Cardiovascular journal of South Africa: official journal for Southern Africa Cardiac Society [and] South African Society of Cardiac Practitioners
A rapidly developing 'second-wave epidemic' of cardiovascular disease is flowing ... more A rapidly developing 'second-wave epidemic' of cardiovascular disease is flowing through developing countries and the former socialist republics. It is now evident from World Health Organisation data that coronary heart disease and cerebrovascular disease are increasing so rapidly that they will rank as numbers 1 and 5 respectively as causes of global burden of disease by the year 2020. In spite of the current low prevalence of hypertension in some countries, the total number of hypertensive subjects in the developing world is high, and a cost-analysis of possible antihypertensive drug treatment indicates that developing countries cannot afford the same treatment as developed countries. In the USA only 20% of cases of hypertension are adequately controlled (blood pressure < 140/90 mmHg), and in the developing world the figure falls to 5 - 10%. Black hypertensives have varying responses to antihypertensive therapy. They respond well to thiazide diuretics, calcium channel blockers, vasodilators such as alpha-blockers, hydrazine and reserpine, and poorly to beta-blockers, angiotensin-converting enzyme (ACE) inhibitors and angiotensin II-receptor antagonists unless these drugs are combined with a diuretic. A comprehensive cardiovascular disease (CVD) programme is necessary. There are social, economic and cultural factors that impair control of hypertension in developing countries. Hypertension control should ideally be the initial component of an integrated CVD control programme that needs to be implemented in developing countries. Primary prevention through a population-based lifestyle-linked programme, as well as cost-effective methods of detection and management, are synergistically linked. The existing health care infrastructure needs to be orientated to meet the emerging challenge of CVD, while empowering the community through health education.
An assessment of specific coping styles in rural-urban Africans is done to evaluate its contribut... more An assessment of specific coping styles in rural-urban Africans is done to evaluate its contribution as cardiometabolic risk factor. In total, 608 apparently healthy Africans were included in a cross-sectional comparative study from the North-West Province in South Africa. The adapted and translated COPE Questionnaire classified participants according to their responses into active (AC) or passive (PC) copers. Fasting resting metabolic syndrome (MS) indicators using the WHO definition (glucose, high density lipoproteins, waist/hip ratio, hypertension prevalence, and triglyceride) and associated MS values, i.e. fibrinogen were obtained. The Finapres recorded resting blood pressure continuously. Co-variates for all statistical analyses included age, body mass index (BMI) and lifestyle factors (alcohol consumption, smoking habits and physical activity). The only MS values prevalent in urbanized participants were higher hypertension prevalence rates and fibrinogen (women only) compared to their rural counterparts. Adding coping styles, it was mainly the urbanized AC participants that indicated higher MS values (hypertension prevalence, glucose and fibrinogen) when compared to their rural and PC counterparts. In conclusion, urbanization is associated with enhanced blood pressure and fibrinogen (women) values only. Coping as cardiometabolic risk is accentuated in the urbanized AC group, especially the men. The urbanized AC group with their higher blood pressure values and more MS indicators appears to have behaviorally an AC style but physiologically a dissociated AC style. ß
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, Jan 22, 1986
An indian man presented in 1960 with malignant hypertension. He was treated with guanethidine (Is... more An indian man presented in 1960 with malignant hypertension. He was treated with guanethidine (Ismelin; Ciba), when it was first introduced onto the pharmaceutical market, in combination with other hypotensive agents. Therapeutic compliance was excellent and after 25 years of hypotensive therapy the patient still has a good quality of life.
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, Jan 18, 1989
Hypertension is of importance mainly as a risk factor for heart, brain and kidney disease. To dat... more Hypertension is of importance mainly as a risk factor for heart, brain and kidney disease. To date, efforts have been made to reduce high blood pressure levels rather than to prevent their development, yet primary prevention of hypertension is important. Aspects of nutrition play an important role in the aetiology and non-pharmacological treatment of hypertension, for which the following are recommended: (i) obese hypertensive patients should be encouraged to follow a low-kilojoule diet and to decrease their consumption of saturated fats and cholesterol; (ii) a moderately restricted sodium intake (2 g or 88 mmol/d) should be encouraged in all hypertensives; however, more controlled long-term prospective intervention studies in large populations are necessary to determine the optimal level of dietary intake of salt; (iii) foods rich in potassium should be recommended; and (iv) alcohol intake should be moderate; hypertensives who drink greater than 30-60 ml of ethanol per day need to ...
Complications of hypertension are associated with an estimated 9.4 million deaths worldwide every... more Complications of hypertension are associated with an estimated 9.4 million deaths worldwide every year . In 2008, globally, the overall prevalence of hypertension (including those on medication for high blood pressure) in adults aged 25 and over was around 40% [2]. On average, global population systolic blood pressure decreased slightly between 1980 and 2008 [3, 4], although the worldwide prevalence of obesity has nearly doubled during this period. In 2008, the global prevalence of high cholesterol was 40% and prevalence of diabetes was 10% in adults over 25 years .
Cardiovascular journal of South Africa: official journal for Southern Africa Cardiac Society [and] South African Society of Cardiac Practitioners
A rapidly developing 'second-wave epidemic' of cardiovascular disease is flowing ... more A rapidly developing 'second-wave epidemic' of cardiovascular disease is flowing through developing countries and the former socialist republics. It is now evident from World Health Organisation data that coronary heart disease and cerebrovascular disease are increasing so rapidly that they will rank as numbers 1 and 5 respectively as causes of global burden of disease by the year 2020. In spite of the current low prevalence of hypertension in some countries, the total number of hypertensive subjects in the developing world is high, and a cost-analysis of possible antihypertensive drug treatment indicates that developing countries cannot afford the same treatment as developed countries. In the USA only 20% of cases of hypertension are adequately controlled (blood pressure < 140/90 mmHg), and in the developing world the figure falls to 5 - 10%. Black hypertensives have varying responses to antihypertensive therapy. They respond well to thiazide diuretics, calcium channel blockers, vasodilators such as alpha-blockers, hydrazine and reserpine, and poorly to beta-blockers, angiotensin-converting enzyme (ACE) inhibitors and angiotensin II-receptor antagonists unless these drugs are combined with a diuretic. A comprehensive cardiovascular disease (CVD) programme is necessary. There are social, economic and cultural factors that impair control of hypertension in developing countries. Hypertension control should ideally be the initial component of an integrated CVD control programme that needs to be implemented in developing countries. Primary prevention through a population-based lifestyle-linked programme, as well as cost-effective methods of detection and management, are synergistically linked. The existing health care infrastructure needs to be orientated to meet the emerging challenge of CVD, while empowering the community through health education.
An assessment of specific coping styles in rural-urban Africans is done to evaluate its contribut... more An assessment of specific coping styles in rural-urban Africans is done to evaluate its contribution as cardiometabolic risk factor. In total, 608 apparently healthy Africans were included in a cross-sectional comparative study from the North-West Province in South Africa. The adapted and translated COPE Questionnaire classified participants according to their responses into active (AC) or passive (PC) copers. Fasting resting metabolic syndrome (MS) indicators using the WHO definition (glucose, high density lipoproteins, waist/hip ratio, hypertension prevalence, and triglyceride) and associated MS values, i.e. fibrinogen were obtained. The Finapres recorded resting blood pressure continuously. Co-variates for all statistical analyses included age, body mass index (BMI) and lifestyle factors (alcohol consumption, smoking habits and physical activity). The only MS values prevalent in urbanized participants were higher hypertension prevalence rates and fibrinogen (women only) compared to their rural counterparts. Adding coping styles, it was mainly the urbanized AC participants that indicated higher MS values (hypertension prevalence, glucose and fibrinogen) when compared to their rural and PC counterparts. In conclusion, urbanization is associated with enhanced blood pressure and fibrinogen (women) values only. Coping as cardiometabolic risk is accentuated in the urbanized AC group, especially the men. The urbanized AC group with their higher blood pressure values and more MS indicators appears to have behaviorally an AC style but physiologically a dissociated AC style. ß
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, Jan 22, 1986
An indian man presented in 1960 with malignant hypertension. He was treated with guanethidine (Is... more An indian man presented in 1960 with malignant hypertension. He was treated with guanethidine (Ismelin; Ciba), when it was first introduced onto the pharmaceutical market, in combination with other hypotensive agents. Therapeutic compliance was excellent and after 25 years of hypotensive therapy the patient still has a good quality of life.
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, Jan 18, 1989
Hypertension is of importance mainly as a risk factor for heart, brain and kidney disease. To dat... more Hypertension is of importance mainly as a risk factor for heart, brain and kidney disease. To date, efforts have been made to reduce high blood pressure levels rather than to prevent their development, yet primary prevention of hypertension is important. Aspects of nutrition play an important role in the aetiology and non-pharmacological treatment of hypertension, for which the following are recommended: (i) obese hypertensive patients should be encouraged to follow a low-kilojoule diet and to decrease their consumption of saturated fats and cholesterol; (ii) a moderately restricted sodium intake (2 g or 88 mmol/d) should be encouraged in all hypertensives; however, more controlled long-term prospective intervention studies in large populations are necessary to determine the optimal level of dietary intake of salt; (iii) foods rich in potassium should be recommended; and (iv) alcohol intake should be moderate; hypertensives who drink greater than 30-60 ml of ethanol per day need to ...
Complications of hypertension are associated with an estimated 9.4 million deaths worldwide every... more Complications of hypertension are associated with an estimated 9.4 million deaths worldwide every year . In 2008, globally, the overall prevalence of hypertension (including those on medication for high blood pressure) in adults aged 25 and over was around 40% [2]. On average, global population systolic blood pressure decreased slightly between 1980 and 2008 [3, 4], although the worldwide prevalence of obesity has nearly doubled during this period. In 2008, the global prevalence of high cholesterol was 40% and prevalence of diabetes was 10% in adults over 25 years .
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