A cross-sectional analysis of the association between age and gender and prescribed minimum benefit chronic disease list conditions among South Africans with concomitant hypertension, diabetes and dyslipidaemia

Afr Health Sci. 2017 Mar;17(1):88-98. doi: 10.4314/ahs.v17i1.12.

Abstract

Background: Prescribed Minimum Benefit Chronic Disease List (PMB CDL) conditions are a regulated list of conditions most common to South Africa.

Objectives: To investigate the prevalence and association between PMB CDL conditions and age and gender among patients with concomitant hypertension, diabetes and dyslipidaemia.

Methods: The study population consisted of patients (n = 17 866) with a prescription containing at least one co-prescribed antilipemics, antihypertensive and antidiabetic (identified using the MIMS Desk Reference). ICD-10 codes on claims for PMB CDL conditions were counted.

Results: 39.5% of patients had a PMB CDL condition. Women had higher odds for hypothyroidism (OR 6.30, 95% CI; 5.52, 7.19, p < 0.001) and lower odds for coronary artery disease (CAD) (OR 0.63, 95% CI; 0.55, 0.72, p < 0.001) than men. In combination with hypothyroidism the odds for CAD were reversed and strongly increased; 3.54 (95% CI; 2.38, 5.25, p < 0.001). The odds for females having cardiac failure (CF) was insignificant and low (OR 0.87, 95% CI; 0.75, 1.01, p = 0.063); however combined with hypothyroidism, the odds increased to 5.35 (95% CI; 3.52, 8.13, p < 0.001).

Conclusion: Hypothyroidism was an important discriminating factor for co-morbidity in women with concomitant hypertension, diabetes and dyslipidaemia, in particular with cardiovascular disease.

Keywords: Concomitant hypertension; South Africa; diabetes and dyslipidaemia; prescribed minimum benefit chronic disease list (PMB CDL) conditions.

MeSH terms

  • Age Factors
  • Antihypertensive Agents / therapeutic use
  • Black People*
  • Chronic Disease / epidemiology*
  • Coronary Artery Disease / epidemiology
  • Coronary Artery Disease / ethnology
  • Diabetes Mellitus / epidemiology*
  • Diabetes Mellitus / ethnology
  • Dyslipidemias / epidemiology*
  • Dyslipidemias / ethnology
  • Female
  • Humans
  • Hypertension / epidemiology*
  • Hypertension / ethnology
  • Hypoglycemic Agents / therapeutic use
  • Hypolipidemic Agents / therapeutic use
  • Hypothyroidism / epidemiology
  • Hypothyroidism / ethnology
  • International Classification of Diseases
  • Male
  • Middle Aged
  • Prevalence
  • Sex Factors
  • South Africa / epidemiology

Substances

  • Antihypertensive Agents
  • Hypoglycemic Agents
  • Hypolipidemic Agents