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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Risk factors associated with myocardial infarction in Africa: The INTERHEART Africa Study
Circulation, Volume 112, No. 23, Year 2005
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Description
Background - Cardiovascular disease (CVD) is rising in low-income countries. However, the impact of modifiable CVD risk factors on myocardial infarction (MI) has not been studied in sub-Saharan Africa (SSA). Therefore, we conducted a case-control study among patients with acute MI (AMI) in SSA to explore its association with known CVD risk factors. Methods and Results - First-time AMI patients (n=578) were matched to 785 controls by age and sex in 9 SSA countries, with South Africa contributing ≈80% of the participants. The relationships between risk factors and AMI were investigated in the African population and in 3 ethnic subgroups (black, colored, and European/other Africans) and compared with those found in the overall INTERHEART study. Relationships between common CVD risk factors and AMI were found to be similar to those in the overall INTERHEART study. Modeling of 5 risk factors (smoking history, diabetes history, hypertension history, abdominal obesity, and ratio of apolipoprotein B to apolipoprotein A-1) provided a population attributable risk of 89.2% for AMI. The risk for AMI increased with higher income and education in the black African group in contrast to findings in the other African groups. A history of hypertension revealed higher MI risk in the black African group than in the overall INTERHEART group. Conclusions - Known CVD risk factors account for ≈90% of MI observed in African populations, which is consistent with the overall INTERHEART study. Contrasting gradients found in socioeconomic class, risk factor patterns, and AMI risk in the ethnic groups suggest that they are at different stages of the epidemiological transition. © 2005 American Heart Association, Inc.
Authors & Co-Authors
Steyn, Krisela
South Africa, Tygerberg
South African Medical Research Council
Sliwa, Karen S.
South Africa, Johannesburg
Chris Hani Baragwanath Hospital
Hawken, Steven J.
Canada, Hamilton
Hamilton General Hospital
Commerford, Patrick Joseph
South Africa, Observatory
Groote Schuur Hospital
Onen, Churchill Lukwiya
Botswana, Gaborone
Gaborone Private Hospital
Damascene, Albertino
Mozambique, Maputo
Universidade Eduardo Mondlane
Ôunpuu, Stephanie
Canada, Hamilton
Hamilton General Hospital
Yusuf, Salim N.
Canada, Hamilton
Hamilton General Hospital
Statistics
Citations: 397
Authors: 8
Affiliations: 6
Identifiers
Doi:
10.1161/CIRCULATIONAHA.105.563452
ISSN:
00097322
Research Areas
Noncommunicable Diseases
Study Design
Cross Sectional Study
Case-Control Study
Study Locations
South Africa