Cardiovascular or heart-related diseases have raced to the top three causes of death in the past two decades, say South African life assurers, who are starting to address the underlying causes.
The increase, said Dr Marion Morkel, chief medical officer at Sanlam, is linked to lifestyle diseases and was magnified by the added mortality burden of the pandemic.
And because of a failure to address the key causes of diseases of lifestyle, “sadly, we’re likely to see these increase in the future”.
Obesity remains a major challenge in our country, with type 2 diabetes linked to this, she told Daily Maverick.
The Heart and Stroke Foundation of South Africa says one in three men will have a cardiac event before they die; for women, this statistic is one in four. Younger women have marginal protection due to their hormones, which decreases when menopause is reached.
Dr Nadia Goolam Amod, senior medical officer at PPS Life Solutions, said CVD encompasses conditions such as heart attacks, strokes and heart failure. Notably, ischaemic heart disease – or coronary heart disease – refers to issues resulting from narrowed coronary arteries that supply blood to the heart muscle.
“This condition stands out as a significant threat to women’s health. Alarmingly, women with ischaemic heart disease face a heightened risk of mortality from acute heart attacks compared with men of a similar age,” she said.
Over the past year, five of the big life assurers have seen CVD in the top three causes of death claims:
• Sanlam: CVD accounted for 22% of all death and funeral claims. It also accounted for 19% of disability claims for men.
• Liberty: CVD made up 23.4% of all lifestyle protection claims. It was the second highest claim condition – beaten only by cancer and ahead of respiratory disorders, strokes and traumatic injuries. It was responsible for 26% of claims for men and 18% for women.
• Momentum Life: Cancer and cardiovascular conditions topped the mortality claims, accounting for 57% of deaths, with significant gender differences observed. Cardiovascular conditions and cancer were responsible for more than half of death claims (57%) in 2023 and were the top two causes of death for both sexes.
• Old Mutual: In 2022, cardiovascular conditions were the second highest reason for claims among men and the top claim category for women. Old Mutual has not yet released its claims stats for 2023.
What South Africans can do about it
A new white paper released by Discovery Vitality emphasises the need to view cardiorespiratory fitness (measured as VO2 max) as an important health risk metric.
Cardiorespiratory fitness refers to how well your respiratory and circulatory systems supply your body with enough oxygen to keep exercising. VO2 max is a measure of the maximum amount of oxygen used by the body during exercise.
As your VO2 max increases, so does your aerobic endurance and ultimately your cardiorespiratory fitness. Cardiorespiratory fitness is a powerful indicator of the potential for a long and healthy life, as even a moderate improvement in VO2 max can reduce the risk of death by 21%-30%.
“The insights from this research on cardiorespiratory fitness help inform the global effort to combat the growing epidemic of physical inactivity and its associated health risks,” said Vitality chief executive officer Dinesh Govender.
“We’re continually exploring ways to incentivise and promote healthier lifestyles among our members, and it’s important that these are backed by research and enabled through the smart use of technology to fit easily into people’s lives.”
Vitality’s white paper on navigating cardio fitness for optimal health outcomes shows that Vitality members with higher cardiorespiratory fitness levels experience 30% lower hospital claims, and exhibit a 95% lower prevalence of obesity, an 84% lower prevalence of high-risk blood glucose levels, and a 70% lower prevalence of high blood pressure.
Those with higher cardio fitness levels also tend to have earlier bedtimes, earlier wake-up times, and longer sleep durations.
“Through (the use of) wearable technology … our members can easily estimate their VO2 max. This cardio fitness measurement serves as a valuable benchmark for overall health,” says Dr Mosima Mabunda, Vitality’s head of wellness.
Aerobic exercise for the win
Jon Patricios, Professor of Sports and Exercise Medicine at Wits University, said the prescription of aerobic-based exercise provides some of the most effective disease prevention strategies and should be a core lifestyle intervention.
See more from MedicalBrief archives:
Chronic diseases on the rise, warns Stats SA
Cardiologists call for help, local research, for Africa’s CVD burden
Pulmonary hypertension death risk high in South Africa – local study