An epidemiological study of hypertension and its determinants in a population in transition: the THUSA study

Rooyen, Johannes M. Van; Krüger, Heike; Huisman, Hugo W.; Wissing, Marié P.; Margetts, Barrie; Venter, C S; Vorster, Hester H.

doi:10.1038/sj.jhh.1001098

Cited by 91 publications

(85 citation statements)

References 26 publications

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“…stated that the BP of Africans changes proportional to their age, level of urbanisation, and waist-to-hip ratio 6. There is a high prevalence of hypertension in African-Americans 7.…”

Section: Discussionmentioning

confidence: 99%

Coping and metabolic syndrome indicators in urban black South African men

Plessis¹,

Malan²,

Malan³

2010

CardioVascular Journal of Africa

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SummaryUrbanisation is associated with obesity, hypertension and development of the metabolic syndrome (MS). We aimed to assess the use of different coping styles and their influence on increases in MS indicators and target end-organ damage (TOD) in urban black African men. A sample of 53 men was classified as clear high active (AC, n = 30) or passive coping (PC, n = 23) responders, using the Amirkhan African validated coping style indicator. Blood pressure (BP) was recorded with an aneroid sphygmomanometer and waist circumference (WC) was determined. Carotid intima–media thickness (CIMT) and microalbuminuria were analysed to determine TOD.Fasting serum and eight-hour urine samples revealed elevated MS indicators in AC men. Strong associations existed between MS indicators and TOD in AC but not PC men. To conclude, only BP and seeking social support were positively associated with TOD in urban PC African men, while in urban AC African men, most MS indicators were positively associated with TOD, i.e. sub-clinical atherosclerosis and renal impairment.

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“…stated that the BP of Africans changes proportional to their age, level of urbanisation, and waist-to-hip ratio 6. There is a high prevalence of hypertension in African-Americans 7.…”

Section: Discussionmentioning

confidence: 99%

Coping and metabolic syndrome indicators in urban black South African men

Plessis¹,

Malan²,

Malan³

2010

CardioVascular Journal of Africa

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“…4,5,9 According to van Rooyen et al, 4 the highest rate of hypertension occurs in stratum 3 (subjects living in informal settlements) with 34.8 and 31.4% for SBP and 22.7 and 26.9% for DBP in males and females, respectively, and they argued that these subjects experience difficult life situations that lead to adjustments in the cardiovascular system. This is also in accordance with the literature.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] The way of life in the urbanized areas differs drastically from those in the rural areas. Tswana's living in informal settlements (townships) seems to be more vulnerable to stress and excessive increases in blood pressure during daily-life events than Tswana's living in the urban areas.…”

Section: Introductionmentioning

confidence: 99%

Prolactin, testosterone and cortisol as possible markers of changes in cardiovascular function associated with urbanization

et al. 2002

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People living in large informal settlements in South Africa showed a significant increase in cardio/cerebrovascular disease. This study was undertaken to compare the cardiovascular and endocrine parameters of urbanized and rural black female and males. The hormone levels such as prolactin, cortisol and testosterone may also change with urbanization and could make a contribution to the high rate of hypertension. For this study, 1202 black subjects were selected from 37 randomly selected rural and urbanized settlements. Resting blood pressure was recorded with a Finapres apparatus. Cardiac output, stroke volume, heart rate, total peripheral vascular resistance and compliance had been obtained with the Fast Modelflow software program. An acute laboratory stressor (hand dynamometer exercise) was applied to challenge the cardiovascular system and the measurements were repeated. Blood sampling was done and hormone levels were determined by biochemical analyses. For females, significant lower levels of cortisol were found in the urban strata in comparison with the rural strata. The testosterone levels were significantly lower and the prolactin levels significantly higher for females in the informal settlements compared with the rural strata. It is noticeable that most cardiovascular parameters showed the highest changes with the application of the stressor in the informal settlement strata and the lowest in people living on farms for both male and female. The prolactin levels in males are significantly higher in the informal settlement stratum. Subjects living in informal settlements showed a noticeable endocrine pattern of ongoing stress that can be associated with changes in the cardiovascular parameters with urbanization. This can partly explain the reported high rate of cardio/cerbrovascular disease in black South Africans living in informal settlements.

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“…Our group and others have clearly documented that urban-dwelling black South Africans suffer from alarming increases in hypertension, resulting in soaring rates of hypertensive heart disease and stroke. [18][19][20] Importantly, the need for effective and affordable markers of early cardiovascular deterioration as part of a prevention scheme is imperative in this population group, as poverty hinders successful treatment programs.…”

Section: Introductionmentioning

confidence: 99%

Blood pressure variability is significantly associated with ECG left ventricular mass in normotensive Africans: The SABPA Study

Schutte

Huisman

et al. 2011

Hypertens Res

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The prognostic significance of blood pressure (BP) variability has lately enjoyed considerable attention. The need for early markers of cardiovascular dysfunction is imperative in black South Africans who have a significant risk for cardiovascular disease. We therefore compared 24-h BP variability with various traditional and advanced BP measurements, regarding their association with sub-clinical organ damage in black and white South Africans. The study included 409 African and Caucasian teachers aged 25-60 yrs. We measured office BP, 1-min continuous (finger) BP, ambulatory BP, BP reactivity and determined weighted 24-h BP variability. Albumin-to-creatinine ratio, Cornell product and carotid cross-sectional wall area (CSWA) were measures of organ damage. Africans had higher 24-h BP, BP variability, BP reactivity and sub-clinical organ damage (Po0.001). Correlations of BP variability with organ damage were overall weak when compared with other BP measurements. In normotensive groups, we found an independent association of 24-h systolic BP (SBP) variability with Cornell product only in Africans (r¼0.37; P¼0.01), confirmed in multiple regression models, with 24-h SBP included in the model. Only in hypertensive Caucasians, a significant correlation between CSWA and 24-h SBP variability was evident (r¼0.30; P¼0.01), although CSWA indicated stronger correlations with office or 24-h SBP than 24-h SBP variability. To conclude, 24-h SBP variability could potentially be an effective measure for the early detection of normotensive Africans at increased risk for the development of cardiovascular complications. Its usefulness based on associations with target organ damage in hypertensive groups seems to be less than traditional office or 24-h BP measurements. Hypertension Research (2011Research ( ) 34, 1127Research ( -1134 doi:10.1038/hr.2011; published online 28 July 2011Keywords: albumin-to-creatinine ratio; ethnicity; intima-media thickness; left ventricular hypertrophy INTRODUCTIONThe prognostic significance of blood pressure (BP) variability has lately enjoyed considerable attention in the literature. [1][2][3][4][5][6][7][8][9][10] Where some papers emphasize the importance of BP variability in prediction of risk of vascular events, 1,2,6,9 others question its prediction of cardiovascular outcome. 4,5,10 Despite this upsurge of recent papers, consistent evidence over the past three decades lends support that both target organ damage and the rate of cardiovascular events of hypertensive patients are significantly and independently related to the degree of BP variability. [11][12][13][14][15] A limitation of many of these papers is that either BP variability alone was investigated, or various measures of BP variability (such as s.d. of 24-h BP, average real variability index 16 and weighted 24-h BP s.d. 17 ) were being compared, regarding the strength of their association with target organ damage.The question therefore arises how BP variability would benchmark against a comprehensive range of both traditional and advanced

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An epidemiological study of hypertension and its determinants in a population in transition: the THUSA study

Cited by 91 publications

References 26 publications

Coping and metabolic syndrome indicators in urban black South African men

Coping and metabolic syndrome indicators in urban black South African men

Prolactin, testosterone and cortisol as possible markers of changes in cardiovascular function associated with urbanization

Blood pressure variability is significantly associated with ECG left ventricular mass in normotensive Africans: The SABPA Study

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