Hypertension and Its Associated Mental Health Challenges Among Female African Refugees in Durban, South Africa

Abstract

Hypertension is a serious medical condition that leads to various adverse health complications when left untreated. In addition to psychological challenge that female migrant refugees are exposed to premigration, they encounter barriers to care postmigration from xenophobia that affects their hypertension. We investigated the extent and mental health drivers of hypertension in refugees in Durban, South Africa. We interviewed 178 adult female African help-seeking refugees/migrants for hypertension (blood pressure ≥130/90 mm Hg) and mental health challenges (e.g., adverse childhood experience [ACE] and depression using the Center for Epidemiologic Studies-Depression scale). Eighty-six percent (n = 153) of participants were hypertensive, and based on the adjusted regression models, exposure to at least one ACE (adjusted odds ratio [aOR], 2.83; 95% confidence interval [CI], 1.11-7.26) and depression (aOR, 3.54; 95% CI, were associated with hypertension, independent of smoking, alcohol, obesity, and physical exercise status. Hypertension and its associated mental health challenges are overlooked conditions in this population, with further efforts for screening being needed.

Severe depressive symptoms in patients with hypertension: Are antihypertensive medications implicated?

“…Patients with hypertension are at higher risk of developing mental health challenges, compared to their healthy peers. 54 Although the relationship between insomnia, anxiety, and depression is strong, nevertheless, the complete underlying mechanisms are not established yet. Existing literature points to the role of interacting social, psychological, and biological factors.…”

Intimate partner violence, adverse childhood experiences and prenatal substance use in South Africa

“…The main outcome of the study was IPV experienced during a lifetime. There are four types of IPV outcomes 1 , 15 , 16 , 17 : (1) threat (e.g. threw, twisted your arm or hair, pushed, shoved or grabbed); (2) physical violence (e.g., were kicked, punched or hit, beat up, burned or scalded, choked); (3) sexual violence (e.g., were raped, or someone forced their private parts or object in the vagina or anal area) and (4) any IPV which refers to either threat and/or physical and/or sexual violence.…”

“…It was previously used in other South African studies also. 3 , 15 , 16 Adverse Childhood Experiences International Questionnaire consists of 13 categories of experiences during the first 18 years of life.…”

“…Out of the 223 participants, 32 (14.4%) reported substance use during pregnancy, and 105 (47.1%) living with HIV. The prevalence of threat, physical violence, sexual violence, and any IPV, were 19.7% (n = 44), 16.6% (n = 37), 1.8% (n = 4) and 20.2% (n = 45), respectively (Table 1).…”