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The relationship between
cardiovascular risk factors and
knowledge of cardiovascular disease
in African men in the North-West
Province
A Burger; R Pretorius; CMT Fourie; AE Schutte
Background
Main factors that contribute to the development of
hypertension and its complications (WHO, 2013:18).
Background
• South Africa – High prevalence of CVD
• Especially urban areas
• ⅔ Africans – multiple risk factors
• Limited research – relation between CVD
risk factors & knowledge
Background
Aim
To determine the relationship between CV
risk factors and knowledge of CVD in a
group of African men in the North-West
Province.
Method
Method
The Team
1 Registered Nurse
1 Dietician
4 Physiology Assistants
4 Student Nurses
1 Biokineticist
Method
• 118 African men from North-West Province
• Working at Vaalharts Water Scheme
• Questionnaires: General Health; Heart Disease
Knowledge
• Health Screening: Blood glucose; Lipid profile; BP;
BMI
Risk factors (Adapted from ESH/ESC Guidelines (Mancia et al., 2013:1288).
Male sex
Age (men ≥55 years)
Smoking
Total cholesterol > 4.9 mmol/l, and/or
LDL-C > 3 mmol/l and/or
HDL-C < 1 mmol/l (men) and < 1.2 mmol/l (women) and/or
Triglycerides > 1.7 mmol/L
Fasting plasma glucose 5.6–6.9 mmol/L
Obesity [BMI ≥30 kg/m2 (kg/height
2)]
Method – Risk stratification
Results – Risk markers
AGE (years)42.79 ± 0.9
20-30 years
30-40 years
40-50 years
50-60 years
60-70 years
Results – Risk markers
BLOOD PRESSURE (mmHg)
SBP 145.55 ± 22.76DBP 91.54 ±16.25
Normotensive(SBP<=139 mmHgand/or DBP=<89mmHg)
Hypertensive(SBP>139 mmHgand/or DBP>89mmHg)
Results – Risk markers
HT MEDICATION USE
NO
YES
Results – Risk markers
BODY MASS INDEX (kg/m2)
25.92 ± 5.87
Underweight
Optimal
Overweight
Obese
Results – Risk markers
TOTAL CHOLESTEROL (mmol/l)3.82 ± 1.309
<4.9 mmol/l
>=4.9 mmol/l
Results – Risk markers
TRIGLYCERIDES (mmol/l)2.47 ± 1.67
<1.7 mmol/l
>=1.7 mmol/l
Results – Risk markers
LDL-C (mmol/l)1.4 ± 1.12
<3.0 mmol/l
>=3.0 mmol/l
Results – Risk markers
HDL-C (mmol/l)1.22 ± .612
<1.0 mmol/l
>=1.0 mmol/l
Results – Risk markers
FASTING BLOOD GLUCOSE (mmol/l)5.85 ± 1.99
<5.6 mmol/l
>=5.6 mmol/l
Other risk factors,
asymptomatic
organ damage or
disease
Blood pressure (mmHg)
High normal
SBP 130-
139mmHg or
DBP 85-89
mmHg
Stage 1:
Mild
hypertension
SBP140-159
mmHg or DBP
90-99 mmHg
Stage 2:
Moderate
hypertension
SBP 160-179
mmHg or DBP
100-109 mmHg
Stage 3:
Severe
hypertension
SBP > 180 mmHg
or DBP > 110
mmHg
No other RF Low risk Moderate risk High risk
1-2 RF Low risk Moderate risk Moderate to
high risk High risk
≥3 RF
Low to
moderate
risk
Moderate to
high risk High risk High risk
OD, CKD stage 3 or
diabetes
Moderate to
high risk High risk High risk
High to very high
risk
Symptomatic CVD,
CKD stage ≥ 4 or
diabetes with
OD/RFs
Very high
risk
Very high
risk Very high risk Very high risk
Results – Risk stratification
Cardiovascular risk stratification of participant group
according to ESH/ESC Guidelines (2013)
Results –CVD knowledge
Response of the Heart Disease Knowledge
Questionnaire used in this study
Total score = 75.25% = Good CVD knowledge
Results
Table 1 Pearson Correlation Coefficients for the relationship
between CVD knowledge and CV risk factors
CV risk markers r p
Age -0.092 0.320
Body mass index 0.040 0.660
Waist circumference 0.037 0.626
Systolic blood pressure 0.075 0.421
Diastolic blood pressure 0.036 0.700
Results
Table 1. Pearson Correlation Coefficients for the
relationship between CVD knowledge and CV risk factors
Total cholesterol 0.080 0.388
Triglycerides 0.167 0.071
LDL-C 0.024 0.825
HDL-C 0.070 0.453
Blood glucose -0.003 0.970
To conclude…
Despite African men’s high CV risk and a
relatively good understanding of CVD risk factors,
there was no significant correlation between their
CV risk factors and CVD knowledge.
What we recommend…
• Nursing practice• CVD prevention & control
• Nursing education• Create risk awareness and self-efficacy
• Nursing research• Validated questionnaire for SA population
• Effective health intervention programmes
