Social drift of cardiovascular disease risk factors in Africans from the North West province of South Africa: The PURE study

Centre of Excellence for Nutrition (CEN), North-West University, Potchefstroom, South Africa.
Cardiovascular journal of Africa (Impact Factor: 0.85). 01/2012; 23:371–378. DOI: 10.5830/CVJA-2012-018

ABSTRACT Objective: This study examined whether the association
between socio-economic status (SES) and cardiovascular
disease (CVD) risk factors in black South Africans from
the North West Province had shifted from the more affluent
groups with higher SES to the less affluent, lower SES groups
over a period of nine years.
Method: Cross-sectional baseline data of 2 010 urban and
rural subjects (35 years and older) participating in the
Prospective Urban and Rural Epidemiology (PURE) study and collected
in 2005 were analysed to examine the relationship of level of
education, employment and urban or rural residence with
dietary intakes and other CVD risk factors. These relationships
were compared to those found nine years earlier in
the Transition and Health during the Urbanisation of South
Africans (THUSA) study conducted in the same area.
Results: The results showed that urban women had higher
body mass index (BMI), serum triglyceride and fasting
glucose levels compared to rural women and that both urban
men and women had higher blood pressures and followed a
more Westernised diet. However, rural men and women had
higher plasma fibrinogen levels. The more highly educated
subjects (which included both urban and rural subjects)
were younger than those with no or only primary school
education. Few of the risk factors differed significantly
between education groups, except that more highly educated
men and women had lower BMIs, and women had lower
blood pressure and triglyceride levels. These women also
followed a more prudent diet than those with only primary
school education. Employed men and women had higher
BMIs, higher energy intakes but lower plasma fibrinogen
levels, and employed women had lower triglyceride levels.
No significant differences in total serum cholesterol values
were observed.
Conclusion: These results suggest a drift of CVD risk factors
from groups with higher SES to groups with a lower SES
from 1996 to 2005, indicating that interventions to prevent
CVD should also be targeted at Africans living in rural
areas, those with low educational levels, and the unemployed.

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