Regional prevalence and spatial modeling of hypertension in South Africa

Abstract

Abstract Background In 2000, hypertension was the cause of nearly 47,000 deaths in South Africa. Since then, its prevalence has increased from 25% to over 40% of the population. Diabetes, sedentary lifestyle, diet, psychosocial stress, and certain medications are all risk factors for hypertension. The purpose of this research is to assess the regional prevalence and risk factors for hypertension, as well as to conduct spatial modeling of hypertension in South Africa. Method The study analyzed data from the 2016 South African Demographic and Health Survey, with a focus on participants aged 15 and older. Hypertension was defined as a diastolic blood pressure level of 90 mmHg or higher or a systolic blood pressure level of 140 mmHg or higher. Logistic regression analysis was employed to investigate significant factors associated with hypertension (p  ≤ 0.05). Additionally, ArcGIS was utilized to conduct spatial scans and hotspot analyses to identify regions with unusually high hypertension prevalence. Geostatistical modeling was performed using R. Results Hypertension was common in South Africa, accounting for 43.0%. The provinces of the Northern Cape, Eastern Cape, Free State, and Mpumalanga had a noticeably higher risk of hypertension with 55.7, 52.8, 52.4, and 50.7%, respectively. Older age, unmarried status, and diabetes or pre-diabetes were statistically associated with hypertension, with AOR [95% CI]: 2.32 [1.77–3.04], 1.63 [1.20–2.23], and 1.61 [1.12–2.31], respectively. Having an increased level of education and residing in the North West (0.45 [0.29–0.72]) and Limpopo (0.27 [0.17–0.43]) provinces showed to have a protective effect on hypertension. Significant hotspots of hypertension prevalence were detected among residents of coastal communities.