There is a paucity of data to describe advanced forms of cardiovascular disease (CVD)
in urban black Africans with hypertension (HT).
Chris Hani Baragwanath Hospital services the black African community of 1.1 million
people in Soweto, South Africa. We prospectively collected detailed demographic and
clinical data from all de novo presentations to the hospital's Cardiology Unit in
2006.
Overall, 761 black African patients (56% of de novo cases) presented with a diagnosis
of HT with more women (63%, aged 58.5±14.9 years) than men (aged 58.0±15.6 years).
On presentation, 396 women (82%) versus 187 men (67%) had dizziness, palpitations
and/or chest pain (OR 1.23, 95% 1.12-1.34: p<0.0001). HT was the primary diagnosis
in 266 cases (35%). In the rest (n=495), non-ischaemic forms of heart failure were
common (54% of total) while only 6.2% had coronary artery disease. Concurrent left
ventricular hypertrophy, renal dysfunction and anaemia were present in 39%, 24% and
11% of cases, respectively, with a similar age-adjusted pattern of co-morbidity according
to sex. However, men were more likely to present with impaired systolic function (OR
2.13, 95% CI 1.50 to 3.00; p<0.0001).
In the absence of effective primary and secondary prevention strategies, these unique
data highlight the potentially devastating impact of advanced forms of hypertensive
heart disease in urban black African communities with more women than men affected.
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