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Sep 19, 2007Article Details
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Main Article Content
Estimating the burden of disease attributable to high cholesterol in South Africa in 2000
Abstract
Objectives. To estimate the burden of disease attributable to high
cholesterol in adults aged 30 years and older in South Africa in
2000.
Design. World Health Organization comparative risk assessment
(CRA) methodology was followed. Small community studies
were used to derive the prevalence by population group.
Population-attributable fractions were calculated and applied
to revised burden of disease estimates for the relevant disease
categories for each population group. The total attributable
burden for South Africa in 2000 was obtained by adding the
burden attributed to high cholesterol for the four population
groups. Monte Carlo simulation-modelling techniques were
used for uncertainty analysis.
Setting. South Africa.
Subjects. Black African, coloured, white and Indian adults aged
30 years and older.
Outcome measures. Mortality and disability-adjusted life years
(DALYs) from ischaemic heart disease (IHD) and ischaemic
stroke.
Results. Overall, about 59% of IHD and 29% of ischaemic stroke
burden in adult males and females (30+ years) were attributable
to high cholesterol (≥ 3.8 mmol/l), with marked variation by
population group. High cholesterol was estimated to have
caused 24 144 deaths (95% uncertainty interval 22 404 - 25 286) or
4.6% (95% uncertainty interval 4.3 - 4.9%) of all deaths in South
Africa in 2000. Since most cholesterol-related cardiovascular
disease events occurred in middle or old age, the loss of life
years comprised a smaller proportion of the total: 222 923
DALYs (95% uncertainty interval 206 712 - 233 460) or 1.4% of
all DALYs (95% uncertainty interval 1.3 - 1.4%) in South Africa
in 2000.
Conclusions. High cholesterol is an important cardiovascular
risk factor in all population groups in South Africa.
South African Medical Journal Vol. 97 (8) Part 2 2007: pp. 708-715
