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

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 ye...

Full description

Saved in:
Bibliographic Details
Main Authors: F Xavier Gómez-Olivé, Brian Houle, Stephen M Tollman, Thomas A Gaziano, Chodziwadziwa W Kabudula, Nicole Angotti, Sanyu A Mojola
Format: Article
Language:English
Published: BMJ Publishing Group 2021-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/12/e049621.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846129267647184896
author F Xavier Gómez-Olivé
Brian Houle
Stephen M Tollman
Thomas A Gaziano
Chodziwadziwa W Kabudula
Nicole Angotti
Sanyu A Mojola
author_facet F Xavier Gómez-Olivé
Brian Houle
Stephen M Tollman
Thomas A Gaziano
Chodziwadziwa W Kabudula
Nicole Angotti
Sanyu A Mojola
author_sort F Xavier Gómez-Olivé
collection DOAJ
description 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.
format Article
id doaj-art-b5c85a321fa54f3d9b533497ae0aa9e4
institution Kabale University
issn 2044-6055
language English
publishDate 2021-12-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open
spelling doaj-art-b5c85a321fa54f3d9b533497ae0aa9e42024-12-10T07:20:12ZengBMJ Publishing GroupBMJ Open2044-60552021-12-01111210.1136/bmjopen-2021-049621Hypertension incidence among middle-aged and older adults: findings from a 5-year prospective study in rural South Africa, 2010–2015F Xavier Gómez-Olivé0Brian Houle1Stephen M Tollman2Thomas A Gaziano3Chodziwadziwa W Kabudula4Nicole Angotti5Sanyu A Mojola6MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa1 School of Demography, The Australian National University, Acton, Australian Capital Territory, AustraliaMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaDivision of Cardiovascular Medicine, Brigham and Women`s Hospital, Boston, Massachusetts, USAMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa2 MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa2 MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South AfricaObjectives 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.https://bmjopen.bmj.com/content/11/12/e049621.full
spellingShingle F Xavier Gómez-Olivé
Brian Houle
Stephen M Tollman
Thomas A Gaziano
Chodziwadziwa W Kabudula
Nicole Angotti
Sanyu A Mojola
Hypertension incidence among middle-aged and older adults: findings from a 5-year prospective study in rural South Africa, 2010–2015
BMJ Open
title Hypertension incidence among middle-aged and older adults: findings from a 5-year prospective study in rural South Africa, 2010–2015
title_full Hypertension incidence among middle-aged and older adults: findings from a 5-year prospective study in rural South Africa, 2010–2015
title_fullStr Hypertension incidence among middle-aged and older adults: findings from a 5-year prospective study in rural South Africa, 2010–2015
title_full_unstemmed Hypertension incidence among middle-aged and older adults: findings from a 5-year prospective study in rural South Africa, 2010–2015
title_short Hypertension incidence among middle-aged and older adults: findings from a 5-year prospective study in rural South Africa, 2010–2015
title_sort hypertension incidence among middle aged and older adults findings from a 5 year prospective study in rural south africa 2010 2015
url https://bmjopen.bmj.com/content/11/12/e049621.full
work_keys_str_mv AT fxaviergomezolive hypertensionincidenceamongmiddleagedandolderadultsfindingsfroma5yearprospectivestudyinruralsouthafrica20102015
AT brianhoule hypertensionincidenceamongmiddleagedandolderadultsfindingsfroma5yearprospectivestudyinruralsouthafrica20102015
AT stephenmtollman hypertensionincidenceamongmiddleagedandolderadultsfindingsfroma5yearprospectivestudyinruralsouthafrica20102015
AT thomasagaziano hypertensionincidenceamongmiddleagedandolderadultsfindingsfroma5yearprospectivestudyinruralsouthafrica20102015
AT chodziwadziwawkabudula hypertensionincidenceamongmiddleagedandolderadultsfindingsfroma5yearprospectivestudyinruralsouthafrica20102015
AT nicoleangotti hypertensionincidenceamongmiddleagedandolderadultsfindingsfroma5yearprospectivestudyinruralsouthafrica20102015
AT sanyuamojola hypertensionincidenceamongmiddleagedandolderadultsfindingsfroma5yearprospectivestudyinruralsouthafrica20102015