Hypertension incidence among middle-aged and older adults: findings from a 5-year prospective studyin rural Sotuh Africa, 2010-2015
Date
2021
Authors
Houle, Brian
Gaziano, Thomas
Angotti, Nicole
Mojola, Sanyu A
Kabudula, Chodziwadziwa
Tollman, Stephen M.
Gomez-Olive, F. Xavier
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BMJ Publishing Group
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.
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BMJ Open
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Journal article
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CC BY-NC
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