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SA JOURNAL OF DIABETES & VASCULAR DISEASE
RESEARCH ARTICLE
VOLUME 17 NUMBER 1 • JULY 2020
15
Relationship between obesity and blood pressure
among employees in the Vhembe district municipality of
Limpopo Province, South Africa
TAKALANI CLEARANCE MULUVHU, MAKAMA ANDRIES MONYEKI, GERT LUKAS STRYDOM,
ABEL LAMINA TORIOLA
Correspondence to: Takalani Clearance Muluvhu
Physical Activity, Sport and Recreation (PhASRec), Faculty of Health Sciences,
North-West University, Potchefstroom, South Africa
e-mail:
muluvhu@gmail.comMakama Andries Monyeki
Physical Activity, Sport and Recreation (PhASRec), Faculty of Health Sciences,
North-West University, Potchefstroom, South Africa
Gert Lukas Strydom
Physical Activity, Sport and Recreation (PhASRec), Faculty of Health Sciences,
North-West University, Potchefstroom, South Africa
Abel Lamina Toriola
Department of Sport, Rehabilitation and Dental Sciences, Tshwane
University of Technology, Pretoria, South Africa
Previously published in
Cardiovasc J Afr
2019;
30
: 361–368
S Afr J Diabetes Vasc Dis
2020;
17
: 15–22
Abstract
Objective:
The aim of this study was to investigate the
relationship between obesity and blood pressure among
employees of the Vhembe district municipality of Limpopo
province.
Methods:
A cross-sectional study was conducted among 452
local government employees (207 males, 245 females) aged
24–65 years. Body mass index (BMI), blood pressure (BP)
and waist circumference (WC) measurements, and waist-to-
height ratio (WHtR) were assessed. Data were analysed
using Statistical Package for Social Sciences (SPSS) statistics,
version 21.
Results:
The results showed that 27% of the participants
were classified as overweight and 34% as obese, with
females being more overweight and obese (29 and 48%,
respectively) compared to males (24 and 17%, respectively).
Twenty-five per cent of the participants were hypertensive,
with females (27%) showing a higher prevalence compared
to males (22%). Based on BMI categories, the obese group
(35%) had a higher prevalence of hypertension in contrast to
groups that were of normal weight (18%) and overweight
(22%). The results also showed that systolic blood pressure
(SBP) was positively (
p
≤ 0.05) correlated with BMI (
r
=
0.15), WC (
r
= 0.26) and WHtR (
r
= 0.29) in the normal and
overweight groups (WC,
r
= 0.23 and WHtR,
r
= 0.26), and
WHtR correlated with SBP (
r
= 0.26) and diastolic blood
pressure (DBP) (
r
= 0.19).
Conclusion:
The study showed a high prevalence of
overweight, obesity and hypertension, with females more
affected than their male counterparts. BMI, WC and WHtR
were positively correlated with SBP in the normal and
overweight groups, with WHtR positively correlated with
both SBP and DBP in the overweight group. Therefore, it
is recommended that intervention regimes designed to
address obesity and hypertension should consider risk
awareness for cardiovascular diseases, impaired quality of
life and productivity among local government employees.
Keywords:
obesity, hypertension, employees, blood pressure,
body mass index
Obesity is one of the most important public health problems
worldwide.
1
It is a major independent risk factor for chronic
diseases, such as cardiovascular disease and diabetes mellitus,
and is associated with high morbidity and mortality rates.
2
According to the World Health Organisation (WHO), up to 20%
of the population in developed countries may suffer from obesity-
associated hypertension, which may account for 78 and 65% of
essential hypertension in males and females, respectively.
3,4
The
WHO
4
reported that one in six adults is obese and one in three has
elevated blood pressure (BP), with the highest prevalence recorded
in Africa. Obesity and hypertension are among the preventable
risk factors for cardiovascular disease that impose a considerable
economic burden, particularly in developing countries.
5
Hypertension is one of the 10 leading contributors to the global
burden of disease and the most important risk factor for mortality
worldwide,
4,6,7
and has been described as a silent killer due to its
asymptomatic nature among sufferers.
8
Studies have reported that
about nine million people die from hypertension annually.
9,10
The
prevalence of hypertension in Africa has been reported in several
previous studies.
9,11,12
Hypertension was once considered a disease
of affluence but is now prevalent among the poor.
13
South Africa
is facing a serious burden of hypertension.
14
More than 6.2 million
South Africans are hypertensive, with 3.2 million having a BP of >
160 mmHg.
15
Several studies have shown a clear association with BP increase
and weight gain.
5,16,17
It has been reported that obese subjects have
a 3.5 times increased likelihood of hypertension and that 60% of
hypertension is attributable to an increase in adipose tissue stores.
2
Data from the National Health and Nutrition Examination Survey in
2004 indicated that the prevalence of hypertension among obese
individuals with a body mass index (BMI) > 30 kg/m² was 42.5%,
compared with 15.3% in lean individuals.
18
Visceral fat distribution
is another genetic factor that contributes to the increase in BP
levels among obese individuals.
19
In addition, environmental and
behavioural factors, such as alcohol intake, cigarette smoking,
timing of onset of childhood obesity, change in daily lifestyle habits