Heart of Soweto Study

The Heart of Soweto Study: a unique study of the emerging causes and consequences of cardiovascular disease in South Africa.

  • Professor Karen Sliwa (MD, PhD, FESC, DTM&H)
  • Professor Simon Stewart (BA, BN, PhD, FCSANZ, FESC, FAHA)
  • Professor David Wilkinson (MBChB, PhD, DSc, FAFPHM, FRACGP)
  • Professor John McMurray (MBChB (Hons), MD, FRCP, FACC, FESC)

A collaborative project between University of the Witwatersrand, Republic of South Africa & The University of Queensland, Australia

Background

Patients at Chris Hani Baragwanath Hospital, Soweto, South Africa.

There is strong evidence to suggest that the Republic of South Africa (RSA) is currently in an epidemiological transition in terms of cardiovascular disease: rheumatic heart disease of the young, although still prevalent, is giving way to hypertension and acute (e.g. myocardial infarction) followed by chronic manifestations (e.g. heart failure) of coronary artery disease in older individuals.

However, we do not know in detail the cardiovascular risk factors and clinical presentations of emergent heart disease in the predominantly black African population (around 1.2 million people) living in Soweto or other similar communities in Africa. Such data are vital for effective prevention and health-care service planning.

The Heart of Soweto Study

The Heart of Soweto Study is a collaborative project, bringing together internationally renowned academics, that will examine the following research questions in relation to the emergence of heart disease in Soweto and other African communities in epidemiological transition:

  1. Have the profound political and socio-economic changes in South Africa negatively impacted on the cardiovascular risk behaviour profile and subsequent incidence of heart disease?
  2. Is an increasing incidence of HIV, compounded by the recent introduction of Anti-Retroviral Therapy, associated with a parallel increase in acute myocardial infarction due to thromboembolic events?
  3. Will culturally specific programmes focused on primary/secondary prevention and chronic disease management initially based at Chris Hani Baragwanath Hospital and extending to nurse-led community centres in Soweto, improve the risk factor profile and cardiac-related outcomes in that community?

Consistent with the research questions listed above, the Heart of Soweto Study comprises three distinct projects that will provide a wealth of information concerning the emergence and consequences of heart disease in an internationally celebrated and renowned community:

  1. A prospective registry of more than 12,000 men and women from Soweto presenting to the Chris Hani Baragwanath Hospital with heart disease (study design published in International Journal of Cardiology, 2006; see PDF).
  2. A case-control study of HIV-positive and negative patients presenting to the Coronary Care Unit with an acute coronary syndrome (PhD project led Dr Anthony Becker).
  3. A randomised controlled study of a multi-disciplinary, community-based, chronic heart failure management programme in Soweto.

The Heart of Soweto Study will provide definitive evidence of the impact of socio-economic changes to the cardiovascular health of this urban African community and develop a community-based programme of health care in response. In the process, the team of internationally renowned investigators will build local research capacity to develop a sustainable programme of research and health service development to minimise the impact of an emerging health problem. The research team envisions that both the process of undertaking the Heart of Soweto Study and its research outcomes will have significant implications for the millions of individuals living in similar urban communities in epidemiological transition throughout South Africa and other parts of the African continent. [Download PDF]

Ruf V, Stewart s, Pretorius S, Kubheka S, Lautenschiager C, Presek P and Sliwa K, Medication adherence, self-care behaviour and knowledge on heart failure in urban South Africa: the Heart of Soweto study. Cardiovascular Journal of Africa. 2010: March/April

Summary graphic of the Heart of Soweto Study. (Download this slide in PDF format; 160kb)

For more details, please contact:

Professor Karen Sliwa

Tel: +27 11 9338197
Fax: +27 11 9388945
Email: Karen.Sliwa-Hahnle@wits.ac.za