Determinants and treatment of hypertension in South Africans: the first Demographic and Health Survey

Abstract

Objectives: To identify the groups of patients with high prevalence and poor control of hypertension in South Africa.

Methods: In the first national Demographic and Health Survey, 12 952 randomly selected South Africans aged 15 years and older were surveyed. Trained interviewers completed questionnaires on socio-demographic characteristics, lifestyle and the management of hypertension. This cross-sectional survey included blood pressure, height and weight measurements. Logistic regression analyses identified the determinants of hypertension and the treatment status.

Results: A high risk of hypertension was associated with less than tertiary education, older age groups, overweight and obese people, excess alcohol use, and a family history of stroke and hypertension. Hypertension risk was lowest in rural blacks and significantly higher in obese black women than in women with a normal body mass index. Improved hypertension control was found in the wealthy, women, older persons, Asians, and persons with medical insurance.

Conclusions: Rural black people had lower hypertension prevalence rates than the other groups. Poorer, younger men without health insurance had the worst level of hypertension control.