Understanding diabetes and heart disease in Africa

  • September 11, 2013

Observational studies are needed to understand the growing burden of cardiovascular disease and diabetes in sub-Saharan Africa, according to a study led by a Gates Cambridge Scholar.

Prospective observational studies are needed to understand the growing burden of cardiovascular disease and diabetes in sub-Saharan Africa, according to a study led by a Gates Cambridge Scholar.

The study, Cardiometabolic Risk in a Rural Ugandan Population, led by Georgina Murphy [2009], is published in the journal Diabetes Care.

It says that few studies of diabetes and cardiovascular disease have been carried out on African populations, leading to an incomplete understanding of their prevalence and distribution.

A better understanding, says the research, could lead to better preventive health policies.

The researchers involved over 8,000 participants living in rural areas of Uganda, all aged 13 and over. Fifty-five per cent were women. Participants were assessed for whether they were at risk of developing diabetes or cardiovascular disease using the Framingham Risk Score (FRS), a gender-specific algorithm used to estimate the 10-year cardiovascular risk of an individual, and metabolic syndrome, for which their are many definitions including the World Health Organization, the International Diabetes Federation, and the newly proposed harmonised definition.

The harmonised definition of metabolic syndrome appeared to be the most sensitive and showed a prevalence of 13.7%. The prevalence of metabolic syndrome increased with age and women had a higher prevalence, possibly linked to higher obesity in women.

However, according to the FRS, men had a higher risk of cardiovascular disease compared to women. The researchers say there were inconsistencies in results using the different measurements of risk and add that this shows the need for prospective observational studies (studies which follow people over time) in sub-Saharan Africa in order to better understand the relationship between such risk measurements and actual disease outcome.

Georgina, who is doing a PhD in Public Health and Primary Care, says: “Cardiometabolic diseases, such as heart disease and diabetes, are rapidly becoming leading causes of illness and death in sub-Saharan Africa. Current methods for identifying individuals who might be at increased risk of cardiometabolic diseases include diagnosing metabolic syndrome, for which there are many definitions, and calculating the Framingham risk score.However, the impact and relevance of such approaches to identify high risk population groups in sub-Saharan African populations is unclear. This study highlight the need for prospective observational studies in sub-Saharan African populations to evaluate and assess the distribution and determinants of cardiometabolic disease risk and to help to inform policy and healthcare programmes in sub-Saharan Africa.”

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