<xref ref-type="table-fn" rid="table4-fn3-01.hjr.0000174792.24188.8e"><sup>∗∗</sup></xref></td><td colspan="1" rowspan="1">≥ 1.0 men, ≥ 0.8 women</td><td colspan="1" rowspan="1">50.3</td><td colspan="1" rowspan="1">61.6</td><td colspan="1" rowspan="1">71.0</td><td colspan="1" rowspan="1">78.0</td><td colspan="1" rowspan="1">82.9</td><td colspan="1" rowspan="1">72.4</td><td colspan="1" rowspan="1">68.5</td><td colspan="1" rowspan="1">3.2</td><td colspan="1" rowspan="1">1.1</td><td colspan="1" rowspan="1">3.9</td><td colspan="1" rowspan="1">2.5</td><td colspan="1" rowspan="1">7.0</td><td colspan="1" rowspan="1">3.9</td><td colspan="1" rowspan="1">3.4</td></tr><tr><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1">Waist<xref ref-type="table-fn" rid="table4-fn3-01.hjr.0000174792.24188.8e"><sup>∗∗</sup></xref></td><td colspan="1" rowspan="1">≥ 102 cm men; ≥ 88 cm women</td><td colspan="1" rowspan="1">28.2</td><td colspan="1" rowspan="1">39.3</td><td colspan="1" rowspan="1">46.3</td><td colspan="1" rowspan="1">49.2</td><td colspan="1" rowspan="1">49.1</td><td colspan="1" rowspan="1">44.5</td><td colspan="1" rowspan="1">42.7</td><td colspan="1" rowspan="1">3.2</td><td colspan="1" rowspan="1">4.4</td><td colspan="1" rowspan="1">10.7</td><td colspan="1" rowspan="1">6.6</td><td colspan="1" rowspan="1">7. 8</td><td colspan="1" rowspan="1">6.9</td><td colspan="1" rowspan="1">6.7</td></tr><tr><td colspan="1" rowspan="1">Obese</td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td></tr><tr><td colspan="1" rowspan="1">Apple-shaped</td><td colspan="1" rowspan="1">BMI ≥ 30 and waist ≥ 88/102 cm women/men</td><td colspan="1" rowspan="1">19.5</td><td colspan="1" rowspan="1">17.4</td><td colspan="1" rowspan="1">30.2</td><td colspan="1" rowspan="1">30.4</td><td colspan="1" rowspan="1">19.2</td><td colspan="1" rowspan="1">25.7</td><td colspan="1" rowspan="1">26.9</td><td colspan="1" rowspan="1">0</td><td colspan="1" rowspan="1">2.2</td><td colspan="1" rowspan="1">8.7</td><td colspan="1" rowspan="1">3.3</td><td colspan="1" rowspan="1">5.6</td><td colspan="1" rowspan="1">4.4</td><td colspan="1" rowspan="1">5.0</td></tr><tr><td colspan="1" rowspan="1">Pear-shaped</td><td colspan="1" rowspan="1">BMI ≥ 30 and waist <88/102 cm women/men</td><td colspan="1" rowspan="1">5.5</td><td colspan="1" rowspan="1">2.9</td><td colspan="1" rowspan="1">3.1</td><td colspan="1" rowspan="1">3.7</td><td colspan="1" rowspan="1">1.2</td><td colspan="1" rowspan="1">2.9</td><td colspan="1" rowspan="1">3.1</td><td colspan="1" rowspan="1">1.6</td><td colspan="1" rowspan="1">2.2</td><td colspan="1" rowspan="1">1.9</td><td colspan="1" rowspan="1">7.4</td><td colspan="1" rowspan="1">2.1</td><td colspan="1" rowspan="1">3.2</td><td colspan="1" rowspan="1">3.3</td></tr></tbody></table><table-wrap-foot><fn id="table4-fn1-01.hjr.0000174792.24188.8e"><p>ALT, Alanine aminotransferase; BMI, body mass index; GGT, gamma glutamyltransferase; HDLC, high-density lipoprotein-cholesterol; LDLC, low-density lipoprotein-cholesterol; TC, total cholesterol; WHR, waist/hip ratio. Significant difference between men and women, Fisher's exact test;</p></fn><fn id="table4-fn2-01.hjr.0000174792.24188.8e"><p><sup>∗</sup><italic>P</italic><0.05 and</p></fn><fn id="table4-fn3-01.hjr.0000174792.24188.8e"><p><sup>∗∗</sup><italic>P</italic><0.001.</p></fn></table-wrap-foot></table-wrap><table-wrap id="table5-01.hjr.0000174792.24188.8e" position="float"><label>Table 5</label><caption><p>Cardiovascular disease risk factors based on blood values [mean (SD)] and a global cardiovascular disease risk score (%) in a rural black population of Limpopo (age-standardized to the world population [<xref ref-type="bibr" rid="bibr21-01.hjr.0000174792.24188.8e">21</xref>])</p></caption><graphic alternate-form-of="table5-01.hjr.0000174792.24188.8e" position="float" xlink:href="10.1097_01.hjr.0000174792.24188.8e-table5.tif" xlink:type="simple"></graphic><table><colgroup span="1"><col align="left" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col><col align="center" span="1"></col></colgroup><thead><tr><td colspan="1" rowspan="1"></td><td colspan="7" rowspan="1">Women</td><td colspan="7" rowspan="1">Men</td></tr><tr><td colspan="1" rowspan="1">Age group (years)</td><td colspan="1" rowspan="1">30–34</td><td colspan="1" rowspan="1">35–44</td><td colspan="1" rowspan="1">45–54</td><td colspan="1" rowspan="1">55–64</td><td colspan="1" rowspan="1">65+</td><td colspan="1" rowspan="1">≥ 30</td><td colspan="1" rowspan="1">Age-standardized</td><td colspan="1" rowspan="1">30–34</td><td colspan="1" rowspan="1">35–44</td><td colspan="1" rowspan="1">45–54</td><td colspan="1" rowspan="1">55–64</td><td colspan="1" rowspan="1">65+</td><td colspan="1" rowspan="1">≥ 30</td><td colspan="1" rowspan="1">Age-standardized</td></tr></thead><tbody><tr><td colspan="1" rowspan="1">Number</td><td colspan="1" rowspan="1">98</td><td colspan="1" rowspan="1">243</td><td colspan="1" rowspan="1">234</td><td colspan="1" rowspan="1">268</td><td colspan="1" rowspan="1">253</td><td colspan="1" rowspan="1">1096</td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1">31</td><td colspan="1" rowspan="1">47</td><td colspan="1" rowspan="1">55</td><td colspan="1" rowspan="1">77</td><td colspan="1" rowspan="1">85</td><td colspan="1" rowspan="1">295</td><td colspan="1" rowspan="1"></td></tr><tr><td colspan="1" rowspan="1">Glucose (mmol/l)</td><td colspan="1" rowspan="1">4.7 (1.6)</td><td colspan="1" rowspan="1">5.0 (1.9)</td><td colspan="1" rowspan="1">5.9 (3.6)</td><td colspan="1" rowspan="1">5.9 (3.7)</td><td colspan="1" rowspan="1">5.6 (2.6)</td><td colspan="1" rowspan="1">5.5 (3.0)</td><td colspan="1" rowspan="1">5.4 (2.9)</td><td colspan="1" rowspan="1">4.9 (1.1)</td><td colspan="1" rowspan="1">5.2 (1.7)</td><td colspan="1" rowspan="1">4.9 (1.4)</td><td colspan="1" rowspan="1">5.7 (3.2)</td><td colspan="1" rowspan="1">5.5 (2.2)</td><td colspan="1" rowspan="1">5.3 (2.3)</td><td colspan="1" rowspan="1">5.2 (2.0)</td></tr><tr><td colspan="1" rowspan="1">Triglycerides (mmol/l)</td><td colspan="1" rowspan="1">0.9 (0.4)</td><td colspan="1" rowspan="1">1.0 (0.6)</td><td colspan="1" rowspan="1">1.2 (0.6)</td><td colspan="1" rowspan="1">1.3 (0.7)</td><td colspan="1" rowspan="1">1.4 (0.8)</td><td colspan="1" rowspan="1">1.2 (0.7)</td><td colspan="1" rowspan="1">1.1 (0.7)</td><td colspan="1" rowspan="1">1.0 (0.6)</td><td colspan="1" rowspan="1">1.3 (0.9)</td><td colspan="1" rowspan="1">1.4 (1.0)</td><td colspan="1" rowspan="1">1.5 (0.9)</td><td colspan="1" rowspan="1">1.4 (0.7)</td><td colspan="1" rowspan="1">1.3 (0.8)</td><td colspan="1" rowspan="1">1.3 (0.8)</td></tr><tr><td colspan="1" rowspan="1">Cholesterol (mmol/l)</td><td colspan="1" rowspan="1">4.1 (1.0)</td><td colspan="1" rowspan="1">4.4 (1.0)</td><td colspan="1" rowspan="1">4.6 (1.1)</td><td colspan="1" rowspan="1">4.9 (1.2)</td><td colspan="1" rowspan="1">5.0 (1.1)</td><td colspan="1" rowspan="1">4.7 (1.1)</td><td colspan="1" rowspan="1">4.6 (1.1)</td><td colspan="1" rowspan="1">4.2 (1.1)</td><td colspan="1" rowspan="1">4.4 (0.8)</td><td colspan="1" rowspan="1">4.5 (0.9)</td><td colspan="1" rowspan="1">4.7 (1.0)</td><td colspan="1" rowspan="1">4.5 (1.1)</td><td colspan="1" rowspan="1">4.5 (1.0)</td><td colspan="1" rowspan="1">4.4 (1.0)</td></tr><tr><td colspan="1" rowspan="1">LDLC (mmol/l)</td><td colspan="1" rowspan="1">2.6 (0.9)</td><td colspan="1" rowspan="1">2.8 (1.0)</td><td colspan="1" rowspan="1">2.9 (1.0)</td><td colspan="1" rowspan="1">3.1 (1.1)</td><td colspan="1" rowspan="1">3.2 (1.0)</td><td colspan="1" rowspan="1">2.9 (1.0)</td><td colspan="1" rowspan="1">2.9 (1.0)</td><td colspan="1" rowspan="1">2.5 (1.0)</td><td colspan="1" rowspan="1">2.5 (0.7)</td><td colspan="1" rowspan="1">2.7 (0.8)</td><td colspan="1" rowspan="1">2.8 (1.0)</td><td colspan="1" rowspan="1">2.7 (1.1)</td><td colspan="1" rowspan="1">2.7 (1.0)</td><td colspan="1" rowspan="1">2.6 (0.9)</td></tr><tr><td colspan="1" rowspan="1">HDLC (mmol/l)</td><td colspan="1" rowspan="1">1.2 (0.2)</td><td colspan="1" rowspan="1">1.2 (0.2)</td><td colspan="1" rowspan="1">1.2 (0.2)</td><td colspan="1" rowspan="1">1.2 (0.3)</td><td colspan="1" rowspan="1">1.2 (0.2)</td><td colspan="1" rowspan="1">1.2 (0.2)</td><td colspan="1" rowspan="1">1.2 (0.2)</td><td colspan="1" rowspan="1">1.2 (0.3)</td><td colspan="1" rowspan="1">1.2 (0.2)</td><td colspan="1" rowspan="1">1.2 (0.2)</td><td colspan="1" rowspan="1">1.2 (0.2)</td><td colspan="1" rowspan="1">1.2 (0.2)</td><td colspan="1" rowspan="1">1.2 (0.2)</td><td colspan="1" rowspan="1">1.2 (0.2)</td></tr><tr><td colspan="1" rowspan="1">Cholesterol/HDLC ratio</td><td colspan="1" rowspan="1">3.5 (0.9)</td><td colspan="1" rowspan="1">3.7 (1.0)</td><td colspan="1" rowspan="1">3.9 (1.1)</td><td colspan="1" rowspan="1">4.2 (1.1)</td><td colspan="1" rowspan="1">4.1 (1.0)</td><td colspan="1" rowspan="1">4.0 (1.1)</td><td colspan="1" rowspan="1">3.9 (1.1)</td><td colspan="1" rowspan="1">3.5 (0.9)</td><td colspan="1" rowspan="1">3.6 (0.9)</td><td colspan="1" rowspan="1">3.9 (0.9)</td><td colspan="1" rowspan="1">4.1 (1.5)</td><td colspan="1" rowspan="1">4.5 (1.1)</td><td colspan="1" rowspan="1">3.9 (1.1)</td><td colspan="1" rowspan="1">3.8 (1.1)</td></tr><tr><td colspan="1" rowspan="1">ALT (U/l)</td><td colspan="1" rowspan="1">45 (78)</td><td colspan="1" rowspan="1">37 (24)</td><td colspan="1" rowspan="1">41 (27)</td><td colspan="1" rowspan="1">40 (13)</td><td colspan="1" rowspan="1">38 (33)</td><td colspan="1" rowspan="1">39 (34)</td><td colspan="1" rowspan="1">40 (39)</td><td colspan="1" rowspan="1">41 (28)</td><td colspan="1" rowspan="1">47 (31)</td><td colspan="1" rowspan="1">47 (23)</td><td colspan="1" rowspan="1">46 (21)</td><td colspan="1" rowspan="1">53 (82)</td><td colspan="1" rowspan="1">48 (49)</td><td colspan="1" rowspan="1">47 (42)</td></tr><tr><td colspan="1" rowspan="1">GGT (U/l)</td><td colspan="1" rowspan="1">28 (21)</td><td colspan="1" rowspan="1">26 (21)</td><td colspan="1" rowspan="1">39 (73)</td><td colspan="1" rowspan="1">39 (47)</td><td colspan="1" rowspan="1">36 (34)</td><td colspan="1" rowspan="1">35 (46)</td><td colspan="1" rowspan="1">33 (46)</td><td colspan="1" rowspan="1">106 (433)</td><td colspan="1" rowspan="1">61 (54)</td><td colspan="1" rowspan="1">95 (284)</td><td colspan="1" rowspan="1">80 (154)</td><td colspan="1" rowspan="1">84 (133)</td><td colspan="1" rowspan="1">84 (212)</td><td colspan="1" rowspan="1">84 (234)</td></tr><tr><td colspan="1" rowspan="1">Total CVD score [<xref ref-type="bibr" rid="bibr20-01.hjr.0000174792.24188.8e">20</xref>]</td><td colspan="1" rowspan="1">0.01 (0.01)</td><td colspan="1" rowspan="1">0.04 (0.03)</td><td colspan="1" rowspan="1">0.10 (0.08)</td><td colspan="1" rowspan="1">0.17 (0.10)</td><td colspan="1" rowspan="1">0.29 (0.13)</td><td colspan="1" rowspan="1">0.14 (0.13)</td><td colspan="1" rowspan="1">0.11 (0.12)</td><td colspan="1" rowspan="1">0.02 (0.01)</td><td colspan="1" rowspan="1">0.06 (0.03)</td><td colspan="1" rowspan="1">0.13 (0.08)</td><td colspan="1" rowspan="1">0.26 (0.14)</td><td colspan="1" rowspan="1">0.36 (0.14)</td><td colspan="1" rowspan="1">0.21 (0.17)</td><td colspan="1" rowspan="1">0.17 (0.15)</td></tr><tr><td colspan="1" rowspan="1">CVD risk</td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td><td colspan="1" rowspan="1"></td></tr><tr><td colspan="1" rowspan="1"><10%</td><td colspan="1" rowspan="1">100</td><td colspan="1" rowspan="1">95.1</td><td colspan="1" rowspan="1">60.7</td><td colspan="1" rowspan="1">24.6</td><td colspan="1" rowspan="1">4.4</td><td colspan="1" rowspan="1">50.0</td><td colspan="1" rowspan="1">61.7</td><td colspan="1" rowspan="1">100</td><td colspan="1" rowspan="1">85.1</td><td colspan="1" rowspan="1">41.8</td><td colspan="1" rowspan="1">9.1</td><td colspan="1" rowspan="1">2.4</td><td colspan="1" rowspan="1">34.9</td><td colspan="1" rowspan="1">47.7</td></tr><tr><td colspan="1" rowspan="1">10–19.9%</td><td colspan="1" rowspan="1">0</td><td colspan="1" rowspan="1">4.5</td><td colspan="1" rowspan="1">26.9</td><td colspan="1" rowspan="1">44.8</td><td colspan="1" rowspan="1">24.9</td><td colspan="1" rowspan="1">23.5</td><td colspan="1" rowspan="1">19.4</td><td colspan="1" rowspan="1">0</td><td colspan="1" rowspan="1">14.9</td><td colspan="1" rowspan="1">40</td><td colspan="1" rowspan="1">33.8</td><td colspan="1" rowspan="1">8.2</td><td colspan="1" rowspan="1">21.0</td><td colspan="1" rowspan="1">20.2</td></tr><tr><td colspan="1" rowspan="1">≥ 20%</td><td colspan="1" rowspan="1">0</td><td colspan="1" rowspan="1">0.4</td><td colspan="1" rowspan="1">12.4</td><td colspan="1" rowspan="1">30.6</td><td colspan="1" rowspan="1">70.8</td><td colspan="1" rowspan="1">26.6</td><td colspan="1" rowspan="1">18.9</td><td colspan="1" rowspan="1">0</td><td colspan="1" rowspan="1">0</td><td colspan="1" rowspan="1">18.2</td><td colspan="1" rowspan="1">57.1</td><td colspan="1" rowspan="1">89.4</td><td colspan="1" rowspan="1">44.1</td><td colspan="1" rowspan="1">32.1</td></tr></tbody></table><table-wrap-foot><fn id="table5-fn1-01.hjr.0000174792.24188.8e"><p>ALT, Alanine aminotransferase; CVD, cardiovascular disease; GGT, gamma glutamyltransferase; HDLC, high-density lipoprotein-cholesterol; LDLC, low density lipoprotein-cholesterol.</p></fn></table-wrap-foot></table-wrap><p>The total Framingham risk score increases with age in both men and women. Approximately 50% of the women and 33% of the men had less than a 10% chance of having a CVD event in the next 10 years; however, approximately 27% of the women and 44% of the men had more than a 20% chance to have such an event in the next 10 years.</p></sec><sec id="section4-01.hjr.0000174792.24188.8e"><title>Discussion</title><p>Despite the limitations of this study (low response rate, few men), and a caution with regard to generalizing the results, the study is one of only two that have screened for risk factors and chronic diseases in a rural black community in South Africa during the past 20 years [<xref ref-type="bibr" rid="bibr21-01.hjr.0000174792.24188.8e">21</xref>]. These findings suggest that this population has already been developing significant levels of chronic disease risk factors comparable to those found in urban areas of South Africa. Despite living in a rural area under poor socio-economic circumstances approximately a fifth of the women in this community (see <xref ref-type="table" rid="table4-01.hjr.0000174792.24188.8e">Table 4</xref>, age-standardized to the world population) and approximately a third of the men had 20% or more chances to suffer a CVD event in the next 10 years according to the Framingham risk equation [<xref ref-type="bibr" rid="bibr19-01.hjr.0000174792.24188.8e">19</xref>].</p><p>Type 2 diabetes (American Diabetes Association criteria of fasting glucose ≥ 7.0 mmol/l) was found in 8.5% of men and in 8.8% of women (age-standardized against the world population). This prevalence is even higher than that reported earlier by Joffe and Seftel [<xref ref-type="bibr" rid="bibr22-01.hjr.0000174792.24188.8e">22</xref>] and Omar <italic>et al.</italic> [<xref ref-type="bibr" rid="bibr23-01.hjr.0000174792.24188.8e">23</xref>] in urban black people. Levitt <italic>et al.</italic> [<xref ref-type="bibr" rid="bibr24-01.hjr.0000174792.24188.8e">24</xref>] found the prevalence of diabetes (identified by glucose tolerance tests) to be 9.2% in the peri-urban black community of Cape Town. According to Levitt <italic>et al.</italic> [<xref ref-type="bibr" rid="bibr25-01.hjr.0000174792.24188.8e">25</xref>] there is also an association between the degree of urbanization and diabetes. However, the level of diabetes found in this rural study hardly differed from that reported in Cape Town, but was higher than the reported prevalence in Durban of 5.9% (American Diabetes Association criteria) by Omar <italic>et al.</italic> [<xref ref-type="bibr" rid="bibr23-01.hjr.0000174792.24188.8e">23</xref>].</p><p>The prevalence of regular tobacco use in this rural community was higher than that found in the national demographic and health survey (DHS) in the same black community of South Africa in 1998. These women markedly smoked more frequently than the national sample of black women. They also used smokeless tobacco (snuff and chewing tobacco) far more frequently than their black counterparts participating in the national survey [<xref ref-type="bibr" rid="bibr26-01.hjr.0000174792.24188.8e">26</xref>]. The use of smokeless tobacco, such as snuff and chewing tobacco, is widely accepted, and is even considered to have beneficial health effects. These findings highlight the urgent need to address this traditional form of tobacco use in black women, while also protecting them from active industry promotion to adopt the tobacco smoking habit.</p><p>When comparing the BP levels recorded for the different age and sex groups in this study population with those found in the DHS in 1998 [<xref ref-type="bibr" rid="bibr27-01.hjr.0000174792.24188.8e">27</xref>], it can be seen that for each age category the women had higher systolic and diastolic BP levels. This was not the case for men. In the DHS it was found that in the black community only 15% of women and 7% of men with hypertension had a controlled BP less than 140/90 mmHg. Although the level of control of hypertension was not recorded in this study, the high systolic and diastolic BP levels found in these participants suggest that poor BP control was an equally important contributor to the pathology in this poor community.</p><p>Twenty-nine per cent of women in the current study were obese. This is higher than those in the USA (24.7%) and in Canada (15%) (Centers for Disease, Control and Prevention [<xref ref-type="bibr" rid="bibr10-01.hjr.0000174792.24188.8e">10</xref>]). Although approximately 50% of the women were either overweight or obese or had a waist circumference above the usual cutoff point, far more had a WHR suggestive of central obesity (<xref ref-type="table" rid="table4-01.hjr.0000174792.24188.8e">Table 4</xref>). It has previously been shown that central obesity has more adverse health consequences than peripheral obesity [<xref ref-type="bibr" rid="bibr25-01.hjr.0000174792.24188.8e">25</xref>, <xref ref-type="bibr" rid="bibr28-01.hjr.0000174792.24188.8e">28</xref>], as this is associated with hypertension, diabetes, CVD, and stroke that are part of the metabolic syndrome [<xref ref-type="bibr" rid="bibr29-01.hjr.0000174792.24188.8e">29</xref>, <xref ref-type="bibr" rid="bibr30-01.hjr.0000174792.24188.8e">30</xref>].</p><p>The data shown in <xref ref-type="table" rid="table4-01.hjr.0000174792.24188.8e">Table 4</xref> suggest that central obesity (apple-shaped) occurred far more frequently in obese individuals than in those with peripheral obesity (pear-shaped). These high rates may account for the high prevalence of diabetes and hypertension found in this study population.</p><p>The detailed lipid profile for black South Africans is infrequently reported, and this study is only the second one reporting these data for a rural black community. The previously published study was conducted in a rural black community in QwaQwa [<xref ref-type="bibr" rid="bibr21-01.hjr.0000174792.24188.8e">21</xref>]. The levels and prevalence of hypercholesterolaemia found in these rural people in Limpopo are very similar to those reported for the people from QwaQwa. At the time of the publication of the QwaQwa data on hypercholesterolaemia, in 1995, this was an unexpected high risk factor level. As in the past, hypercholesterolaemia was thought to occur infrequently in black individuals, particularly in those from rural settings in Africa. These data in another rural black community confirm that an increase in cholesterol levels is now occurring in more rural black communities.</p><p>Although this study did not include a dietary survey, an earlier study in the same area found that adults still consumed a fairly traditional diet, which is high in carbohydrate and low in fat, yet low in dietary fibre. In addition, the types of food items eaten were not always conducive to a healthy meal plan [<xref ref-type="bibr" rid="bibr31-01.hjr.0000174792.24188.8e">31</xref>].</p><p>The data presented here have highlighted the finding that even rural black people in South Africa have a CVD risk profile that predisposes them to the emergence of atherosclerosis and related chronic diseases. The availability of a complete dataset to calculate the Framingham global CVD risk score among black people is unusual in the South African setting. The data presented here have shown that the health services of the country should start designing intervention strategies aimed at combatting the high levels of CVD risk to prevent the predicted CVD epidemic in South Africa.</p></sec></body><back><ack><p>The authors’ sincere thanks go to all the students, nurses and fieldworkers who assisted with the study. Ms J. Fourie is acknowledged for editing the manuscript.</p></ack><ref-list><title>References</title><ref id="bibr1-01.hjr.0000174792.24188.8e"><citation citation-type="book" xlink:type="simple"><label>1</label><collab xlink:type="simple">World Health Organization</collab>. <source>Consultation on indicators and strategies for iron deficiency and anaemia programmes. 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of South Africa</title></titleInfo><name type="personal"><namePart type="given">Marianne</namePart><namePart type="family">Alberts</namePart><affiliation></affiliation><affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</affiliation><affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</affiliation><affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</affiliation><affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</affiliation><role><roleTerm type="text">author</roleTerm></role><description>Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</description></name><name type="personal"><namePart type="given">Petter</namePart><namePart type="family">Urdal</namePart><affiliation></affiliation><affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</affiliation><affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</affiliation><affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</affiliation><affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</affiliation><role><roleTerm type="text">author</roleTerm></role><description>Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</description></name><name type="personal"><namePart type="given">Krisela</namePart><namePart type="family">Steyn</namePart><affiliation></affiliation><affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</affiliation><affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</affiliation><affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</affiliation><affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</affiliation><role><roleTerm type="text">author</roleTerm></role><description>Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</description></name><name type="personal"><namePart type="given">Inger</namePart><namePart type="family">Stensvold</namePart><affiliation></affiliation><affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</affiliation><affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</affiliation><affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</affiliation><affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</affiliation><role><roleTerm type="text">author</roleTerm></role><description>Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</description></name><name type="personal"><namePart type="given">Aage</namePart><namePart type="family">Tverdal</namePart><affiliation></affiliation><affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</affiliation><affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</affiliation><affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</affiliation><affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</affiliation><role><roleTerm type="text">author</roleTerm></role><description>Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</description></name><name type="personal"><namePart type="given">Johanna H.</namePart><namePart type="family">Nel</namePart><affiliation></affiliation><affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</affiliation><affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</affiliation><affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</affiliation><affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</affiliation><role><roleTerm type="text">author</roleTerm></role><description>Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</description></name><name type="personal"><namePart type="given">Nelia P.</namePart><namePart type="family">Steyn</namePart><affiliation></affiliation><affiliation>aSchool of Health Sciences, University of the North, Private Bag X1106, Sovenga, South Africa</affiliation><affiliation>bDepartment of Clinical Chemistry, Ulleval Hospital, N-0407 Oslo, Norway</affiliation><affiliation>cChronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Cape Town 7505, South Africa</affiliation><affiliation>dNational Board of Health, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>eNational Health Screening Service, The Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo, Norway</affiliation><affiliation>fDepartment of Logistics, University of Stellenbosch, Private Bag X1, Matieland 7602, South Africa.</affiliation><role><roleTerm type="text">author</roleTerm></role><description>Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</description></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>SAGE Publications</publisher><place><placeTerm type="text">Sage UK: London, England</placeTerm></place><dateIssued encoding="w3cdtf">2005</dateIssued><copyrightDate encoding="w3cdtf">2005</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract lang="en">Background To determine the prevalence and associated risk factors of cardiovascular diseases in a rural adult black population from Limpopo Province in South Africa. Design A cross-sectional study. Methods A sample of 1608 women and 498 men aged 30 years and above participated in the study. Sociodemographic data, anthropometric measures (body mass index, waist/hip ratio), blood pressure and biochemical risk factors were measured. A global cardiovascular disease (CVD) risk profile was developed. Results There was a high prevalence of tobacco use for men (57%) and women (35.4%), with women (28.1%) predominantly using smokeless tobacco. Alcohol use was very common in men (57.2%). Women weighed a great deal more than men, and 51.7% were either overweight or obese. Diabetes was diagnosed in 8.8 and 8.5% of women and men, respectively. High-density lipoprotein-cholesterol was relatively high, whereas 42.3% of women and 28.5% of men had low-density lipoprotein-cholesterol levels of 3 mmol/l or more. Hypertension (blood pressure ≥ 140/90 mmHg) was found in 25.5% of women and 21.6% of men. According to the Framingham formulae, 18.9% of women and 32.1% of men had a 20% or higher chance of having a CVD event in the next 10 years. Conclusions There was a high prevalence of chronic disease risk factors in the rural, poor black community in Limpopo, South Africa. Consequently, the population had a higher than expected risk of developing a CVD event in the following 10 years when compared with similar studies in black Africans.</abstract><note type="footnotes">Sponsorship: The Norwegian Universities Committee for Development Research and Education funded the study.</note><subject><genre>keywords</genre><topic>chronic diseases</topic><topic>cross-sectional studies</topic><topic>diabetes mellitus</topic><topic>ethnicity</topic><topic>hyperlipidaemia</topic><topic>hypertension</topic><topic>obesity</topic><topic>risk factors</topic><topic>rural population</topic><topic>tobacco</topic></subject><relatedItem type="host"><titleInfo><title>European journal of preventive cardiology</title></titleInfo><titleInfo type="abbreviated"><title>Eur J Cardiovasc Prev Rehabil</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><identifier type="ISSN">2047-4873</identifier><identifier type="eISSN">2047-4881</identifier><identifier type="PublisherID">CPR</identifier><identifier type="PublisherID-hwp">spcpr</identifier><identifier type="PublisherID-nlm-ta">Eur J Cardiovasc Prev Rehabil</identifier><part><date>2005</date><detail type="volume"><caption>vol.</caption><number>12</number></detail><detail type="issue"><caption>no.</caption><number>4</number></detail><extent unit="pages"><start>347</start><end>354</end></extent></part></relatedItem><identifier type="istex">E6B8B14569ACDE4516A22E2CA1EA131942E83F70</identifier><identifier type="ark">ark:/67375/M70-W1L85N76-L</identifier><identifier type="DOI">10.1097/01.hjr.0000174792.24188.8e</identifier><identifier type="ArticleID">10.1097_01.hjr.0000174792.24188.8e</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2005 European Society of Cardiology</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-0J1N7DQT-B">sage</recordContentSource><recordOrigin>© 2005 European Society of Cardiology</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/document/E6B8B14569ACDE4516A22E2CA1EA131942E83F70/metadata/json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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