Men of European descent over the age of 50 are the most vulnerable to the development of atherosclerosis, the most common disorder associated with cardiovascular diseases (CVDs), a new study has found.
According to the recent atherosclerosis study in the South African population – carried out by researchers in the Human Molecular Biology Unit in the School of Biomedical Sciences at the University of the Free State (UFS) – nearly half of men in this group had visible signs of atherosclerosis in the coronary arteries of the heart.
In contrast, roughly one-tenth of the African-descent males and females and more than a third of women of European descent in the same age bracket had visible atherosclerosis in their coronary arteries.
In theory, the study attributed the discrepancy to the socioeconomic status of the two groups.
A senior lecturer in the Human Molecular Biology Unit, Dr Walter Janse van Rensburg, says the study was conceptualised in 2020 during the COVID-19 pandemic due to reports of excessive blood clots associated with both acute COVID-19 infection and some of the SARS-CoV2 vaccines.
In an abstract of the research article, Van Rensburg says there was however limited data in the region regarding the other underlying causes for blood clot formation, such as atherosclerotic plaque rupture.
“The data was collected during a couple of months in 2021,” says Van Rensburg, who is the principal researcher in the study.
The data was collected out of more than 10 000 case files spanning 10 years.
The study is still ongoing.
“Atherosclerosis remains a major risk factor for CVD and thus believed to be a good indicator of the CVD profile in a population, yet little is known on its prevalence in sub-Saharan African populations.
“We aimed to determine the prevalence of atherosclerosis in a diverse South African population as found in post-mortem investigations.
“A retrospective file audit was done on 10 240 forensic post-mortem reports done at a forensic pathology mortuary in South Africa, over 10 years,” says Van Rensburg.
Cardiovascular diseases, according to the study, are reportedly the number one cause of mortality worldwide.
Statistics South Africa recently reported that diseases of the circulatory system account for nearly a fifth of all deaths in South Africa.
“CVD is a multifactorial disorder – however, the presence of atherosclerosis (an inflammatory condition of artery walls) is the most common disorder associated with CVD.
“In order to assist in the prevention of the formation and progression of atherosclerosis, one can manage factors that have been associated with a higher risk for atherosclerosis, such as the use of tobacco, hypertension, elevated cholesterol, obesity, HIV infection and diabetes,” says Van Rensburg.
He says socioeconomic status is possibly one of the essential roleplayers in CVD aetiology.
The socioeconomic inequality in South Africa is well known, with an economic inequality Gini coefficient of 0.63, the highest in the world.
One study reported that in the Free State province, in the non-agricultural sector, the average household income for a European-descent household is roughly 4.35-times higher than the average African-descent household income.
“Therefore, it is postulated that wealthier people, in the South African context, historically people of European descent, have the means to afford and adopt lifestyles that contribute to the increased risk of lifestyle diseases such as obesity, hypercholesterolaemia and diabetes, which are associated with a higher risk to develop CVD.
“We postulate that CVD-related deaths are traditionally lower among South Africans of African descent compared to the other ethnic populations due to the historical socioeconomic discrepancy between people of African descent and other population groups in higher-income countries,” according to the study.
The study also found that the prevalence of CVDs and the incidence of premature CVD-related deaths are steadily increasing in both rural and urban communities and across the socioeconomic spectrum.
The theory of epidemiological transition says in populations with improved living conditions and better access to healthcare, the proportion of deaths caused by infectious diseases will decrease, and the proportion of deaths due to more chronic “man-made” lifestyle-related diseases, such as CVD, will increase.
“However, our population’s socioeconomic status is not the only driving force behind CVD.
“Therefore, we theorise there has been an upward trend in South Africa across all regions to improve the access to better food and better healthcare, consequently resulting in an increase in CVD-related morbidity and mortality statistics.
“For all population groups, males are more affected than females within their demographic group.
“This may also be possibly attributed to the socioeconomic status and access to the healthcare gender-gap differential in the country.”
Van Rensburg says studies of this nature are vital in raising public awareness regarding disorders associated with the lifestyle choices people make.
He however believes a multidisciplinary approach is needed to ultimately create a lasting impact. – Staff Reporter