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

Nasheeta Peer, Olalekan A Uthman, Andre-Pascal Kengne, Nasheeta Peer, Olalekan A Uthman, Andre-Pascal Kengne

Abstract

Aim: To examine the changes in prevalence, awareness, treatment and control of hypertension between 1998 and 2016 in ≥15-year-old South African men and women and the sociodemographic characteristics associated with those changes.

Methods: In nationally representative surveys in 1998 and 2016, multi-stage sampling was used to select, interview and collect blood pressure and anthropometric measurements in ≥15-year-old adults. Logistic regression analyses evaluated the independent effects of selected sociodemographic characteristics on hypertension management.

Results: Among 13,217 participants in 1998 and 7830 in 2016 (59-60% women in both surveys), hypertension prevalence increased from 27% to 45% in men and 31% to 48% in women. Hypertension increased equally in participants with and without obesity and in daily cigarette smokers vs. their counterparts. Prevalence of awareness among participants with hypertension increased from 7% to 18% (men) and from 17% to 29% (women). Among those aware, hypertension treatment improved markedly from 8% to 85% (men) and from 12% to 82% (women). Hypertension control among those on treatment increased from 17% to 26% (men) and from 21% to 30% (women). Increasing age and survey year were consistently associated with higher prevalence, awareness, treatment and control of hypertension. The richest vs. poorer women, and lower vs. higher educated women were more likely to be treated for hypertension.

Conclusions: The high and rising hypertension burden together with suboptimal awareness and control levels warrant greater attention to curb hypertension-related morbidity and mortality in South Africans. Novel strategies involving community-based or workplace hypertension programmes may overcome some barriers to optimal care.

Keywords: Hypertension awareness; Hypertension control; Hypertension management; Hypertension prevalence; Hypertension treatment; South Africa.

Conflict of interest statement

All authors report no potential conflicts of interest, including specific financial interests, relevant to the subject of this manuscript.

© 2021 The Authors.

Figures

Fig. 1
Fig. 1
Prevalence of hypertension by adiposity and smoking status in ≥15-year-old men and women in 1998 and 2016. Body mass index (kg/m2): underweight: <18.5, normal weight: 18.5–24.9, overweight: 25–29.9 and obesity: ≥30; Raised waist circumference: men: >94 cm and women >80 cm; Daily smoking: smoke ≥1 cigarette/day.

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