Cardiovascular Journal of Africa: Vol 30 No 6 (November/December 2019)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 30, No 6, November/December 2019 AFRICA 361
Physical Activity, Sport and Recreation (PhASRec), Faculty
of Health Sciences, North-West University, Potchefstroom,
South Africa
Takalani Clearance Muluvhu, PhD, , takalani.
Makama Andries Monyeki, PhD
Gert Lukas Strydom, PhD
Department of Sport, Rehabilitation and Dental Sciences,
Tshwane University of Technology, Pretoria, South Africa
Abel Lamina Toriola, PhD
Relationship between obesity and blood pressure
among employees in the Vhembe district municipality of
Limpopo Province, South Africa
Takalani Clearance Muluvhu, Makama Andries Monyeki, Gert Lukas Strydom, Abel Lamina Toriola
Abstract
Objective: The aim of this study was to investigate the rela-
tionship between obesity and blood pressure among employ-
ees of the Vhembe district municipality of Limpopo province.
Methods: A cross-sectional study was conducted among 452
local government employees (207 males, 245 females) aged
24–65 years. Body mass index (BMI), blood pressure (BP)
and waist circumference (WC) measurements, and waist-
to-height ratio (WHtR) were assessed. Data were analysed
using Statistical Package for Social Sciences (SPSS) statistics,
version 21.
Results: The results showed that 27% of the participants
were classified as overweight and 34% as obese, with females
being more overweight and obese (29 and 48%, respectively)
compared to males (24 and 17%, respectively). Twenty-five
per cent of the participants were hypertensive, with females
(27%) showing a higher prevalence compared to males (22%).
Based on BMI categories, the obese group (35%) had a higher
prevalence of hypertension in contrast to groups that were
of normal weight (18%) and overweight (22%). The results
also showed that systolic blood pressure (SBP) was positively
( p ≤ 0.05) correlated with BMI ( r = 0.15), WC (r = 0.26) and
WHtR ( r = 0.29) in the normal and overweight groups (WC, r
= 0.23 and WHtR, r = 0.26), and WHtR correlated with SBP
( r = 0.26) and diastolic blood pressure (DBP) (r = 0.19).
Conclusion: The study showed a high prevalence of over-
weight, obesity and hypertension, with females more affected
than their male counterparts. BMI, WC and WHtR were
positively correlated with SBP in the normal and overweight
groups, with WHtR positively correlated with both SBP and
DBP in the overweight group. Therefore, it is recommended
that intervention regimes designed to address obesity and
hypertension should consider risk awareness for cardiovascu-
lar diseases, impaired quality of life and productivity among
local government employees.
Keywords: obesity, hypertension, employees, blood pressure,
body mass index
Submitted 17/1/19, accepted 18/6/19
Published online 12/9/19
Cardiovasc J Afr 2019; 30: 361–368
DOI: 10.5830/CVJA-2019-035
Obesity is one of the most important public health problems
worldwide.1 It is a major independent risk factor for chronic
diseases, such as cardiovascular disease and diabetes mellitus,
and is associated with high morbidity and mortality rates.2
According to the World Health Organisation (WHO), up
to 20% of the population in developed countries may suffer
from obesity-associated hypertension, which may account for
78 and 65% of essential hypertension in males and females,
respectively.3,4 The WHO4 reported that one in six adults is obese
and one in three has elevated blood pressure (BP), with the
highest prevalence recorded in Africa. Obesity and hypertension
are among the preventable risk factors for cardiovascular disease
that impose a considerable economic burden, particularly in
developing countries.5
Hypertension is one of the 10 leading contributors to the
global burden of disease and the most important risk factor for
mortality worldwide,4,6,7 and has been described as a silent killer
due to its asymptomatic nature among sufferers.8 Studies have
reported that about nine million people die from hypertension
annually.9,10 The prevalence of hypertension in Africa has been
reported in several previous studies.9,11,12 Hypertension was once
considered a disease of affluence but is now prevalent among the
poor.13 South Africa is facing a serious burden of hypertension.14
More than 6.2 million South Africans are hypertensive, with 3.2
million having a BP of > 160 mmHg. 15
Several studies have shown a clear association with BP
increase and weight gain.5,16,17 It has been reported that obese
subjects have a 3.5 times increased likelihood of hypertension
and that 60% of hypertension is attributable to an increase
in adipose tissue stores.2 Data from the National Health and
Nutrition Examination Survey in 2004 indicated that the
prevalence of hypertension among obese individuals with a
body mass index (BMI) > 30 kg/m² was 42.5%, compared
with 15.3% in lean individuals. 18 Visceral fat distribution is
another genetic factor that contributes to the increase in BP
levels among obese individuals.19 In addition, environmental
and behavioural factors, such as alcohol intake, cigarette
smoking, timing of onset of childhood obesity, change in daily
lifestyle habits and alteration in lipid profile may be implicated
in visceral fat distribution and increased BP values.20-22 Most
studies suggest that centrally located body fat is a stronger
determinant of BP elevation than peripheral body fat in both
men and women.21,23