GGT independently predicted cardiovascular and all-cause mortality, as well as hypertension development in black South Africans. Despite non-specificity to excessive alcohol consumption, GGT may be a useful general marker for hypertension development and mortality, also due to its significant association with self-reported alcohol intake.

Self-reported alcohol use was strongly associated with a 5-year increase in BP in Africans with a low socio-economic status. This was not found for biochemical measures, GGT and %CDT. Self-reported alcohol intake could be an important measure to implement in primary healthcare settings in middle to low income countries, where honest reporting is expected.

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BackgroundSmoking is an important modifiable risk factor for cardiovascular disease, with limited research having been done in Africans. We aimed to determine the association between smoking and measurements of vascular function in Africans and Caucasians.MethodsWe determined anthropometric and cardiovascular variables, serum cotinine and C-reactive protein (CRP) in African and Caucasian participants from South Africa (n = 630).ResultsAfricans had significantly lower body mass index (BMI), higher blood pressure and lower socio-economic status (SES) than Caucasians. Only African smokers showed increased arterial stiffness and a significant correlation between smoking and arterial stiffness. African smokers had increased and Caucasian smokers decreased high-density lipoprotein cholesterol (HDL-C) than the non-smokers. After adjusting for confounders, smoking showed few correlations, mainly with heart rate and CRP. In Africans, smoking also correlated positively with HDL-C, with the opposite result in Caucasians.ConclusionAfrican smokers had significantly increased arterial stiffness, which was not found in Caucasian smokers. Africans generally demonstrated more associations between smoking and cardiovascular dysfunction than Caucasians.