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. 2013 Nov 8;8(11):e78567.
doi: 10.1371/journal.pone.0078567. eCollection 2013.

A high burden of hypertension in the urban black population of Cape Town: the cardiovascular risk in Black South Africans (CRIBSA) study

Nasheeta Peer  1 , Krisela Steyn, Carl Lombard, Nomonde Gwebushe, Naomi Levitt
Affiliations

A high burden of hypertension in the urban black population of Cape Town: the cardiovascular risk in Black South Africans (CRIBSA) study

Nasheeta Peer et al. PLoS One. .

Abstract

Objective: To determine the prevalence, associations and management of hypertension in the 25-74-year-old urban black population of Cape Town and examine the change between 1990 and 2008/09 in 25-64-year-olds.

Methods: In 2008/09, a representative cross-sectional sample, stratified for age and sex, was randomly selected from the same townships sampled in 1990. Cardiovascular disease risk factors were determined by administered questionnaires, clinical measurements and fasting biochemical analyses. Logistic regression models evaluated the associations with hypertension.

Results: There were 1099 participants, 392 men and 707 women (response rate 86%) in 2008/09. Age-standardised hypertension prevalence was 38.9% (95% confidence interval (CI): 35.6-42.3) with similar rates in men and women. Among 25-64-year-olds, hypertension prevalence was significantly higher in 2008/09 (35.6%, 95% CI: 32.3-39.0) than in 1990 (21.6%, 95% CI: 18.6-24.9). In 2008/09, hypertension odds increased with older age, family history of hypertension, higher body mass index, problematic alcohol intake, physical inactivity and urbanisation. Among hypertensive participants, significantly more women than men were detected (69.5% vs. 32.7%), treated (55.7% vs. 21.9%) and controlled (32.4% vs. 10.4%) in 2008/09. There were minimal changes from 1990 except for improved control in 25-64-year-old women (1990∶14.1% vs. 2008/09∶31.5%).

Conclusions: The high and rising hypertension burden in this population, its association with modifiable risk factors and the sub-optimal care provided highlight the urgent need to prioritise hypertension management. Innovative solutions with efficient and cost-effective healthcare delivery as well as population-based strategies are required.

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Conflict of interest statement

Competing Interests: Naomi Levitt has received honoraria from Novartis for serving on the steering committee for the Navigator Trial and travel support from Novo Nordisk, Eli Lilly Laboratories and Sanofi Aventis. All other authors report no potential conflicts of interest, including specific financial interests, relevant to the subject of this manuscript. This work was partly supported by an unrestricted grant from Servier Laboratories (South Africa). There are no patents, products in development or marketed products to declare. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.

Figures

Figure 1
Figure 1. Mean systolic and diastolic blood pressures (mmHg) in men and women by age category (years).
Figure 2
Figure 2. Prevalence of hypertension in 25–74-year-old men and women in 2008/09 presented by age category.
Figure 3
Figure 3. Prevalence (with 95% confidence intervals represented by error bars) of hypertension among 25–64-year-old adults in 1990 and 2008/09 presented by age category.
Figure 4
Figure 4. Prevalence of hypertension detection, treatment and control among 25–64-year-old men and women with hypertension in 1990 (n = 166) and 2008/09 (n = 405).
See this image and copyright information in PMC

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