ABSTRACT
BACKGROUND: There are controversies as to what the traditional risk factors for coronary heart disease should be in sub-Saharan Africa. OBJECTIVE: To assess the relationship between cholesterol and cardiovascular disease risk factors including Helicobacter pylori infection in black Africans with congestive heart failure. METHOD: A cross-sectional and observational study of 48 men and 52 women. RESULTS: Congestive heart failure was associated with abdomal obesity, hypertension, chronic renal failure, moderate levels of low HDL-C, excessive alcohol intake and hyperuricaemia, but low levels of cholesterol and triglycerides. TC was related by Univariate analysis with red cells, glucose, weight, waist circumference with HDL-C, CRP, fibrinogen and IgG antibodies against H pylori. Multivariate analysis revealed that waist circumference (B=0.688) and HDL-C (B=0.826) were the significant determinants of TC. There was a respective U-shaped relationship between CVD (P>0.05), chronic renal failure (P<0.05) H. pylori-induced chronic gastritis (P<0.05) and the HDL-categories. Ischemic stroke and myocardial infarction were significantly (p<0.05) associated with low HDL-C, respectively. Clinical insulin resistance (P<0.01) was predominantly more commonin the intermediate HDL-C category than in low and high HDL-categories. There was an inverse relation between lower TC: HDL-C ratio, high HDL-C and abdominal obesity/ insulin resistance in men. H. pylori gastritis was positively related to higher TC: HDL-C ratio in both men and women. CONCLUSION: Preventive measures, more studies on the interplay between HDL-C level and its function and a specific ethnic dfinition of metabolic syndrome in the African are needed.
