CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 7, August 2012
374
AFRICA
no significant differences in C-reactive protein (CRP) between
urban and rural groups. Both rural and urban men reported high
alcohol intakes (17.8 and 20.0 g/day, respectively). Women took
less alcohol, but urban women had significantly higher intakes,
namely 9.0 versus 6.6 g/day reported by rural women.
Table 3 shows the mean values of CVD risk factors of men
with different reported education levels, while Table 4 gives the
same data for women. The values of the 21 men and 37 women
who did not answer the questions on education are also shown.
In both men and women, the mean age of those with higher
education (secondary school and/or additional education) was
significantly lower. There were more educated individuals in
the urban areas compared to rural areas. However, 52 men and
136 women residing in rural areas also completed secondary
schooling and/or additional tertiary education.
Tables 3 and 4 further indicate that the serum lipids, glucose
and fibrinogen levels did not differ significantly between subjects
with different levels of education. In men there were also no
differences in blood pressure, but women with higher education
had significantly lower systolic and diastolic blood pressures.
These women also had lower serum triglyceride levels.
The BMI of men and women were significantly higher
in those subjects who had primary and secondary schooling
compared to those without any schooling. The same pattern
was observed in the dietary intakes, with sustained increases
in energy, fat and protein intake and decreases in carbohydrate
intake in men and women with primary education compared to
those with no education. This change to a more Westernised
diet was sustained in men with secondary education. However,
women with secondary education reported a more prudent diet
with lower energy, protein and alcohol intakes than those with
primary education.
TABLE 2. MEAN (95% CI) CARDIOVASCULAR DISEASE RISK FACTORS (EXCLUDING DIET) OF URBANAND RURAL SUBJECTS
Risk factor (means and 95% CI)
Men
Women
Urban
Rural
Urban
Rural
Number (
n
)
399
347
605
659
Age (years)
50.4 (49. 3–51.6)
49.4 (48.3 – 50.6)
50.8 (49.8–51.7)
a
47.5 (46.7–48.3)
a
High-density lipoprotein cholesterol (mmol/l)
1.62 (1.55–1.69)
1.54 (1.47–1.61)
1.46 (1.40–1.51)
1.51 (1.46–1.56)
Total cholesterol (mmol/l)
4.88 (4.73–5.02)
4.72 (4.58–4.87)
5.20 (5.07–5.32)
5.11 (5.0–5.22)
Fasting glucose (mmol/l)
4.93 (4.76–5.10)
4.81 (4.64–4.99)
5.19 (5.04–5.33)
a
4.94 (4.80–5.07)
a
Triglyceride (mmol/l)
1.27 (1.18–1.36)
1.15 (1.06–1.24)
1.47 (1.40–1.53)
a
1.25 (1.19–1.31)
a
Systolic blood pressure (mmHg)
137.5 (134.0–140.0)
a
132.2 (129.6–134.7)
a
136.7 (134.5–138.8)
b
127.8 (125.8–129.7)
b
Diastolic blood pressure (mmHg)
87.9 (86.4–89.5)
a
84.9 (83.3–86.5)
a
89.5 (88.2–90.8)
b
86.4 (85.3–87.5)
b
Body mass index (kg/m²)
20.9 (20.5–21.4)
20.7 (20.2–21.1)
27.8 (27.2–28.5)
a
25.9 (25.4–26.5)
a
Fibrinogen (g/l)
3.17 (2.95–3.39)
a
3.50 (3.28–3.73)
a
3.74 (3.55–3.93)
b
4.04 (3.87–4.21)
b
C-reactive protein (mg/l)
7.87 (6.50–9.23)
8.56 (7.10–10.0)
9.17 (8.18–10.16)
8.09 (7.14–9.04)
Alcohol consumption g/day
17.8 (15.0–20.7)
20.0 (117.0–23.1)
9.0 (7.3–10.5)
b
6.6 (5.0–8.1)
b
a,b
Means with the same symbol differ significantly (
p
<
0.05); significant differences based on GLM, analysis of variance (ANOVA).
TABLE 3. MEAN (95% CI) OF SELECTED CARDIOVASCULAR DISEASE RISK FACTORS
IN MENWITH DIFFERENT EDUCATION LEVELS
Risk factor: mean (95% CI)
Not answered
None
Primary
Secondary school and higher
Number of subjects
21
270
297
158
Age in years
48.2 (43.3–53.0)
52.5 (51.2–53.9)
49.4 (48.0–50.7)
45.5 (43.7–47.3)*
Number of urban subjects
9
90
194
106
Number of rural subjects
12
180
103
52
High-density lipoprotein cholesterol (mmol/l)
1.42 (1.11–1.74)
1.68 (1.56–1.73)
1.54 (1.45–1.62)
1.58 (1.46–1.70)
Total cholesterol (mmol/l)
4.62 (3.98–5.25)
4.78 (4.60–4.96)
4.79 (4.62–4.97)
4.89 (4.66–5.13)
Fasting glucose (mmol/l)
4.77 (4.00–5.54)
4.78 (4.56–4.99)
4.93 (4.72–5.15)
4.84 (4.55–5.12)
Triglyceride (mmol/l)
1.15 (0.76–1.54)
1.14 (1.03–1.25)
1.25 (1.14–1.35)
1.27 (1.2–1.41)
C-reactive protein (mg/l)
9.55 (3.73–15.37)
9.30 (7.66–10.94)
8.23 (6.65–9.81)
6.02 (3.88–8.17)
Systolic blood pressure (mmHg)
132.1 (121.2–143.0)
132.9 (29.9–136.0)
136.7 (133.6–139.7)
133.5 (129.4–137.5)
Diastolic blood pressure (mmHg)
86.9 (80.1–93.8)
84.4 (82.4–86.3)
87.4 (85.5–89.3)
86.7 (84.1–89.2)
Body mass index (kg/m²)
22.5 (20.6–24.3)
20.0 (19.5–20.5)
21.0 (20.5–21.6)
21.7 (21.0–22.4)*
Fibrinogen (g/l)
3.14 (2.16–4.11)
3.65 (3.78–3.92)
3.17 (2.90–3.44)
3.05 (2.65–3.41)
Total energy (TE) (KJ)
7963 (625–9667)
7626 (7141–8112)
9015 (8555–9474)
9390 (8676–10105)*
Total fat (g) (% of TE)
49.4 (23.6%)
40.7 (20.3%)
52.9 (22.3%)
60.4 (24.4%)*
Total protein (g) (% of TE)
53.9 (11.5%)
51.6 (11.5%)
63.4 (12.0%)
67.9 (12.3%)*
Total carbohydrates (g) (% of TE)
282.3 (60.3%)
273.9 (61.6%)
315.2 (59.4%)
307.7 (55.7%)*
Total fibre (g)
20.0 (15.1–25.0)
20.4 (19.0–21.8)
24.7 (23.3–26.0)
23.4 (21.4–25.4)*
Alcohol consumption (g/day)
12.1 (–0.01–24.3)
17.7 (14.2–21.1)
18.8 (15.5–22.1)
22.0 (17.5–26.5)
*Significant difference across different education levels (
p
<
0.05); significance differences based on GLM, analysis of variance (ANOVA).
