Coronary heart disease (CHD) is still relatively uncommon in the black
population of South Africa. We embarked on a study to determine the p
revalence of risk factors leading to CHD in the black population of Du
rban. The study sample was selected from patients attending a dental c
linic at a hospital. A total of 458 Zulus (age range 16-69 years) were
studied. The prevalence of CHD was 2.4%. The prevalence percentage of
selected risk factors were: hypertension (SBP greater-than-or-equal-t
o 140 mmHg and/or a DBP greater-than-or-equal-to 90 mmHg) was 28%, mal
es 31.9%, females 25.4%; protective levels of high density lipoprotein
cholesterol/total cholesterol (HDLC/TC) (greater-than-or-equal-to 20%
) were 81.3%; diabetes, males 4.9%, females 2.9%; smoking greater-than
-or-equal-to ten cigarettes per day, males 28.1%, females 3.4%; obesit
y, males 3.7%, females 22.6%. We have found the Minnesota Coding Syste
m for ECG changes of CHD and Rose questionnaire to be unreliable for e
liciting CHD in Blacks. Hypercholesterolaemia is less common and this
may explain the low incidence of CHD in Blacks. Epidemics of CHD as se
en in the Indian, 'mixed' and white South Africans can still be preven
ted in the black population but preventive measures must be instituted
rapidly.