High prevalence of metabolic syndrome in the Black population of Cape Town: The Cardiovascular Risk in Black South Africans (CRIBSA) study

To determine the metabolic syndrome prevalence by the 2009 harmonised criteria in 25–74-year-old urban Africans in Cape Town.

In 2008/2009, a representative cross-sectional sample, stratified by age and gender, was randomly selected. Cardiovascular risk factors were determined with questionnaires, clinical measurements and biochemical analyses, including fasting blood samples. Logistic regression analysis assessed the independent effects of socio-demographic variables on metabolic syndrome.

There were 1099 participants, 392 of whom were men and 707 women (response rate 86%). Crude and age-standardised (SEGI) prevalence of metabolic syndrome was 30.7% (95% confidence interval (CI): 27.4–34.1) and 31.7% (95% CI: 28.4–35.3), respectively, with higher rates among women (43.5%, 95% CI: 39.2–47.9 and 44.9%, 95% CI: 40.5–49.3) than men (16.5%, 95% CI: 12.7–21.2 and 17.3%, 95% CI: 13.4–21.9) (p < 0.001). Overall, metabolic syndrome components that were higher in women compared with men were central obesity (86.0% vs. 20.1%) and low high-density lipoprotein cholesterol (75.0% vs. 33.4%) while in men, raised blood pressure (51.4%) was the most frequent. In the multiple logistic models, higher age (55–64 years (peak age) versus 25–34 years: odds ratio (OR): 7.35, 95% CI: 3.27–16.56, p < 0.001) and wealth (highest versus lowest tertile: OR: 1.87, 95% CI: 1.14–3.08, p = 0.014) in women, and higher age (p = 0.002) and employment compared with unemployment (OR: 3.01, 95% CI: 1.18–7.67, p = 0.021) in men were significantly associated with metabolic syndrome.

The high metabolic syndrome prevalence underscores the frequent clustering of cardiovascular risk factors, the need to determine other risk factors, if a single risk factor is present, and the need for comprehensive integrated approaches to tackle cardiovascular disease.