The 30-year cardiovascular risk profile of South Africans with diagnosed diabetes, undiagnosed diabetes, pre-diabetes or normoglycaemia: the Bellville, South Africa pilot study

Abstract

The aim of this pilot study was to assess the 30-year risk for cardiovascular disease (CVD) in the South Africa population of mixed-ancestry in individuals with non-diabetic hyperglycaemia, and undiagnosed and self-reported diabetes. Participants were drawn from an urban community of the Bellville South suburb of Cape Town. In total, 583 subjects without a history of CVD were eligible for lifetime CVD risk estimation. Gender-specific prediction for CVD risk was calculated using the 30-year CVD interactive risk calculator. High CVD risk (> 20%) was evident in normoglycaemic and younger subjects (under 35 years). The significant predictors of CVD were sibling history of diabetes, and triglyceride, low-density lipoprotein cholesterol and glycated haemoglobin levels (p < 0.001). The high lifetime risk in normoglycaemic and younger subjects may be considered a warning that CVD might take on epidemic proportions in the near future in this country. We recommend the inclusion of education on CVD in school and university curricula.

Fig. 1

Intra-class correlation between BMI and lipiddependent equation for full CVD outcome. Intra-class correlation agreement = 0.920, standard error of measurement 6.4%.

Fig. 2

CVD risk score for men and women in relation to their age.

Fig. 3

Covariance analysis with age as covariate between the subjects with IFG, IGT, newly diagnosed diabetes (undiagnosed DM), self-reported diabetes (known DM) and subjects with normal glucose tolerance (normal). Significant differences between the groups are denoted by the letters, a–d. No significant differences were observed between those with IFG and normal glucose tolerance. Vertical bars denote 0.95 confidence interval.