Academic literature on the topic 'Koronêre hartsiektes'

Sedert Friedman en Rosenman in 1959 die begrip van die Tipe A-gedragspatroon (TAG) as potensiële voorspeller van koronêre hartsiektes (KHS) bekendgestel het, is uitgebreide dog teenstrydige navorsingsbevindings oor hierdie onderwerp gerapporteer. In 1981 het die Review Panel on Coronary Prone Behavior and Coronary Heart Disease van die Amerikaanse National Institutes of Health tot die gevolgtrekking gekom dat die verhoogde risiko van KHS as gevolg van TAG hoër is as dié wat onder meer deur rook verteenwoordig word. Die bevindings aangaande TAG as voorspeller van KHS is nie konsekwent deur ander ondersoeke ondersteun nie en gedurende die tagtigerjare het belangstelling in hierdie onderwerp gedaal. Die doel met die onderhawige navorsing was om die rol van die volgende in die voorspelling van KHS-status (pasiënte vs. nie-pasiënte) te ondersoek: TAG, vyandigheid, angs, die modererende uitwerking van emosionele uitdrukkingsvermoë, en die mediërende vs. modererende effek van sigaretrookgedrag op TAG. Ses-en-dertig wit, middeljarige mans wat 'n miokardiale infarksie (MI) binne die voorafgaande 24 maande gehad het sowel as 36 mans met 'n vergelykbare ouderdom, beroep en sosio-ekonomiese agtergrond maar met geen tekens van hartsiektes nie, het vraelyste van TAG, emosionele uitdrukkingsvermoë, vyandigheid en angs voltooi. 'n Diskriminantontleding wat op die persoonlikheidsvraelyste alleen uitgevoer is, het 'n diskriminantfunksie opgelewer wat deur slegs TAG gedefinieer is en wat 56,9% van die proefpersone korrek as óf MI-pasiënt of nie-pasiënt geklassifiseer het. Met die insluiting van gerapporteerde sigaretrookgedrag as bykomende veranderlike, het hierdie veranderlike TAG in die diskriminantfunksie vervang wat 'n persentasie van korrekte klassifikasies van 73,6 opgelewer het. Nóg die interaksie tussen TAG en emosionele uitdrukkingsvermoë, nog dié tussen TAG en gerapporteerde sigaretrookgedrag was beduidend. Die gestandaardiseerde parsiële regressiekoëffisient vir die voorspelling van KHS op grond van sigaretrook was egter 0,46 terwyl dié vir TAG slegs 0,10 was. Hierdie bevinding suggereer dat sigaretrook beskou moet word as 'n mediator, in plaas van 'n moderator, van TAG in die statistiese voorspelling van KHS.

"There are plenty of alternatives in any situation... When you attend a session of group therapy, what on earth are yougoing to see? OpsommingDie konstruk van stres in die lewe van mense met koronere hartsiekte word deur middel van 'n narratiewe benadering heroorweeg. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

People with coronary heart disease have recourse to a palliative intervention such as Coronary Artery Bypass Grafting (CABG). Opsomming Persone met ‘n koronêre hartsiekte is soms genoodsaak om ‘n hartomleiding (CABG), wat ‘n tydelike intervensie ter verligting is, te ondergaan. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

Leisure-time physical inactivity is a global public health concern affecting all people in different walks of life, including employees. This inactivity is associated with chronic diseases of lifestyle as well as low work capacity. The purpose of this study was two-fold: to determine leisure-time physical activity (LTPAI), coronary risk- (CRI), health status (HSI) and lifestyle (LSI) indexes of some executive employees in selected African countries; and to determine the effect of leisure-time physical activity (LTPA) on the coronary risk-, health status- and lifestyle- indexes of some executive employees in selected African countries.A cross-sectional study design was followed on a group of 156 (mean age 41.22±10.17) executive employees. Participants were grouped according to age (<35 years; 36–46 years and > 46 years). Standardized questionnaires were used to collect data. Out of 156 participants in the study, 43% occupied top level management and 57% middle level management positions. When data were analyzed according to age groups, 31% and 69% in the less than 35 years age group were in the top and the middle level management, respectively. In the age group 36 to 46 years of age, 47% were in the top level of management and 52.8% middle level management. With regard to LTPA, top level managers (71.6%) scored low LTPA as compared to middle level managers (62.9%). Top level managers scored higher percentages (14.9%) for developing the risk of coronary heart disease. The results show a negative effect of physical activity on selected health parameters, with significant negative relationships between low LTPA and daily lifestyle index (r= -0.52; p=0.01), and moderate LTPA and daily lifestyle index (r= -0.71; p<0.001) for middle managers. It can be concluded that both top and middle level managers exhibited low LTPA and high risk for developing coronary heart disease. It was apparent that the managers in low LTPA are prone to bad stages of life style, health status and coronary risk- indexes compared to the ones with moderate and high LTPA. Additionally, low and moderate LTPA inversely affected selected health parameters of executive employees. No significant association was found for high LTPA with selected health parameters. The study therefore recommends a strategic intervention programme geared towards improving the present state of affairs among the managers in the corporate environment.
Thesis (MA (Biokinetics))--North-West University, Potchefstroom Campus, 2013.

D.Litt.et Phil. (Psychology)
Cardiovascular disease, and specific disorders associated with this complex disease pattern, has been the subject of numerous investigations to determine the nature and cause of this disturbance in both white and Black population groups in various countries around the world. Although the findings of research into this matter has been directed mainly towards more effective drugs and more advanced surgical techniques, there are numerous indications in literature and current research that certain social and psychological factors might indeed play an important part in the aetiology and nature of cardiovascular diseases. In a developing Third World country such as the Republic of South Africa, with its complex and heterogenous population, evidence derived from past and current research indicates that cardiovascular disease and the consequences of cardiovascular disease are assuming epidemiological proportions among both White and Black South Africans. Against this background, it appeared necessary to establish whether Black patients with cardiovascular disease also showed the type A behaviour pattern which is closely associated with diseases of the cardiovascular system among Whites. The present study was therefore performed to test the hypothesis firstly that cardiovascular disease and the type A behaviour pattern are closely associated in Blacks, and secondly whether factors such as stress, caused by social readjustment and urbanization, as well as anxiety and diet, plays significant role in cardiovascular disease amongst Blacks. Four groups of patients were selected on the basis of the presence or absence of cardiovascular disorders, and the presence or absence of the type A behaviour pattern. All four groups were then subjected to assessment by the Structured Interview, Jenkins Activity Survey, Taylor Manifest Anxiety Scale, Grant's Urban-Rural Scale" the Social Readjustment Rating Scale and a Health Scale to test the hypothesis that basic differences, regarding cardiovascular diseases, existed among people who differ in respect of personality type, social readjustment, the experiencing of anxiety and changing lifestyle due to urbanization and dietary patterns. A prior validation procedure for the assessment devices indicated that the tests demonstrated adequate construct validity and factorial validity. After examining the data of the four groups of patients obtained from the scales, the results were statistically analysed.

M.A. (Psychology)
The health context of South Africa is on the one hand unique in comparison to the rest of the world. On the other hand does it also. show characteristics of both Third World and First World disease patterns. There is a substantial component of the South African health sector that is negatively affected. This can possibly be ascribed to previous health policies. South Africa has unique characteristics concerning the chronic degenerative aspects of the First World disease pattern. White South Africans have the same cardiovascular disease patterns as the rest of the world with the exception that the South African disease patterns has a much larger incidence and degree of seriousness that the rest of the world. Research in the area of the chronic degenerative nature of heart disease and vascular disease is of great importance. It becomes necessary to address degenerative disease and also lifestyle diseases not only medically but also in terms of an individual's lifestyle. The management of an individual's lifestyle will not only have preventive consequences in the South African context, but it can also be utilised in the treat~ent of cardiovascular disease. Research undertaken at the Clinic and Centre for Behavioral Medicine at the Rand Afrikaans University found that the management or treatment of the Type A behavior pattern for the prevention of recurrent cardiovascular diseases were particularly effective. It therefore seems that technology developed elsewhere proves to be effective for the South African context. According to Johnston (1992) two types of risk factors contribute to the development of cardiovascular disease. The first constitute of classical risk factors which include aspects of blood pressure and cholesterol. The second risk factor includes psychological aspects and in particular the Type A behavior pattern and its components. Johnson and Broman (1987) indicate that the components of anger and hostility of the Type A behavior pattern constitute the most important behavioral factor of Type A coronary-prone behavior and cardiovascular disease. Research also indicate that the component of hostility presents a significant predictor of cardiovascular disease (Helmers et al., 1993) . The role of aggression and its components in the Type A behavior pattern was investigated in this study. An attempt was made to establish whether there is a simultaneous reduction in aggression, its components and the Type A behavior pattern and whether certain components of aggression were more important that others. A group of 39 heart patients were investigated on the following indexes: psychological, cardiological and biochemical in order to establish heart disease risk factors in a biopsychosocial context. A modified Type A treatment progranme was administered to this group over a period of twelve weeks at a local heart rehabilitation centre. A second group of 19 patients served as a no-treatment waitinglist control group, but simultaneously underwent an aerobic exercise and cardiovascular counselling programne. The results of this study indicated that cynical hostility was probably the major risk factor of all the components of aggression in the Type A behavior pattern. The second most important component of aggression in the Type A behavior pattern is the expression of anger in general. The latter also corresponds with results found in research on this subj ect. Ov-ert or specific expression of anger .nd the control of anger also contribute to the psychosocial causation of Type A behavior pattern in cardiovascular disease. Comparisons of the experimental and control groups after the intervention showed statistically significant differences of anger expression in general, specific anger expression, inhibition of anger, control of anger, and hostility. It was concluded that significant differences for the diverse components of aggression have been found due to the experimental intervention programme.

The paucity of data concerning the etiology and development of coronary heart disease (CHD) and its risk factors prompted this case-control study. The prevalence of CHD and its accompanying CHD-risk factors among black people from Africa during the twentieth century is covered in the literature review. Differences between developed and developings countries and the possible role of multivariate analyses for the recognition of CHD are addressed. The aims and objectives follow the discussion of the literature review. Between 1982 and 1986 we identified 89 black South African patients with CHD, according to > 2 criteria of the World Health Organization (WHO) for CHD. The diagnosis of underlying coronary artery disease (CAD) was confirmed using coronary angiography, and/or necropsy until 1994. Exercise-radionuclide imaging was also used to confirm manifestations of underlying CHD. A control group of 356 black people living in the same study area and with no evidence of underlying CHD (< 2 WHO criteria or no CHD signs/symptoms along with negative and/or questionable exercise-induced/stress electrocardiography) were also selected. The two study groups were stratified according to age, sex and ethnicity. Using Stata Corp 2001 statistical software release 7, and a multiple logistic regression procedure three models with large surfaces under the Receiver Operator Characteristic (ROC)-curve (0,9331, 0,9350 and 0,9592) were built, for the recognition of CHD in black people. According to the Odds Ratios [95% Confidence Interval] the family history (FH) of myocardial infarction (MI; FHMI): 11,55 [2,63; 50,76]; >Gr II retinopathy (KWB): 8,18 [2,45; 27,26]; left ventricular hypertrophy (LVH): 7,13 [3,08; 16,55]; total cholesterol (TC): 6,4 [2,14; 19,09]; peripheral vascular disease (PVD): 3,72 [1,3; 9,99]; renal target organ damage: 3,41 [1,49; 7,78]; family history of hypertension (FHHT): 2,12 [0,89; 5,01]; and personal history of type 2 diabetes mellitus (NIDDM-II): 2,09 [0,65; 6,57] contributed significantly to the development of CHD in urban black people. From the comparisons between the models it can be concluded that the life-long exposure to lifestyle-related CHD risk factors (hypertension, NIDDM-II and elevated cholesterol levels), which were poorly controlled, along with genetic factors (FHMI and FHHT), lead to the development of CHD and target organ damage. It was accompanied by environmental factors such as poor socio-economic background and extended exposutre to urbanisation. The high prevalence rates of the known CHD risk factors resembled those of African American people with confirmed CHD. The Framingham absolute score for selected risk factor categories gave credibility to the risk factor status of both CHD patients as well as the control group. This is the first South-African study confirming the link between atherosclerotic CHD and the traditional CHD risk factors. A separate substudy using age- and sex-adjusted standardised mortality rates (MR) for CHD (ICDC 410-414) for the total white and black South African populations between 1970 and 1980 revealed a possible changing trend. The decline in white CHD MR in the younger age groups contrasts with those of black people. The observed (O) relative to the expected (E) CHD MR exceeded the 100% mark in the younger age groups. This observation is in agreement with the cumulative incidence rate (3,41) with a 95% confidence interval [2,51; 6,53] of this study relative to the study by Seftel et al. (1965-1968). Shortcomings in the reporting of CHD MR and the datasets, as well as inaccurate vital statistics, provide additional evidence of CHD mortality and morbidity in South African black people. The suggestion of a changing trend remains unsure. The two profiles of CHD in South African black people, 30-40 years apart, form the platform for proposed cardiovascular research in African black people. The study concludes with recommendations leveled at the National Department of Health for the treatment and prevention of CHD in South African black people.
Thesis (MD (Internal Medicine))--University of Pretoria, 2007.
Internal Medicine
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Thesis (MD.(Internal Medicine)--Faculty of Health Sciences)-University of Pretoria, 2004.
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