South Africans must modify risk factors for heart disease

Commissioned by The Heart and Stroke Foundation SA (HSFSA) and released by the Medical Research Council (MRC), this report was authored by Prof Krisela Steyn from UCT Department of Medicine.

The report highlights the need for prevention and management of heart disease, urging everyone to start early and carry on throughout our lives.

This latest research reveals that while in the past it was thought that suffering from severe stress or being overweight in themselves were high risk factors, it is now known that to assess the true level of risk for heart attacks in someone, the impact of all the risk factors present in that person should be assessed. This means that the risk for a heart attack in a person with modest levels of many risk factors can be higher than the risk in a person who only has one risk factor at a very high level.

This applies equally to all South African races as the research shows that known risk factors are present in all South Africans.

The HSFSA's Challenge Complacency Campaign was launched earlier this year to target the whole population. The campaign aims to make people aware of the early signs and symptoms of risk factors for heart disease, and to assist South Africans to identify possible problems and seek help to prevent serious long-term complications.

According to Shân Biesman-Simons, Director of Nutrition and Education of the Heart and Stroke Foundation South Africa, “It is each person's responsibility to find out what their individual risk for cardiovascular disease is and it is for this reason the Heart and Stroke Foundation South Africa encourages everyone to be screened and to follow a heart healthy lifestyle.”

Professor Derick Raal, Director of Carbohydrate & Lipid Metabolism Research Unit and Professor & Head of the Division of Endocrinology & Metabolism at the University of the Witwatersrand has done extensive research with regard to various cultural groups.

He commented, “With urbanisation, urban stress initially results in hypertension which is presently epidemic in our black population. With ongoing exposure to western lifestyle, obesity and diabetes then become increasingly more prevalent. Finally atherosclerosis, particularly CAD, intervenes.

“Increased access to harmful habits of western societies (smoking and diet rich in saturated fat), together with urban stress, will result in the worst of all cardiovascular worlds. In our black population we, therefore, need to institute prevention from birth to prevent these diseases”.

To assess absolute risk for a heart attack the following are taken into account:
• age
• gender
• smoking status
• blood pressure levels
• diabetes status
• total blood cholesterol

The calculations of absolute risk using the above factors are now available and can easily be done at a clinic, doctor's office or some large retail pharmaceutical outlets.

Early signs of heart disease

Recognising the warning signs and seeking medical treatment could save your life. These following early symptoms, which are important to watch for, would call for a visit to the doctor for a check up:
• Dizzy spells or fainting fits;
• Discomfort following meals, especially if prolonged;
• Shortness of breath, after slight exertion;
• Fatigue without otherwise explained origin;
• Pain or tightness in the chest is a common sign of coronary insufficiency and is usually constrictive in nature and is located behind the chest bone with radiation into the arms or a sense of numbness or a severe pain in the centre of the chest; and
• Palpitations.
Having heart disease, a family history of heart disease or even one or two risk factors that can lead to heart disease (high blood cholesterol, high blood pressure, being overweight, etc.) puts you at risk. It is important to know the “warning signs” of a heart attack or stroke so that you, a friend or a family member know when you are in trouble and what to do.
Be aware of the following, but note that symptoms do vary from person to person:
• Heavy pressure, tightness, crushing pain or unusual discomfort in the centre of the chest, which may:
o feel like indigestion
o spread to shoulders, arms, neck or jaw
o last for more than 15 minutes.
o stop or lessen and then recur;
• Sweating, faintness or shortness of breath;
• A rapid, weak pulse; and
• A ‘sense of impending doom'.
A sharp stabbing pain in the left side of the chest is usually not heart pain.

When one or more of these symptoms are experienced, seek immediate medical attention – medical help is most important in the first few hours. If someone becomes unconscious, call an ambulance immediately.