Quantifying Hypertension and Cardiovascular Conditions in South Africa.

Abstract

South Africa has some of the highest prevalence and incidence rates of non-communicable diseases in the world. In this study, the burden of obesity and its impact on cardiovascular conditions such as hypertension were investigated among South African men and women. The study utilized data from the South African National Income Dynamics Study (SA-NIDS) surveys conducted from 2008 to 2017. A total of 80,270 individuals consented to participate, comprising 32,686 men (41%) and 47,584 women (59%). Besides multivariable logistic regression models, the relative importance of obesity on hypertension was assessed and compared to behavioral and socioeconomic conditions. Obesity and elevated waist-circumference measurements were the most prominent correlates of increased prevalence of hypertension. After adjusting for non-modifiable and background risk factors, the population-attributable risk (PAR%) of obesity on hypertension exceeded that of other traditional risk factors. It was substantially higher in women ( $PAR\%s$ ranged: 52%, 95% CI: 50%, 55%) compared to men ( $PAR\%s$ ranged: 33%, 95% CI: 31%, 36%). In sex-specific analyses, men and women with obesity were more than four and three times more likely, respectively, to be hypertensive (adjusted Odds Ratio (aOR): 4.41 and 3.72, p < 0.001) compared to those with normal weights. Prevention strategies targeting key modifiable factors such as obesity, waist circumference, smoking, alcohol use and lack of exercise, are likely the most effective means of identifying and reaching those at highest risk. Furthermore, developing and implementing socially and culturally appropriate awareness programs remain a research priority.