58
VOLUME 10 NUMBER 2 • JUNE 2013
REVIEW
SA JOURNAL OF DIABETES & VASCULAR DISEASE
As found in some other studies, in this study, women were
more frequently aware of their hypertension and more frequently
treated.
7,35
They were not significantly more frequently controlled
than men, though, as found in other studies.
7,36
In the group of
individuals who were unaware of their hypertension, it may have
been because of multiple factors, such as never having been
screened for hypertension, having been previously diagnosed
but had forgotten the diagnosis, the medical provider had not
considered their blood pressure levels to be sufficiently elevated
to warrant the diagnosis, or had had inadequate health education
and limited access to healthcare services.
9,35
Therefore, more efforts,
such as public health education and a blood pressuremonitoring
system should be included for the older age group, particularly
men, to improve their unsatisfactory awareness, treatment and
control of hypertension.
10
Limitations of the study
This study had several limitations. Firstly, the self-report of health
variables such as tobacco or alcohol use should be interpreted with
caution; it is possible that respondents under-reported, especially
females. As in many studies, arterial blood pressure was measured
three times during a single session (two hours), which may have led
to an overestimation of the prevalence of hypertension. In addition,
the awareness and treatment rate of hypertension was solely assessed
by individual self-report. Furthermore, this study was based on data
collected in a crosssectional survey. We cannot, therefore, ascribe
causality to any of the associated factors in the study.
Conclusion
This study revealed high rates of hypertension among older adults
(50 years and more) in South Africa, which put them at risk for
cardiovascular disease. The percentages of hypertensives who
were aware of, treated for and controlled were very low. These
data underscore the urgent need to strengthen the public health
education and blood pressure-monitoring systems to better manage
hypertension among older adults in South Africa. Community
healthcare workers in their new role in South Africa could screen
for hypertension among older adults using a primary care ‘high-
risk’ approach once every two years. This screening process would
enable the health system to identify and cater for the needs of this
vulnerable population group.
37
Funding was provided predominantly from the National
Department of Health with additional funding provided by the
United States National Institute on Aging through an interagency
agreement with the World Health Organisation, and the Human
Sciences Research Council, South Africa.
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