Trends in hypertension prevalence among adults aged ≥40 years in Agincourt, South Africa (2014 - 2022)
1
SAMRC/Wits Rural Public Health andHealth Transitions Research Unit, University of the Witwatersrand, Johannesburg, South Africa
2
School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A2811
ABSTRACT
BACKGROUND:
Hypertension is a leading cause of cardiovascular disease. (1) Limited longitudinal data on temporal trends in hypertension prevalence in rural South Africa exist.
OBJECTIVES:
This study analysed trends in hypertension prevalence and investigated associated factors among adults aged ≥40 years in South Africa.
METHODS:
A retrospective observational secondary analysis of the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) was conducted. Data were collected over three waves (2014, 2018, 2021) from N = 3707 participants within the Agincourt Health and Socio-demographic Surveillance System framework. Descriptive statistics summarised socio-demographic data, and bivariate analyses and multivariable Generalised Estimating Equation (GEE) models determined factors associated with hypertension (p < 0.05).
RESULTS:
Hypertension prevalence declined from 58% (95% CI 56.4–59.6) in wave 1 to 42% (95% CI 40.4–43.6) in wave 2 and 30% (95% CI 28.6–31.4) in wave 3. Transitions between hypertensive and normotensive status were observed: 1018 individuals became normotensive from wave 1 to 2, and 1167 from wave 2 to 3. Significant predictors included high BMI (wave 2, aOR 1.11; 95% CI 1.02–1.21; p = 0.014) and frequent alcohol consumption (wave 3, aOR 1.19; 95% CI 1.04–1.37; p = 0.009). No formal education increased odds of hypertension (aOR 1.07; 95% CI 1.00–1.14; p = 0.026). Protective factors were age 40–49 (wave 2, aOR 0.64; 95% CI 0.48–0.84; p = 0.014), employment (aOR 0.82; 95% CI 0.69–0.96; p = 0.020), and fruit consumption (wave 3, aOR 0.95; 95% CI 0.91–0.99; p = 0.037).
CONCLUSIONS:
Hypertension prevalence in Agincourt decreased from 58% to 30% across waves 1–3. High BMI, frequent alcohol use, and lack of formal education were key predictors. Targeted interventions, including screening, lifestyle modification, and management of risk factors, are essential to reduce hypertension-related morbidity and mortality in rural South Africa.
Hypertension is a leading cause of cardiovascular disease. (1) Limited longitudinal data on temporal trends in hypertension prevalence in rural South Africa exist.
OBJECTIVES:
This study analysed trends in hypertension prevalence and investigated associated factors among adults aged ≥40 years in South Africa.
METHODS:
A retrospective observational secondary analysis of the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) was conducted. Data were collected over three waves (2014, 2018, 2021) from N = 3707 participants within the Agincourt Health and Socio-demographic Surveillance System framework. Descriptive statistics summarised socio-demographic data, and bivariate analyses and multivariable Generalised Estimating Equation (GEE) models determined factors associated with hypertension (p < 0.05).
RESULTS:
Hypertension prevalence declined from 58% (95% CI 56.4–59.6) in wave 1 to 42% (95% CI 40.4–43.6) in wave 2 and 30% (95% CI 28.6–31.4) in wave 3. Transitions between hypertensive and normotensive status were observed: 1018 individuals became normotensive from wave 1 to 2, and 1167 from wave 2 to 3. Significant predictors included high BMI (wave 2, aOR 1.11; 95% CI 1.02–1.21; p = 0.014) and frequent alcohol consumption (wave 3, aOR 1.19; 95% CI 1.04–1.37; p = 0.009). No formal education increased odds of hypertension (aOR 1.07; 95% CI 1.00–1.14; p = 0.026). Protective factors were age 40–49 (wave 2, aOR 0.64; 95% CI 0.48–0.84; p = 0.014), employment (aOR 0.82; 95% CI 0.69–0.96; p = 0.020), and fruit consumption (wave 3, aOR 0.95; 95% CI 0.91–0.99; p = 0.037).
CONCLUSIONS:
Hypertension prevalence in Agincourt decreased from 58% to 30% across waves 1–3. High BMI, frequent alcohol use, and lack of formal education were key predictors. Targeted interventions, including screening, lifestyle modification, and management of risk factors, are essential to reduce hypertension-related morbidity and mortality in rural South Africa.
| eISSN: | 2654-1459 |
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