Hypertension incidence among middle-aged and older adults: Findings from a 5-year prospective study in rural South Africa, 2010-2015

Brian Houle, Thomas A. Gaziano, Nicole Angotti, Sanyu A. Mojola, Chodziwadziwa W. Kabudula, Stephen M. Tollman, F. Xavier Gómez-Olivé

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives There is a scarcity of longitudinal cohort studies in sub-Saharan Africa to understand the epidemiology of cardiovascular disease as a basis for intervention. We estimated incident hypertension and associated sociodemographic, health and behavioural risk factors in a population aged 40 years and older over a 5-year period. Design We assessed the association between incident hypertension and sociodemographic, health and behavioural factors using Poisson regression. We adjusted for non-response in 2015 using inverse probability sampling weights from a logistic regression including sex and age at baseline. Setting Rural South Africa. Participants We used a population-based cohort of normotensive adults in 2010 who were aged 40 years and older at retest in 2015. Results Of 676 individuals completing baseline and 5-year follow-up, there were 193 incident cases of hypertension. The overall hypertension incidence rate was 8.374/100 person-years. In multivariable analyses, those who became hypertensive were more likely to be older, have a high waist circumference (incidence rate ratio (IRR): 1.557, 95% CI: 1.074 to 2.259) and be employed (IRR: 1.579, 95% CI: 1.071 to 2.329) at baseline. Being HIV positive and not on antiretroviral therapy at baseline was associated with lower risk of incident hypertension. Conclusions Over a 5-year period, 29% of respondents developed hypertension. Given the high burden of hypertension in South Africa, continued longitudinal follow-up is needed to understand the complex interplay of non-communicable and infectious diseases and their underlying and modifiable risk factors to inform public health prevention strategies and programmes.

Original languageEnglish (US)
Article numbere049621
JournalBMJ open
Volume11
Issue number12
DOIs
StatePublished - Dec 7 2021

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Keywords

  • South Africa
  • cohort
  • hypertension
  • incidence
  • rural population

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