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Hypertension in childhood leads to hypertension in adult life, the strongest risk factor being obesity. This study determined the prevalence of primary hypertension and its risk factors in Grade XII learners in KwaZulu-Natal, South Africa, from March 2016 to June 2017. Weight, height, body mass index (BMI), random finger prick cholesterol and glucose, and spot urine for an albumin : creatinine ratio were measured. An average of three separate blood pressure readings taken was at least 5 minutes apart. Five hundred and sixty-four learners had weight, height, and BMI; 536 had random blood glucose; and 545 had cholesterol and random spot urine albumin : creatinine ratios measured. Prehypertension was detected in 168 (29.7%) and hypertension in 77 (13.7%) of learners. Ninety (15.9%) were overweight and 75 (13,3%) were obese. Hypercholesterolaemia was present in 58 (10.8%) and a high spot random urine albumin : creatinine ratio in 5 (1.0%). None had a high blood glucose level. Both prehypertension and hypertension in all learners showed a significant increase with increasing BMI. Six (1.0%) learners had metabolic syndrome. Female learners in other racial groups (defined as Indian, mixed race, and White learners), overweight, and obese learners showed significantly higher rates of hypercholesterolaemia. We showed overweight and obesity as risk factors for prehypertension and hypertension. This presages the need for an appropriate diet and adequate exercise in a child's school career.

Background: The profiles of patients with chronic kidney disease (CKD) in rural areas have long been thought to differ from those of their urban counterparts. However, there have been few local studies to confirm this. Methods: A retrospective review was conducted to compare the characteristics of patients with CKD from rural and urban areas in the South African province of KwaZulu-Natal, who were referred to Inkosi Albert Luthuli Central Hospital (IALCH) from April 2012 to April 2013. Results: A total of 529 patients were included. The mean age of those from rural areas was lower than that of urban participants (40.6 vs. 53.4 years) and all these patients were Black. The rural patients had lower estimated glomerular filtration rates (mean values of 16.3 vs. 25.4 mL/min/1.73 m², P < 0.001). Regarding comorbidity, rural patients had higher rates of HIV infection (47.9% vs. 18.3%) but lower rates of hypertension (69.6% vs. 83.9%) and diabetes (20.3% vs. 54.1%) than the urban patients. Conclusions: Patients with CKD referred from rural areas differed significantly from their urban counterparts. Rural patients presented at a younger age, had a higher prevalence of HIV infection, and had more advanced kidney disease at referral. Poor socioeconomic circumstances limiting access to health care and less screening for CKD may have contributed to delayed referrals from rural areas.

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