Determination of the prevalence of cardiovascular risk factors in adults has been conducted in several parts of the world; however, few studies were performed in African populations and to our knowledge, there have been no studies conducted in Angola. In this study, the prevalence of cardiovascular risk factors was investigated in the adult population of public-sector workers at UAN, which is the oldest public institution of higher education in Angola.
Illiteracy and low education levels are prevalent in low-income countries, and it is known that there is a strong correlation of illness and death with poverty. A low level of education is one of the major determinants of disease and mortality because it is associated with malnutrition and acute and chronic infections . Although the participants of this study worked in an institution of higher education, the prevalence of low education level was 34.6%. This figure is similar to the Angolan norm because, according to the Inquiry into the Welfare of the Population , illiteracy in the Angolan population aged 15 years and older was 34.4%. In Africa, the illiteracy rate varies from 10 to 87.2% . In a study conducted in India, the illiteracy rate was found to be 45.3% for women and 17.0% for men, and there was an inverse relationship between education and mortality from all causes . Education increases people’s communication skills, reduces inequalities in the knowledge of disease transmission, and provides new opportunities in the production and marketing sectors. The improvement of education is thus crucial for the prevention, early diagnosis, and adequate management of chronic disease risk factors.
Therefore, education serves as a social catalyst.
Socioeconomic inequalities remain one of the main constraints to sustainable development in Africa. The percentage of our sample group in the low socioeconomic class was slightly less than that reported by IBEP , where the proportion of the Angolan population living below the national poverty line was found to be 33.6%.
Previous studies have reported that more individuals from low socioeconomic groups die from acute coronary events compared with individuals from high socioeconomic groups . Angola is a low-income country, where many regions remain at an early stage of epidemiological transition, with sequelae from a long civil war and large pockets of poverty. These factors certainly negatively affect Angola’s sustainable development, particularly taking into account the early death of the work force.
The prevalence of hypertension in the current study was 45.2%, which is a higher value than those reported in other African countries, such as South Africa , Uganda , Nigeria , Ethiopia , and Ghana , where the prevalence of hypertension varied from 13.7% in rural areas to 30.5% in urban areas. The SBP of individuals in the low socioeconomic class was higher than that of individuals in the upper class. Similarly, the prevalence of hypertension was higher in the low socioeconomic class than in the upper class. These findings may be associated with psychosocial factors related to poverty, chronic stress at work in activities that involve physical exhaustion , and limited access to antihypertensive drugs.
The mean blood glucose level in the upper class was higher than those in the low class. The prevalence of diabetes in our study was similar in both genders. These values are higher than those found in a rural community of Angola (2.8%) ; however, our values are close to those found in the adult population of urban Ghana (6.3%) . Nevertheless, the prevalence of diabetes in the present study was lower than in Cameroon (10.4%)  and Afro-Surinamese (14.2%) .
The benefits of low cholesterol in the primary and secondary prevention of CVD are clear. The mean cholesterol level found in this study was normal according to the previously defined points. The overall prevalence of hypercholesterolemia was lower than the values previously reported for Nigeria (28.3%)  and African-Americans (28.9%) . Although no significant difference was found, the prevalence of hypercholesterolemia in the low socioeconomic class was slightly higher than that in the upper socioeconomic class. The prevalence of low HDL was high, and more women were affected than men. This discrepancy is likely because the majority of women included in the study were premenopausal phase since the mean age of the women was 44.0 ± 10.1 years. Regarding socioeconomic status, although no significant difference was found, there was a trend to higher HDL levels in the upper class. The proportion of high LDL (19.8%) was similar between genders and between different socioeconomic classes.
The prevalence of hypertriglyceridemia was similar to the prevalence found in the Nigerian population (15.0%)  but lower than the prevalence found in the third National Survey on Health and Nutrition (NHANES III) in African-American men and women (21.0 and 14.0%, respectively) .
The BMI was higher in women than in men, and a direct relationship with socioeconomic status was found, namely, BMI progressively increased as socioeconomic status increased. This finding was marked in men and was also observed with regard to waist circumference (WC), where 62.3% of women and 15.3% of men exhibited values higher than recommended . Angola is a low- income country, but overweight and obesity appear to coexist with undernutrition and malnutrition. In 2006, the overall prevalence of malnutrition was 44.0% , and 20.0% of children die from this cause . Excessive weight increases the probability of obesity and weight-related disorders. In this study, the prevalence of obesity was higher in women than in men.
Overweight and obesity are prevalent in many countries, and according to Nishida and Mucavele , the prevalence of obesity is higher in women than in men in countries such as Egypt (33.0 vs. 12.6%), South Africa (30.1 vs. 9.4%), and the Seychelles Islands (28.2 vs. 8.5%). Nutrition plays a significant role in many risk factors associated with CVD. Considering that approximately 49.0% of the sample population had body weights above the recommended values, it is necessary to take preventative measures to mitigate future complications. Physical inactivity is a malady of the modern world because the comfort provided by various types of technology and the consumption of highly caloric industrialized food contribute to weight gain and, consequently, a decreased quality of life. The prevalence of physical inactivity found in this study was very high, and women were more inactive than men. Similar data were reported for the population of Porto, Portugal (84.0%) .
The prevalence of smoking was low, although it was higher in men than in women. These data are similar to those reported by Tran et al. in Ethiopia  and by Addo et al. in Ghana . In general, smoking prevalence among African women is low, likely because smoking is not a culturally well-accepted habit for this gender. Nevertheless, it is necessary to continue policies aimed at reducing the use of tobacco even further.
The progressive remodeling of the left ventricle (LV) is directly related to the further deterioration of cardiac performance and a less favorable outcome in presence of CVD . LVH is an adaptive response of the myocardium to increased cardiac work, resulting in increased cardiac mass, which can lead to ventricular arrhythmias, myocardial ischemia, systolic and diastolic ventricular dysfunction, and sudden death . The prevalence of LVH was higher in men than in women, and the low socioeconomic class was more affected than the upper class. The high prevalence of hypertension found in the low socioeconomic class is due to discrepancies in the prevalence of LVH among socioeconomic classes.
This study demonstrated the existence of a high prevalence of modifiable risk factors for cardiovascular disease among the study participants, such as hypertension, low HDL level, overweight, obesity, sedentary lifestyle, and LVH, rendering them more likely to be affected by a cardiovascular event, especially when associated with low socioeconomic status, as the majority of individuals with this status had three or more risk factors. Because this sample is a convenience sample, generalization of the findings in the present study to a wider Angolan population may be limited; however, our findings serve as indicators of the health of workers in Angola because all socioeconomic groups in this country were represented.