Cardiovascular Disease Profile of the Oldest Adults in Rural South Africa: Data from the HAALSI Study (Health and Aging in Africa: Longitudinal Studies of INDEPTH Communities)

Thiago Veiga Jardim, Miles D. Witham, Shafika Abrahams-Gessel, F. Xavier Gómez-Olivé, Stephen Tollman, Lisa Berkman, Thomas A. Gaziano (Lead / Corresponding author)

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Abstract

Objectives: To characterize the cardiovascular disease (CVD) profile of individuals aged 80 and older in rural South Africa.

Design: First wave of population-based longitudinal cohort.

Setting: Agincourt subdistrict (Mpumalanga Province) in rural South Africa.

Participants: Adults residents (N = 5,059).

Measurements: In-person interviews were conducted to obtain social, behavioral, economic, and clinical data. Prevalence of hypertension, diabetes, dyslipidemia, high waist-to-hip ratio, overweight and obesity, high-risk high-sensitivity C-reactive protein, smoking, stroke, myocardial infarction, angina pectoris, and heart failure in individuals younger than 65, aged 65 to 79, and aged 80 and older were compared. Associations between self-reported treatments and determinants of hypertension treatment in those aged 80 and older were assessed using multivariable regression.

Results: Of 5,059 individuals included, 549 (10.8%) were aged 80 and older, and their CVD prevalence was 17.9% (stroke 3.8%, myocardial infarction 0.5%, angina pectoris 13.5%, heart failure 0.7%). Hypertension prevalence in this group was 73.8%, and along with angina pectoris, it increased with age (p<.001), whereas overweight and obesity (46.4%), dyslipidemia (39.1%), and smoking prevalences (3.1%) decreased (p<.001). Hypertension treatment was significantly associated with being aged 80 and older (odds ratio (OR)=1.48; 95% confidence interval (CI)=1.14-1.92, p=.003). Male sex (OR=0.73, 95% CI=0.66-0.88, p=.001), being an immigrant (OR=0.80, 95% CI=0.65-0.98; p=.03), higher socioeconomic status (OR=1.28, 95% CI=1.06-1.53, p=.009), and higher depression score (OR=1.12, 95% CI=1.05-1.19, p<.001) were associated with hypertension treatment in those aged 80 and older.

Conclusion: This is the first study to characterize the CVD profile of individuals aged 80 and older in sub-Saharan Africa and provides baseline data for comparison with future studies in this rapidly growing age group.

Original languageEnglish
Pages (from-to)2151-2157
Number of pages7
JournalJournal of the American Geriatrics Society
Volume66
Issue number11
Early online date12 Oct 2018
DOIs
Publication statusPublished - 14 Nov 2018

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Keywords

  • cardiovascular disease
  • cohort studies
  • hypertension
  • sub-Saharan Africa

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