Heart Awareness Days

Financially supported by Adcock Ingram/Tigerbrands (Unite 4 Health)

Heart Awareness Days move to Jabulani Mall

On Friday, 2 March 2007, the Heart of Soweto Team had their first Heart Awareness Day at the new Jabulani Mall in Soweto.

The event was again very well attended and about 200 people were screened for body mass index, weight, hip-weight circumference, glucose, cholesterol and microalbuminuria. The focus of the 2007 Heart Awareness Days will be on weight reduction and a healthy diet. The dietician Mrs Sandra Pretorius designed posters with low-glycaemic recipes that are not only tasty but also affordable. Sandra and her colleague Robin gave hourly lectures to an interested audience.

Background

The Heart of Soweto Study is a major study of the emergence of heart disease in Soweto in order to develop new ways to prevent and manage conditions affecting the heart in the future.

It has already uncovered important information about the overall “heart health” of this community.

In 2006, the study moved into the community itself to detect those men and women with heart disease who had not had contact with doctors and nurses at Baragwanath Hospital.

In preparation for the community screening phase of the Heart of Soweto Study, particularly in relation to recruiting volunteers, it is essential to highlight the overall purpose of the study (and its sponsors) and its commitment to the wider community.

On 26 May 2006, Socru marked Heart Awareness Day by bringing the research team, located within the Cardiology Unit at Baragwanath Hospital, to the local people waiting for transport at the taxi ranks/open market opposite the hospital. It is known as one of the busiest taxi ranks in the world and it is used by thousands of people from Soweto each day.

A team of five nurses and supporting medical personnel, including Dr. Lucas Ntyintyane and Professor Karen Sliwa, established a highly visible “heart health station” at this busy transport hub opposite the hospital with the following information clearly highlighted:

The emerging importance of heart disease and the silent but deadly nature of hypertension, high cholesterol and diabetes
The role of the Heart of Soweto Study and Heart Awareness Day in highlighting the need for healthy lifestyles and appropriate risk reduction and treatment

At the “heart health station”, passers-by were offered a free and rapid health review to check the following risk factors for heart disease:

Height and weight (obesity)
Blood lipid profile*
Blood sugar profile*
Age and sex
Blood pressure and heart rate
Clinical or family history of HD

*blood drawn from finger prick

Due to the success of the inaugural Heart Awareness Day, it has become a regular event.

Research Summary

Cardiovascular Screening and Preventative Education in an African Population: Heart Awareness Day in Soweto

Ntyintyane L (1), Tibazarwa K B (1), Stewart S (1+2), Wilkinson D (1+2), Sliwa K (1)

1. Soweto Cardiovascular Research Unit, Chris Hani Baragwanath Hospital, University of Witwatersrand, SA.

2. The University of Queensland, Australia.

Methods

Study Site; Soweto Taxi Rank in Johannesburg, where a fixed monitoring stand was placed. Study population; Includes residents and passers-by of Soweto, the largest black African residential area in South Africa. All adults residing within the catchment area of Chris-Hani Baragwannath Hospital presenting at the screening site were eligible to participate. Measures were put in place to prevent duplication of participants entered.
Study Instruments and Data Collection; Educational pamphlets were distributed to passing members of the public. Log sheets were used to enter measurements of volunteering participants; including clinical history, height, weight, blood pressure, blood glucose, and blood cholesterol.

Results

In total 1355 participants were screened on single screening days conducted at monthly intervals over six months. 62% were female, and the median age 45 years (Inter-Quartile range [IQR] 34-55years). Median BMI was 25.8 kg/m2 (IQR 22.0-29.5) for males, and significantly higher for females (30.8kg/m2 [IQR 26.3-35.9]; p<0.001). 27% (n=246) of those responding to previous history of CVD admitted to having a history of documented hypertension, while 31% (n=338) of those measured were found to have raised blood pressures; 49% of which were apparently newly found diagnoses.

Table 1. Blood Pressure Characteristics of Screened Participants

Risk Factor	Total (N= 1355)		Males (N= 411+)		Females (N= 705+)		p-value
		%	No.	%	No.	%
Age	45 (34-55)	N/A	42 (32-55)	N/A	46 (36-56)	N/A	<0.001
Prior history of documented Hypertension (N=905)	246	27	62	19	180	32	<0.001
Blood pressure:
- Systolic	130 (119-141)	N/A	130 (120-140)	N/A	130 (119-141)	N/A	0.756
- Diastolic	81 (73-90)		80 (71-90)		81 (74-90)		0.063
Raised blood pressure:
- Systolic (>140mmHg)	280	25	96	24	179	26	0.410
- Diastolic (>90mmHg)	237	21	82	20	149	22	0.607
- Both systolic and diastolic	179	16	60	15	115	17	0.426
- At least one raised	338	31	118	29	213	31	0.547
“Newly diagnosed” raised blood pressure (N=905)	146	51*	63	61*	78	44*	-

*Figures represent the percentage of those with raised blood pressure (either systolic or diastolic) that denied prior documentation of hypertension, within each sub-group shown; hence implying these raised values found on screening are newly found.

Comments

Commonly-known risk factors to coronary heart disease and heart failure are not rare in this urban black African population. Second only to obesity as a risk factor to coronary heart disease, hypertension is highly prevalent in this African society. Increased effort is needed to pool private funds with that of the public to enable more effective campaigns to raise awareness on preventable cardiovascular disease in developing communities, and allow more rigorous epidemiologic surveys of CVD risk factors in African societies.