56
VOLUME 10 NUMBER 2 • JUNE 2013
REVIEW
SA JOURNAL OF DIABETES & VASCULAR DISEASE
p < 0.05 in bivariate analyses were included in the multivariable
models. In the analysis, weighted percentages were reported.
Results
The total sample included 3 840 South African subjects 50 years
or older, 44.1% were men and 55.9% were women. The most
prevalent population group was black Africans (74%), and almost
half (49.9%) were between 50 and 59 years old. The educational
level of most participants (71.6%) was lower than secondary school
education and almost two-thirds (64.9%) lived in an urban area.
A large group (72.4%) of older adults were overweight or obese,
20.4% were daily tobacco users, 4.0% had had a stroke, and 9.2%
had diabetes. More than half (52.2%) engaged in lowphysical activity,
two-thirds (67.7%) ate insufficient fruit and vegetables, and a small
proportion (13.7%) were current alcohol users. A sizeable proportion
(17.5%) rated their health status as bad or very bad, 10.7% reported
severe or extreme activity limitation and 28.1% were out-patients
five times or more. The prevalence rates of hypertension were 77.3%
(male 74.4%, female 79.6%) (Table 1).
The results of the multivariate logistic regression analysis
revealed that the prevalence of hypertension was associated with
being in the Coloured population group, having had a stroke, being
overweight and having had five or more out-patients care visits
in the past 12 months. Prevalence of hypertension was inversely
associated with current alcohol use (Table 2).
Overall, 30.3% of older hypertensive people were aware of their
diagnosis, 24.8% of older hypertensives were taking treatment in
the past two weeks to lower their blood pressure, and 48.8% of
those who were taking antihypertensive treatment had their blood
pressure controlled. Women, older age and more frequent out-
patient visits in the past 12 months were associated with awareness
of their hypertensive status and were taking treatment to lower
their blood pressure in the past two weeks.
However, there were no statistical differences in gender, age and
out-patient visits among those who were taking antihypertensive
treatment and had their blood pressure controlled. Of the total 2
841 hypertensive participants, 1 081 (38.1%) were aware of their
hypertension, 985 (32.7%) were being treated, and 486 (17.1%)
had their hypertension under controll (Table 3).
Discussion
The study found significant rates of hypertension of 77.3% (male
74.4%, female 79.6%) among older adults (50 years and older) in
South Africa. These rates seemed to be higher than in a previous
survey in South Africa (men 44.0–52.0% and women 51.6–60.4%)
in 1998,
3
and similar to other studies such as in urban Senegal
(65.4%),
4
urban Zimbabwe (72%),
5
and Turkey (71.2–82.2%).
12
The
rates were higher than in a number of other countries including
rural Malawi, Rwanda and Tanzania (36.6– 41.0%),
6
Brazil (55%),
9
China (24.2–64.9%),
10,11
and Taiwan (31.1–38.0%).
13
The study further found that regarding socio-demographics, with
multivariate analysis, being in the Coloured population group was
associated with higher rates of hypertension. This confirms previous
studies in women.
3
Further initiatives are required to address the
high rate of hypertension in this population group. Unlike in other
studies,
13-15,17
this study did not find any effect of gender, age, level
of education and geolocality on hypertensive status.
In terms of health variables, this study was in agreement with
other studies,
4,10,13,14,18,31
that having had a stroke, being overweight
Table 1.
Sample characteristics and prevalence rate of hypertension among
older South Africans
Prevalence rate of hypertension
Total
Male
Female
sample (n = 1638) (n = 2202)
Total
All
3840 1159 (74.4) 1683 (79.6) 2842 (77.3)
Age (years)
50–59
1695 (49.9) 520 (71.3) 682 (77.9) 1202 (74.9)
60–69
1233 (30.6) 391 (79.4) 563 (81.6) 954 (80.6)
70 and over
912 (19.5) 248 (75.1) 438 (80.5) 686 (78.4)
Population group
African black
2053 (74.0) 575 (73.1) 975 (80.0) 1550 (77.3)
White
269 (9.3)
92 (75.6) 101 (83.0) 193 (79.6)
Coloured
655 (12.8) 195 (88.1) 350 (83.1) 545 (85.0)
Indian or Asian
307 (3.8)
97 (74.1) 117 (78.5) 214 (76.8)
Marital status
Single
512 (14.3) 97 (71.5) 292 (83.1) 389 (80.1)
Married
2007 (55.9) 870 (74.2) 571 (74.2) 1441 (74.2)
Separated/divorced
230 (5.9)
60 (66.0) 116 (82.3) 176 (77.7)
Widow
1020 (23.9) 120 (84.8) 667 (82.6) 787 (82.9)
Educational level
No schooling
854 (25.2) 231 (78.3) 422 (81.2) 653 (80.2)
Less than primary
803 (24.0) 227 (69.4) 404 (85.6) 631 (78.9)
Primary
779 (22.4) 232 (79.2) 364 (79.3) 596 (79.2)
Secondary
923 (28.3) 261 (74.9) 337 (76.5) 598 (75.8)
Wealth
Low
1482 (40.6) 429 (71.1) 646 (78.7) 1075 (75.4)
Medium
731 (18.2) 197 (74.7) 377 (79.9) 574 (78.3)
High
1608 (41.2) 525 (77.1) 651 (80.2) 1176 (78.6)
Geolocality
Rural
1276 (35.1) 392 (75.9) 524 (78.7) 916 (77.5)
Urban
2561 (64.9) 766 (73.7) 1157 (80.1) 1923 (77.2)
Other conditions
Stroke
139 (4.0)
48 (88.2)
71 (91.5) 119 (90.0)
Angina
219 (5.2)
62 (76.2) 114 (76.2) 176 (76.2)
Diabetes
360 (9.2) 107 (88.4) 202 (90.2) 309 (89.6)
Overweight
(BMI ≥ 25 kg/m
2
)
2505 (72.4) 745 (77.3) 1253 (82.8) 1998 (80.5)
Underweight
(BMI < 18.5 kg/m
2
)
184 (4.3)
51 (64.4)
63 (66.8) 114 (65.5)
Arthritis
851 (24.7) 198 (81.8) 472 (83.0) 670 (82.6)
Daily tobacco use
810 (20.4) 295 (74.6) 315 (76.3) 610 (75.4)
Alcohol use (past month) 557 (13.7) 248 (66.6) 151 (77.5) 399 (70.3)
Physical activity
Low
2100 (52.2) 567 (73.2) 940 (79.0) 1507 (76.6)
Moderate
692 (16.6) 233 (79.6) 302 (76.9) 535 (78.1)
High
1044 (31.2) 357 (73.4) 440 (82.1) 797 (78.1)
Insufficient fruit and
vegetables
2817 (67.7) 834 (77.3) 1245 (77.0) 2079 (77.1)
Subjective health status
Very/good
1469 (37.9) 486 (71.3) 565 (75.4) 1051 (73.4)
Moderate
1681 (44.9) 495 (78.2) 834 (80.9) 1329 (79.8)
Bad/very bad
617 (17.5) 177 (73.9) 281 (84.4) 458 (79.9)
Activity limitation
None
1465 (38.5) 487 (73.6) 566 (74.8) 1053 (74.2)
Mild
625 (16.7) 191 (71.6) 297 (80.5) 488 (76.5)
Moderate
1275 (34.2) 369 (75.9) 628 (81.0) 997 (78.9)
Severe/extreme
370 (10.7) 103 (78.5) 178 (89.6) 281 (85.8)
Social cohesion index
(range 9–72);
mean (SD)
22.1 (6.5) 21.9 (6.2) 21.4 (6.1) 21.6 (6.1)
Outpatient visits in
past 12 months
0
1176 (38.2) 372 (72.2) 464 (74.5) 836 (73.3)
1–4
908 (33.7) 271 (76.2) 414 (79.2) 685 (77.9)
5 or more
941 (28.1) 282 (80.4) 513 (86.4) 795 (84.2)
