A description of dyslipidaemia and selected risk factors for cardiovascular disease in patients attending Port Elizabeth Hospital Complex

Kotze, Vanessa (2017-03)

Thesis (MNutr)--Stellenbosch University, 2017.

Thesis

ENGLISH SUMMARY : CVD is a global as well as national burden of disease. Aim: To identify and describe dyslipidaemia as well as the selected risk factors for cardiovascular disease in patients diagnosed with dyslipidaemia attending Port Elizabeth Hospital Complex (PEHC). Setting: Port Elizabeth Hospital Complex, Port Elizabeth, South Africa. Sample: Adult patients (18 years of age or above; both sexes; all races) attending PEHC and diagnosed with dyslipidaemia. Convenience sampling was used. Methods: Observational descriptive cross-sectional study in the quantitative domain. Each participant was interviewed, anthropometric measurements taken, and patient files consulted. Variables investigated included lipid profiles, glucose control, a family history of cardiovascular diseases, presence of hypertension (HPT) and diabetes mellitus (DM), android obesity, smoking status, physical activity (PA) levels, and fat (total, saturated and cholesterol) intake. Dietary intake was compared to the therapeutic lifestyle change program. Clinical signs of dyslipidaemia were assessed to detecting familial hypercholesterolaemia (FH). Each referral to the dietetics department was counted. Descriptive statistics were used. Regression analysis and contingency tables were used to analyse relationships between variables. Results: N=103 patients (59% female) with a mean age of 59.9 years were included. Coloured and Caucasian ethnic groups represented the majority (45% and 33% respectively). Hypercholesterolaemia was present in 98%. A third presented with elevated LDLC. Caucasians (50%) presented with decreased HDLC and/or elevated LDLC levels. Africans (80%) presented with decreased HDLC levels whilst 91% of the Indian ethnic group presented with elevated LDLC levels. DM had the lowest frequency in the sample (36%) and 60% presented with hypertension. Android obesity was present in 82% of participants; more females were obese than overweight and vice versa in males. Forty-four percent (44%) had a smoking history; 22% was current smokers. No significant relationship was found between low HDL levels and smoking status. Thirty percent followed a diet in excess of the recommended SFA intake of <7%, whilst the majority had low PA levels. There was a high prevalence of FH (1/34 compared to the national prevalence of 1/70). Only 35% of participants were recently referred to the dietetics department. Conclusion: The CVD risk factors HPT, elevated LDLC levels, smoking, low PA and dietary intake high in SFA were found to be present. Possible FH had a high frequency. Dietitians could be utilised more effectively in managing patients with CVD risk.

AFRIKAANSE OPSOMMING : KVS is a wêreldwye asook nasionale siektelas. Doel: Om dislipidemie sowel as gekose risikofaktore te identifiseer en te beskryf in pasiënte gediagnoseer met dislipidemie en wie Port Elizabeth Hospitaalkompleks (PEHK) besoek. Omgewing: Port Elizabeth Hospitaalkompleks, Port Elizabeth, Suid Afrika Proefsteek: Volwasse pasiënte (18 jaar en ouer; albei geslagte; alle rasse) wat PEHC besoek en gediagnoseer met dislipidemie. Geriefsteekproef was gebruik. Metodes: Waarnemings, beskrywende, deursnee studie in die kwantitatiewe domein is uitgevoer. Elke deelnemer is ʼn onderhoud mee gevoer, antropometriese metings geneem, en pasiënt lêers nagegaan. Die veranderlikes ingesluit was lipied profiele, glukose beheer, 'n familiegeskiedenis van kardiovaskulêre siektes (KVS), teenwoordigheid van hoë bloeddruk en diabetes mellitus (DM), androïde vetsug, rook status, fisiese aktiwiteit (FA) vlakke, en vet (totaal, versadig en cholesterol) inname. Dieet inname is vergelyk met die terapeutiese lewenstyl veranderings program. Kliniese tekens van dislipidemie is ondersoek vir die identifisering van familiële hipercholesterolemie. Elke verwysing na die dieetkunde departement is gereken. Opsommingstatistiek is gebruik om veranderlikes te beskryf. Regressieanalise en gebeurlikheidstabelle gebruik is om verwantskappe tussen veranderlikes te ontleed. Resultate: N=103 pasiënte (59% vroulike) is ingesluit met 'n gemiddelde ouderdom van 59.9jaar. Die Kleurling en Blanke etniese groepe was in die meerderheid (45% en 33% onderskeidelik). Hipercholesterolemie was teenwoordig in 98%. 'n Derde het met verhoogde LDLC voorgedoen. Blankes (50%) het met verlaagde HDLC en/of verlaagde LDLC vlakke vertoon. Afrikane (80%) het met verlaagde HDLC vertoon terwyl 91% van die Indiese etniesegroep met verhoogde LDLC vlakker vertoon het. DM het die laagste frekwensie (36%) in die steekproef gehad en 60% het met hoë bloeddruk voorgedoen. Androïde vetsug was teenwoordig in 82% van die deelnemers; meer vroue was vetsugtig as oorgewig en vice versa vir mans. Vier en veertig persent (44%) het 'n rook geskiedenis gehad; 22% was huidige rokers. Geen beduidende verband is tussen lae HDL-vlakke en rook status gevind nie. Dertig persent het 'n dieet ingeneem wat meer as die aanbevole VVS inname van <7% was, terwyl die meerderheid ook lae PA vlakke gehad het. Daar was 'n hoë voorkoms van FH (1/34 deelnemers vergelyking met die nasionale voorkoms van 1/70). Slegs 35% van die deelnemers was onlangs verwys na die dieetkunde departement. Gevolgtrekking: Die KVS risikofaktore HPT, verhoogde LDLC vlakke, rook, lae FA en „n dieet hoog in VVS was algemeen. Moontlike FH het 'n hoë voorkoms. Dieetkundiges kan meer doeltreffend benut word in die bestuur van pasiënte met KVS risiko.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/101446
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