Rising prevalence, and improved but suboptimal management, of hypertension in South Africa: A comparison of two national surveys

Peer, Nasheeta; Uthman, Olalekan A.; Kengne, André-Pascal

doi:10.1016/j.gloepi.2021.100063

Cited by 11 publications

(11 citation statements)

References 15 publications

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“…This could be due to the growth of hypertension in the decade between data collection. In South Africa the prevalence of hypertension has increased from 29% to 49% in men and from 34% to 51% in women between 1998 and 2016 (Peer et al, 2021). A study of more than 4 million adults has shown that hypertension and diabetes often occur together as they share common causes such as obesity, inflammation, oxidative stress, and insulin resistance.…”

Section: Discussionmentioning

confidence: 99%

The prevalence and social determinants of multimorbidity in South Africa

Brady

Castelli

Walker

et al. 2022

World Med & Health Policy

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Multimorbidity is an increasing global public health challenge, however, most existing research focuses on high‐income countries, with limited evidence from low‐ and middle‐income countries. This paper aims to estimate the prevalence of multimorbidity in South Africa and analyse the associations between multimorbidity and social determinants of health in the adult population. Multimorbidity will be defined as the coexistence of two or more chronic diseases in an individual throughout this paper. Data from the South African National Income Dynamics Survey of 2017 was used with a total sample of 20,833. A binary logistic regression was performed to analyse the associations between multimorbidity and several social determinants of health indicators based on the Commission on Social Determinants of Health Framework. Multimorbidity was prevalent in 5.4% of the South African adult population surveyed, with 71.35% of those with multimorbidity being female. Hypertension was the most common NCD and the highest contributor to multimorbidity. Multimorbidity was found to have statistically significant associations with age, obesity, being female, being of Colored or Asian/Indian ethnicity, being in employment, and having no schooling. This study highlights the importance of analysing the associations between multimorbidity and the social determinants of health. Further research on multimorbidity is required in low‐ and middle‐income countries to understand the specific challenges not identifiable in the existing research predominately based in high‐income nations.

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Section: Discussionmentioning

confidence: 99%

The prevalence and social determinants of multimorbidity in South Africa

Brady

Castelli

Walker

et al. 2022

World Med & Health Policy

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“…1,2 Globally, hypertension is a major cause of mortality, accounting for 7.0-9.4 million deaths annually, and affects approximately 1 billion people, this being projected to increase by over 500 million by 2025. 1,3,4,5,6 Currently, the global prevalence of hypertension is estimated to be 59% (55% -62%) in women, and 49% (46% -52%) in men, and these are close to the levels reported in South Africa. 5,6 Hypertension is ranked amongst the top seven causes of death in South Africa, the Black African population being the most affected.…”

Section: Introductionmentioning

confidence: 77%

“…1,3,4,5,6 Currently, the global prevalence of hypertension is estimated to be 59% (55% -62%) in women, and 49% (46% -52%) in men, and these are close to the levels reported in South Africa. 5,6 Hypertension is ranked amongst the top seven causes of death in South Africa, the Black African population being the most affected. 7 These hypertension-related deaths are mainly because of cardiovascular complications of uncontrolled blood pressure (BP), such as heart failure, ischaemic heart disease (IHD), stroke and kidney failure, 2,8 these being amongst the most common clinical, public health and socio-economic challenges of uncontrolled BP.…”

Section: Introductionmentioning

confidence: 77%

Blood pressure control in hypertensive patients attending a rural community health centre in Gauteng Province, South Africa: A cross-sectional study

Onwukwe

Ngene

2022

South African Family Practice

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Background: Hypertension is a major cause of morbidity and mortality and its control has important clinical and socio-economic benefits to the family and community. Unfortunately, the extent of blood pressure (BP) control and its potential predictors in hypertensive patients in many rural communities in low-resource settings are largely unknown. This study assessed the extent of uncontrolled BP and its predictors amongst hypertensive patients accessing primary health care in a rural community in South Africa.Methods: This cross-sectional study included 422 randomly selected hypertensive patients. Demographic and clinical data were collected using structured face-to-face questionnaire supplemented by respondents’ clinical records.Results: Obesity plus overweight (n = 286, 67.8%) and diabetes (n = 228, 54.0%) were the most common comorbidities. Treatment adherence was achieved in only 36.3% and BP was controlled to target in 50.2% of the respondents. Significant predictors of uncontrolled BP were poor treatment adherence (odds ratio [OR] = 15.88, 95% confidence interval [CI] = 8.96, 28.14, p 0.001), obesity compared with normal weight and overweight (OR = 3.75, 95% CI = 2.17, 6.46, p 0.001) and being a diabetic (OR = 2.83, 95% CI = 1.74, 4.61, p 0.001).Conclusion: Poor adherence to treatment was the major predictor of uncontrolled BP. The increase in uncontrolled BP in the presence of diabetes and/or obesity as risk predictors, indicates the need for appropriate behaviour change/interventions and management of these conditions in line with the health belief model (HBM). We also propose the use of Community-Based Physical and Electronic Reminding and Tracking System (CB-PERTS) to address poor treatment adherence.

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“…In South Africa between 1998 and 2016, hypertension rates in young adults (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) years) more than doubled calling for preventive interventions. However, with many youth unemployed, young adults struggle to prioritize health or implement healthy behaviors.…”

Section: Introductionmentioning

confidence: 99%

“…12 Despite the prevalence doubling in young adults, there remains a general lack of awareness. [14][15][16][17] Due to the fact that HTN often remains asymptomatic, 1,18 frequently young adults only get diagnosed when being examined for unrelated conditions. 1 Studies also show that young adults perceive themselves as too "young" to have HTN and therefore generally do not readily go for HTN screening.…”

Section: Introductionmentioning

confidence: 99%

Hypertension perspectives and health behaviors of African youth: The effect of health education and employment

Mhlaba

Mpondo

Ware

2022

Preprint

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In South Africa between 1998 and 2016, hypertension rates in young adults (15-34 years) more than doubled calling for preventive interventions. However, with many youth unemployed, young adults struggle to prioritize health or implement healthy behaviors. We conducted six focus group discussions comparing hypertension-related beliefs and behaviors between NEET youth (n=20; not in employment, education or training) and previously NEET youth on a health-focused learnership (n=20). While all youth viewed hypertension as life threatening leading to cardiovascular disease or death, especially if left untreated, only youth undertaking health education felt empowered to implement healthy behaviors for disease prevention. In contrast, NEET youth felt hypertension was inevitable and described negative experiences at clinics and fear of lifelong medication use if diagnosed as reasons not to be screened. Our results suggest that engaging NEET youth in culturally appropriate health education programs can motivate preventive health behavior for chronic diseases such as hypertension.

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Rising prevalence, and improved but suboptimal management, of hypertension in South Africa: A comparison of two national surveys

Cited by 11 publications

References 15 publications

The prevalence and social determinants of multimorbidity in South Africa

The prevalence and social determinants of multimorbidity in South Africa

Blood pressure control in hypertensive patients attending a rural community health centre in Gauteng Province, South Africa: A cross-sectional study

Hypertension perspectives and health behaviors of African youth: The effect of health education and employment

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