Journal Article

Social epidemiology of hypertension in Buffalo City Metropolitan Municipality (BCMM): cross-sectional study of determinants of prevalence, awareness, treatment and control among South African adults

Goon, Daniel Ter, Seekoe, Eunice, Adeniyi, Oladele Vincent, Owolabi, Eyitayo Omolara

2017

Overview

ObjectivesThis study examined hypertension prevalence, awareness, treatment and control and their determinants among adults attending health facilities in Buffalo City Metropolitan Municipality (BCMM) in the Eastern Cape.DesignA cross-sectional analytical study.SettingsThe three largest outpatient clinics in BCMM.ParticipantsAmbulatory adults (aged 18 years and over) attending the study settings during the study period (n=998).Primary outcome measureThe prevalence of hypertension (systolic blood pressure (BP) of ≥140 mm Hg and/or a diastolic BP of ≥90 mm Hg or current medication for hypertension), the awareness of it (prior diagnosis of it) and its treatment and control (Eighth Joint National Committee Criteria of BP <140/90/90 mm Hg).Secondary outcome measureAssociated factors of hypertension, hypertension unawareness and uncontrolled hypertension.ResultsOf the 998 participants included, the prevalence of hypertension was 49.2%. Hypertension unawareness was reported by 152 participants (23.1%) with significant gender difference (p=0.005). Male sex, age <45 years, higher level of education, single status, current employment, higher monthly income, current smoking, alcohol usage, absence of diabetes and non-obese were significantly associated (p<0.05) with hypertension unawareness.Of the participants who were aware of having hypertension (n=339), nearly all (91.7%, n=311) were on antihypertensive medication and only 121 participants (38.9%) achieved the BP treatment target. In the multivariate logistic regression model analysis, ageing (95% CI 1.9 to 4.4), being married (95% CI 1.0 to 2.0), male sex (95% CI 1.2 to 2.3), concomitant diabetes (95% CI 1.9 to 3.9), lower monthly income (95% CI 1.2 to 2.2), being unemployed (95% CI 1.0 to 1.9) and central obesity (95% CI 1.5 to 2.8) were the significant and independent determinants of prevalent hypertension.ConclusionThe prevalence and awareness of hypertension was high in the study population. In addition, the suboptimal control of BP among treated individuals, as well as the significant cardiovascular risk factors, warrant the attention of health authorities of BCMM and the country.

• Publisher: BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Adult / Aged / Antihypertensive Agents - therapeutic use / Antihypertensives / Awareness / Blood pressure / Body mass index / Cardiovascular disease / Cardiovascular Diseases - drug therapy / Cross-Sectional Studies / Data collection / Diabetes / Disease prevention / Education / Epidemiology / Fasting / Female / Glucose / Health care / Health facilities / Health Knowledge, Attitudes, Practice / Health surveillance / Humans / Hypertension / Hypertension - drug therapy / Hypertension - epidemiology / Logistic Models / Low income groups / Male / Middle Aged / Mortality / Obesity / Outpatient care facilities / Population / Prevalence / Public health / Risk Factors / Rural areas / Sample size / Smoking / Socioeconomic factors / South Africa - epidemiology / Systematic review / Young Adult