The impact of lifestyle choices on heart health in South Africa: what you need to know

Every weekend, South Africans gather for braais, indulge in rich foods, and often binge drink without a second thought.

These habits, seemingly harmless in the moment, can quietly pave the way to one of the world’s deadliest health crises: cardiovascular disease (CVD).

It’s the small, everyday choices what we eat, how we move, and the stress we carry that slowly chip away at our heart health.

Cardiovascular disease isn’t just a health statistic; it’s a silent epidemic. Globally, it claims 17.9 million lives every year.

In South Africa, non-communicable diseases (NCDs) like CVD account for 43% of adult deaths, with nearly a fifth of these directly caused by heart-related conditions, according to the World Heart Federation.

But here’s the truth: CVD is largely preventable. The choices we make today could save our hearts tomorrow.

The numbers paint a sobering picture of South Africa’s heart health crisis:

• 18% of adults smoke.
• 11 litres of pure alcohol are consumed per person annually.
• 1 in 3 adults (33.7%) suffers from hypertension, a major risk factor for heart attacks, kidney disease, and strokes.
• 31.3% of adults are obese, and 40% of South African women are classified as obese.

Even more alarming, South African women aged 35–59 are 1.5 times more likely to die from CVD than their counterparts in the United States. Children aren’t spared either; 1 in 4 girls and 1 in 5 boys aged 2–14 are overweight or obese.

Dr Renata Maharaj, medical affairs country head at Novartis South Africa, explains the hidden dangers: “Many people are unaware they’re developing cardiovascular disease. Conditions like hypertension, high cholesterol, and diabetes often progress without any symptoms. That’s why hypertension is called the ‘silent killer'.”

The problem isn’t just medical, it’s emotional, financial and societal.

CVD doesn’t just harm your health; it devastates families and communities.

Maharaj highlights the financial burden: “The costs extend beyond medical expenses to include lost income, long-term care, and reduced productivity. Many South Africans face crippling out-of-pocket expenses for treatment, which can push entire families into financial hardship.”

The emotional toll is equally heavy. Heart disease often leads to stress, anxiety, and depression, creating a vicious cycle where mental health issues worsen heart conditions.

“The anxiety of managing a chronic condition and the lifestyle changes required can be overwhelming. Many patients also experience social isolation due to physical limitations,” Maharaj adds.

Most risk factors for heart disease are modifiable. That means your lifestyle choices can either shield your heart or make it more vulnerable.

1. What’s on your plate?

Key principles of the DASH Diet:

Focus on whole foods: Fresh vegetables, fruits, legumes, whole grains, lean proteins and low-fat dairy.

Limit salt intake: Aim for less than 1,500 to 2,300 mg per day. Avoid processed foods and use herbs, spices, and lemon juice for flavour instead of salt.

Healthy fats: Include unsaturated fats from nuts, seeds, avocados, and oils like olive or canola oil.

Portion control: Be mindful of serving sizes to avoid overeating.

Drink plenty of water throughout the day. Swap sugary drinks for herbal teas like rooibos and avoid sugary sodas.

“Think about eating as fuel for your heart,” advises Maharaj. “Small changes, like cutting down on salt and sugar, can significantly lower your risk of hypertension and diabetes.”

2. Get moving

Recent years have seen South Africans becoming more sedentary, with less exercise and more reliance on processed foods. But even moderate physical activity, 30 minutes, five times a week, can lower your blood pressure, reduce cholesterol, and improve your overall heart health.

You don’t have to train for a marathon. A brisk walk, a dance class, or even gardening counts as exercise.

3. Quit smoking and limit alcohol

Smoking is a direct assault on your heart, contributing to clogged arteries and increased risk of stroke. And while South Africans consume an average of 11 litres of pure alcohol annually, excessive drinking can cause high blood pressure, arrhythmias, and heart failure.

4. Know your numbers

Understanding your health metrics is crucial. Schedule regular check-ups to monitor your:

• Blood pressure.
• Cholesterol levels (specifically LDL cholesterol).
• Blood sugar levels.

“If there’s a family history of heart disease, it’s even more important to discuss these risk factors with your doctor,” Maharaj emphasises.

Workplaces can also play a role by implementing wellness programs, offering regular health screenings, and encouraging active lifestyles. These initiatives not only improve employee well-being but also boost productivity.

Heart disease doesn’t develop overnight. It’s a slow build, often driven by years of small, seemingly insignificant choices. The message is clear: prevention is the ultimate cure.