CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 3, April 2013
AFRICA
69
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
and having had more out-patients care visits in the past 12
months were associated with hypertension. Unlike some other
studies,
10,13,21,23-25,33
this study did not find insufficient fruit and
vegetable intake, smoking, being physically inactive and having
more limitations in activities of daily living to be associated with
hypertension. The finding that current alcohol use was protective
for hypertension in this study may be in line with some previous
studies where light-to-moderate alcohol consumption decreased
hypertension risk in women and increased the risk in men.
21
The rates of awareness, treatment and control among the
hypertensive participants in the present study (38.1, 32.7 and
17.1%, respectively) were as low as in some studies in rural
China (35.2, 28.7 and 1.0%),
10
Senegal (49.5, 37.0 and 5.7%),
4
and Italy (65.6, 59.5 and 10.5%).
18
They were however lower
than in studies in Costa Rica (74.9% aware and more than half
controlled)
7
and in the USA (74% aware and 51.6% controlled
among men and 37% controlled among women).
34
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 pressure-
monitoring system should be included for the older age group,
TABLE 2. MULTIPLE LOGISTIC REGRESSION OF HYPERTENSION
PREVALENCE IN OLDER SOUTHAFRICANS
UOR (95% CI)
AOR (95% CI)
Gender
Female
Male
1.00
0.75 (0.57–0.98)*
1.00
0.85 (0.80–1.63)
Age (years)
50–59
60–69
70 and over
1.00
1.40 (1.12–1.75)**
1.22 (0.87–1.70)
1.00
1.30 (0.94–1.79)
1.19 (0.80–1.78)
Population group
African black
White
Coloured
Indian or Asian
1.00
1.14 (0.64–2.05)
1.66 (1.07–2.59)*
0.97 (0.59–1.60)
1.00
1.23 (0.66–2.30)
1.89 (1.04–3.44)*
0.82 (0.47–1.42)
Marital status
Single
Married
Separated/divorced
Widow
1.00
0.71 (0.43–1.18)
0.86 (0.43–1.72)
1.20 (0.66–2.19)
Educational level
No schooling
Less than primary
Primary
Secondary
1.00
1.15 (0.74–1.81)
1.18 (0.86–1.60)
0.97 (0.71–1.31)
Wealth
Low
Medium
High
1.00
1.18 (0.78–1.77)
1.20 (0.80–1.80)
Geolocality
Rural
Urban
1.00
0.98 (0.59–1.65)
Other conditions
Stroke
Angina
Diabetes
Overweight(BMI
≥
25 kg/m
2
)
Underweight (BMI
<
18.5 kg/m
2
)
Arthritis
2.67 (1.10–6.47)*
0.92 (0.56–1.51)
2.65 (1.86–3.78)***
1.67 (1.41–1.98)***
0.53 (0.30–0.97)*
1.49 (1.06–2.11)*
4.48 (1.48–13.59)**
1.30 (0.86–1.98)
1.52 (1.15–2.01)**
0.77 (0.36–1.64)
1.13 (0.75–1.69)
Daily tobacco use
0.85 (0.56–1.30)
Alcohol use (past month)
0.64 (0.47–0.85)** 0.64 (0.49–0.84)**
Physical activity
Low
Moderate
High
1.00
1.01 (0.70–1.45)
0.92 (0.66–1.27)
Insufficient fruit and vegetables
0.96 (0.65–1.43)
Subjective health status
Very/good
Moderate
Bad/very bad
1.00
1.43 (1.12–1.83)**
1.44 (0.77–2.68)
1.00
1.41 (0.95–2.10)
1.27 (0.62–2.58)
Activity limitation
None
Mild
Moderate
Severe/extreme
1.00
1.13 (0.84–1.52)
1.30 (0.90–1.88)
2.10 (1.12–3.93)*
1.00
0.92 (0.59–1.45)
0.92 (0.58–1.48)
1.60 (0.70–3.64)
Social cohesion index (range 9–72);
mean (SD)
1.01 (0.9-1.03)
Outpatient visits in past 12 months
0
1–4
5 or more
1.00
1.28 (0.84–1.96)
1.94 (1.34–2.81)***
1.00
1.14 (0.80–1.63)
1.93 (1.48–2.51)***
***
p
<
0.001; **
p
<
0.01; *
p
<
0.5.
TABLE 3. MULTIVARIATE LOGISTIC REGRESSION OFAWARENESS,
TREATMENTAND CONTROL RATES OF HYPERTENSIONAMONG
OLDERADULTS IN SOUTHAFRICA
Awareness
(30.3%)
Treatment
(24.8%)
Control of treated
(48.8%)
AOR (95% CI)
AOR (95% CI)
AOR (95% CI)
Gender
Female
Male
1.00
0.68 (0.51–0.90)**
1.00
0.67 (0.50–0.88)**
1.00
1.09 (0.81–1.46)
Age
50-59
60-69
70 and over
1.00
1.70 (1.16–2.48)**
1.77 (1.22–2.59)**
1.00
1.89 (1.38–2.58)***
2.15 (1.40–3.30)***
1.00
0.73 (0.55–0.95)
0.73 (0.50–1.06)
Population group
African black
White
Coloured
Indian or Asian
1.00
0.81 (0.40–1.62)
1.00 (0.65–1.52)
1.08 (0.56–2.07)
1.00
0.97 (0.52–1.83)
1.09 (0.73–1.63)
1.45 (0.73–2.91)
1.00
0.89 (0.44–1.80)
0.80 (0.58–1.10)
1.25 (0.64–2.45)
Marital status
Single
Married
Separated/divorced
Widow
1.00
1.38 (0.83–2.29)
1.17 (0.69–1.97)
1.67 (0.96–2.92)
1.00
1.50 (0.85–2.66)
1.11 (0.62–1.99)
1.45 (0.81–2.62)
1.00
1.44 (0.90–2.29)
1.11 (0.65–2.45)
1.51 (0.93–2.46)
Educational level
No schooling
Less than primary
Primary
Secondary
1.00
0.96 (0.65–1.52)
1.10 (0.72–1.68)
0.94 (0.65–1.38)
1.00
1.03 (0.67–1.58)
1.03 (0.65–1.61)
1.09 (0.75–1.59)
1.00
0.99 (0.64–1.54)
1.04 (0.73–1.49)
1.54 (1.04–2.27)*
Wealth
Low
Medium
High
1.00
1.43 (0.98–2.08)
1.55 (1.00–2.40)*
1.00
1.36 (0.84–2.20)
1.34 (0.75–2.40)
1.00
0.75 (0.49–1.15)
0.93 (0.64–1.33)
Geolocality
Rural
Urban
1.00
1.27 (0.95–1.71)
1.00
1.30 (0.84–2.01)
1.00
1.17 (0.87–1.58)
Outpatient visits in
past 12 months
0
1–4
5 or more
1.00
1.85 (1.10–3.11)*
4.49 (3.02–6.66)***
1.00
1.94 (1.20–3.12)**
5.95 (3.96–8.95)***
1.00
0.85 (0.61–1.17)
0.87 (0.63–1.19)
***
p
<
0.001; **
p
<
0.01; *
p
<
0.5.
