This week marks the final week of Heart Awareness Week, with the global campaign rounding off with World Heart Day on Sunday (29 September).
Since the start of the month Eikestadnuus has featured articles sharing details on Heart Failure (HF) thanks to submissions of the Heart and Stroke Foundation of South Africa (HSFSA). This week, we look at diabetes type 2 and other risk factors for HF.
HF is a common complication of diabetes, with a prevalence of between 9% to 22% in individuals with diabetes, especially in those over 60 years old and increasing incidence rates. The prevalence of diabetes has risen by 30% globally in the past decade, increasing the burden of HF on the health-care system.
HF may develop in individuals with diabetes even without hypertension, coronary heart disease or valvular heart disease, making it a major cardiovascular complication in this vulnerable population. According to the American Diabetes Association, having an glycated hemoglobin A1C of more than 7% was tied to a greater chance of developing later stages of HF.
Each 1% increase in glycated haemoglobin A1c increases the risk of HF by 30% in type 1 diabetes (T1DM) and by 8% in type 2 diabetes (T2DM).
The epidemiologic association between HF and diabetes is well-known, with longitudinal observational studies showing a two- to four-fold increased risk of HF among men and women with diabetes or pre-diabetes compared to those without diabetes. A systematic review by Ohkuma in 2019, with 47 cohorts studies, found that both T1DM and T2DM were significantly higher risk factors for HF in women than men, with T1DM associated with a 47% higher excess risk and T2DM with a 9% higher risk.
Diabetes management may reduce HF incidence and progression, impacting quality of life and life span.
The other risk factors for HF include coronary-artery disease, high-blood pressure, obesity, metabolic syndrome, hyperactive thyroid problems, aging, smoking, alcohol or drug abuse and certain types of radiation and chemotherapy.
Unhealthy behaviours such as eating food that are high in fat, cholesterol and sodium diets, physical inactivity, smoking tobacco and electronic vaping devices and alcohol consumption can increase the risk of HF.
According to the American Heart Association, hypertension, obesity, diabetes and smoking are responsible for 52% of HF incidences. Hypertension control reduces HF risk, with effective treatment reducing HF events.
A meta-analysis by Thomopoulos in 2016, found that controlling blood pressure within normal ranges can result in a 40% reduction in HF.
Men and women both experience HF, but men tend to develop it at a younger age, while women tend to have worse symptoms. Research has found that individuals of African origin have an estimated 19% higher risk of developing HF than those of European origin. Hispanic individuals carry multiple HF risk factors and healthcare disparities, which suggests elevated HF risk in this population.
Shonisani Nephalama, the HSFSA’s nutrition-science team lead, said that healthy eating patterns, including the Mediterranean, whole-grain, and plant-based diets, as well as dietary approaches to stop hypertension (DASH) diets, are inversely associated with incident hypertension and may offer protection against HF.
She also encouraged the public to look out for the foundation’s Heart Mark logo on food products, which is an indication that the HSFSA endorsed the product as being a healthy food choice.
Throughout the month of September, the Foundation’s health-care practitioners have been involved and hosted many activities in community-based settings across the country. They also provided health talks and health risk assessments (HRAs).
The HSFSA emphasised the crucial importance of understanding your risk for cardiovascular diseases. Regular cardiovascular screening is vital to knowing your key health indicators: blood pressure, blood-glucose levels, blood-cholesterol levels and BMI. By monitoring these numbers, you can significantly reduce your chances of developing heart attacks, strokes, and other cardiovascular diseases.
Juandre Watson, the health promotion and health-risk assessment team lead at the foundation, urged all South Africans to know their numbers, be informed about matters relating to their health, and to adopt healthy behaviours
This year, the global theme for World Heart Day is “Use Heart For Action”. It is driven by the World Heart Federation (WHF), of which the HSFSA is a proud member. The theme goes beyond mere awareness, emphasising purposeful efforts to drive meaningful change.
For more information about any HSFSA programme and outreach initiative, visit www.heartfoundation.co.za.
