Prevalence and sociodemographic correlates of cardiovascular risk factors among patients with hypertension in South African primary care.

Abstract

To determine the prevalence and sociodemographic correlates of cardiovascular risk factors among patients with hypertension at Johan Heyns Community Health Centre, Sedibeng district, South Africa. A total of 328 participants were systematically sampled. A researcher-administered questionnaire collected information on: socio-demography, presence of diabetes, family history of hypercholesterolaemia, family history of fatal cardiovascular (CV) events, and engagement in physical activities. Other measurements included: blood pressure (BP), weight, height, abdominal circumference and electrocardiography (ECG). Data analysis included descriptive statistics, chi-squared test and regression analysis. Main outcome measures included the proportions of participants with each CV risk and their significant sociodemographic determinants. Participants' mean age was 57.7 years. Most participants were black (86.0%), female (79%) and pensioners (43.6%). The mean BP was 139/84 mmHg, and 60.7% had their BP controlled to targets. There was an average of 3.7 CV risk factors per participant and the prevalence of CV risk factors was: abdominal obesity (80.8%), physical inactivity (73.2%), diabetes (30.2%), alcohol use (28.0%), hypercholesterolaemia (26.5%), smoking (11.9%), past family history of fatal CV event (14.9%), and left ventricular hypertrophy (5.2%). Sociodemographic factors significantly associated with each CV risk factor were: obesity and being female (p = 0.00); alcohol use and young age (p = 0.00); smoking, being male and race other than black (p = 0.00 and p = 0.00, respectively); physical inactivity, being a pensioner and male (p = 0.02 and p = 0.02, respectively); diabetes and being male (p = 0.03); hypercholesterolaemia and race other than black (p = 0.03); family history of hypercholesterolaemia and race other than black (p = 0.00); and family history of fatal CV event and race other than black (p = 0.00). There is a high burden of CV risk factors among patients with hypertension in South African primary care, signifying a substantial risk of cardiovascular disease (CVD) in this setting. Interventions aimed at CVD risk reduction need to take cognisance of the sociodemographic correlates of CV risk factors.