ObjectivesThis study examined hypertension prevalence, awareness, treatment and control and their determinants among adults attending health facilities in Buffalo City Metropolitan Municipality (BCMM) in the Eastern Cape.DesignA cross-sectional analytical study.SettingsThe three largest outpatient clinics in BCMM.ParticipantsAmbulatory adults (aged 18 years and over) attending the study settings during the study period (n=998).Primary outcome measureThe prevalence of hypertension (systolic blood pressure (BP) of ≥140 mm Hg and/or a diastolic BP of ≥90 mm Hg or current medication for hypertension), the awareness of it (prior diagnosis of it) and its treatment and control (Eighth Joint National Committee Criteria of BP <140/90/90 mm Hg).Secondary outcome measureAssociated factors of hypertension, hypertension unawareness and uncontrolled hypertension.ResultsOf the 998 participants included, the prevalence of hypertension was 49.2%. Hypertension unawareness was reported by 152 participants (23.1%) with significant gender difference (p=0.005). Male sex, age <45 years, higher level of education, single status, current employment, higher monthly income, current smoking, alcohol usage, absence of diabetes and non-obese were significantly associated (p<0.05) with hypertension unawareness.Of the participants who were aware of having hypertension (n=339), nearly all (91.7%, n=311) were on antihypertensive medication and only 121 participants (38.9%) achieved the BP treatment target. In the multivariate logistic regression model analysis, ageing (95% CI 1.9 to 4.4), being married (95% CI 1.0 to 2.0), male sex (95% CI 1.2 to 2.3), concomitant diabetes (95% CI 1.9 to 3.9), lower monthly income (95% CI 1.2 to 2.2), being unemployed (95% CI 1.0 to 1.9) and central obesity (95% CI 1.5 to 2.8) were the significant and independent determinants of prevalent hypertension.ConclusionThe prevalence and awareness of hypertension was high in the study population. In addition, the suboptimal control of BP among treated individuals, as well as the significant cardiovascular risk factors, warrant the attention of health authorities of BCMM and the country.

BackgroundIn South Africa, especially in the Eastern Cape province, despite reported high prevalence of underweight and obesity, little is known regarding the relationship of body composition (BC) with blood pressure (BP) in primary school children. Understanding the relationship between BC and BP in these children is important because it is associated with adverse effects on health and social repercussion in both adolescence and adulthood.AimThe aim of this study was to examine the relationship between BC and BP among South African primary school children.SettingThis study was conducted on a cohort of primary school learners in the Eastern Cape Province of South Africa.MethodsA school-based cross-sectional survey was conducted among 876 school children aged 9–14 years, using multistage sampling techniques. Body mass and stature were measured using a calibrated scale. Anthropometric measurements including weight, height, waist circumference, triceps, gluteal and subscapular were also collected. Body mass index, percentage body fat and waist-to-hip ratio were calculated.ResultsOf the 876 participants, 356 (40.6%) were boys and 520 (59.0%) were girls. The Spearman’s rho correlation coefficients revealed positive significant correlations between systolic BP with age (r = 0.171; p < 0.0001), stature (r = 0.205; p < 0.0001), weight (r = 0.277; p < 0.0001), body mass index (r = 0.243; p < 0.0001), waist circumference (r = 0.259; p < 0.0001), gluteal (r = 0.214; p < 0.0001), triceps (r = 0.203; p < 0.0001), subscapular (r = 0.167; p < 0.0001), body fat percentage (r = 0.206; p < 0.0001), fat mass (r = 0.257; p < 0.0001) and fat-free mass (r = 0.238; p < 0.0001). There was no statistically significant correlation between waist-to-hip ratio and systolic BP (r = 0.064; p = 0.059). In terms of diastolic BP, there existed no significant correlations with age (r = 0.026; p = 0.443) and waist-to-hip ratio (r = 0.002; p = 0.947). Collectively, the prevalence of hypertension was 76.4% in the normal group compared with those who were pre-hypertensive (18.4%) and hypertensive (5.3%). Girls showed a higher prevalence of pre-hypertension than boys (19.6% compared with 16.6%, respectively).ConclusionThere is a relationship between most of the BC variables and BP in children. The screening of BP as part of physical examinations of school children is necessary for early prevention and intervention programmes for hypertension.

Aim: Tobacco use increases the risk of cardiovascular disease, premature death and certain cancers. This study investigated the prevalence and determinants of tobacco use among adults in Buffalo City Metropolitan Municipality (BCMM), South Africa. Methods: This study forms part of the cardio-metabolic risk survey carried out at the three largest outpatient clinics in BCMM. This multi-centre cross-sectional survey utilised the relevant items of the WHO STEPwise questionnaire to obtain information on demographic and behavioural characteristics of 1 107 participants. A total of 109 participants were excluded as a result of incomplete data. Thus, 998 participants (male = 327; female = 671) were included in the analysis. Self-reported, current use of any tobacco product was defined as tobacco use while secondary smoking was defined as exposure of non-smokers to environmental tobacco smoke, either at home or in the workplace. Results: Of all the study participants, 150 (15%) were current tobacco users and 335 (39.5%) of the non-smoking participants were exposed to secondary smoking. The majority of the tobacco users were males (70.7%) compared with females (29.3%). The commonest form of tobacco use was the manufactured cigarette. The mean age at initiation of smoking was 18.3 ± 5.1 and 22.6 ± 8.0 years for men and women, respectively. Only male sex (p = 0.000), single status (p = 0.003), no formal education (p = 0.007) and self-employment (p = 0.043) were significantly associated with tobacco use. Conclusion: High prevalence of tobacco use, especially cigarette smoking, in BCMM is worrisome given its strong association with cardiovascular events and cancers. The district health authorities should prioritise smoking cessation measures at the primary health care level.

BackgroundNurses in primary health care settings are key stakeholders in the diagnosis and management of hypertensive patients. Unfortunately, the working conditions of nurses predispose them to stress, long hours of work, shift duties and unhealthy diets, which are drivers of hypertension. Yet nurses are often overlooked in health screening exercises, primarily because they are assumed to be informed and ‘healthy’.AimThis study examined the prevalence, awareness, control and determinants of hypertension among professional primary health care nurses in the Eastern Cape Province of South Africa.SettingThis was a cross-sectional survey of 203 professional nurses working at 41 primary health care facilities of the Eastern Cape Province.MethodsA modified WHO STEPwise questionnaire was used for data collection during face-to-face interviews. The information obtained included demographic information, behavioural lifestyles, anthropometric and blood pressure (BP) measurements. Hypertension is defined as an average of two BP ≥ 140/90 mmHg or self-reported history of antihypertensive medication use.ResultsThe prevalence of hypertension was 52%. Of this, 41% were unaware of their hypertension status. Of those who were aware and on treatment, only 38.1% had a controlled blood pressure. After adjusting for confounders (for physical activity, dietary practices, parity, income and alcohol use), only age and duration of practice were independent predictors of hypertension among the study population.ConclusionThere is a high prevalence of hypertension among the study participants. There is an unexpected low rate of awareness and suboptimal control of blood pressure among the participants. Age is the significant predictor of hypertension among professional nurses in Eastern Cape Province, South Africa. There is an urgent need for the implementation of an effective workplace health programme for nurses in the province.

South Africa has a high prevalence of obesity in black female adolescents and a paucity of knowledge regarding contributing dietary practices. The aim of this study was to assess the dietary practices and weight status of male and female adolescents at secondary schools in the Eastern Cape province in urban and rural areas. Sixteen schools and grade 8–12 learners (N = 1360) were randomly selected from three health districts comprising poor disadvantaged communities. A short unquantified food frequency questionnaire was used to collect data on learners’ usual eating practices with regards to weekly meal pattern, breakfast consumption, foods taken to school, takeaways, and snacks eaten while watching television (TV). Body mass index measurements were determined for each learner. Prevalence of combined overweight and obesity differed significantly between genders, 9.9% in males versus 36.1% in females (p < 0.001). Significant gender differences were noted regarding eating practices. Females had a higher frequency of eating sugary snacks (p < 0.001) and a lower frequency of eating breakfast (p < 0.01) than males. Females ate significantly more fried fish (p < 0.05), pizza (p < 0.05) fat cakes (fried dough balls) (p < 0.05), hotdogs (p < 0.01), candy (p < 0.001), cake (p < 0.01), and crisps (p < 0.001). Compared to urban areas, the frequency of eating breakfast (p < 0.01) and sugary snacks (p < 0.05) was significantly higher in rural areas. Significantly more learners in urban areas consumed boerewors (beef sausage) rolls (p = 0.027), hamburgers (p = 0.004), and soft drinks (p = 0.019), while more learners in the rural areas consumed cordial (p = 0.001). In conclusion, a high prevalence of combined overweight and obesity was found in black female adolescents and a high prevalence of poor dietary practices was observed, with significant gender and urban–rural differences.