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)

TY - JOUR

T1 - Cardiovascular Disease Profile of the Oldest Adults in Rural South Africa

T2 - Data from the HAALSI Study (Health and Aging in Africa: Longitudinal Studies of INDEPTH Communities)

AU - Jardim, Thiago Veiga

AU - Witham, Miles D.

AU - Abrahams-Gessel, Shafika

AU - Gómez-Olivé, F. Xavier

AU - Tollman, Stephen

AU - Berkman, Lisa

AU - Gaziano, Thomas A.

N1 - The Divi-sion of Clinical Pharmacology Laboratory at the Universityof Cape Town, South Africa is supported by the NationalInstitute of Allergy and Infectious Diseases, National Insti-tutes of Health under Awards UM1 AI068634, UM1AI068636, UM1 AI106701, and U01 AI0686 32; the EuniceKennedy Shriver National Institute of Child Health andHuman Development; and the National Institute of Me ntalHealth (AI068632). HAALSI, funded by the National Insti-tute on Aging (P01 AG041710), is nested within the Agin-court Health and Demographic Surveillance System site,funded by the University of the Witwatersrand and MedicalResearch Council, South Africa, and the Wellcome Trust,United Kingdom (058893/A/99A; 069683/Z /02/Z; 085477/Z08/Z)

PY - 2018/11/14

Y1 - 2018/11/14

N2 - 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.

AB - 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.

KW - cardiovascular disease

KW - cohort studies

KW - hypertension

KW - sub-Saharan Africa

U2 - 10.1111/jgs.15567

DO - 10.1111/jgs.15567

M3 - Article

C2 - 30312474

SN - 0002-8614

VL - 66

SP - 2151

EP - 2157

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

IS - 11

ER -