Hypertension in a rural community in South Africa: what they know, what they think they know and what they recommend

Abstract

BackgroundHypertension is one of the most important risk factors for cardiovascular disease and has a high prevalence in South Africa and other low- and middle-income countries. However, awareness of hypertension has been reported to be low. Health programmes can increase awareness of hypertension and its causes, but hinge on the knowledge and perception of the targeted community. Therefore, this study investigated knowledge on and perceptions about hypertension of community members in a rural area in Limpopo, South Africa with the aim to increase awareness of hypertension and cardiovascular disease in the local population.MethodsUsing a mixed methods study approach, 451 participants of the Ndlovu Cohort Study, attending a follow-up visit between August 2017 and January 2018, completed a questionnaire on cardiovascular risk perception. A knowledge score was calculated for all participants. Sixty participants were invited to participate in six focus group discussions, of which 56 participated. Audio recordings were transcribed verbatim, transcripts coded, and thematic analysis of the data undertaken to obtain an understanding of knowledge and perception of hypertension in the community.ResultsMost members of the community seemed to have intermediate (74.3%) or good (14.0%) knowledge of hypertension based on the knowledge score, and only 11.8% of the population had poor knowledge. The risk factors of hypertension seemed to be well known in the community. Poverty was identified as a major vulnerability in this community limiting choices for healthy lifestyles such as nutritious foods, recreational physical activity and accessing health care timely. Participants proposed community-based activities as an effective way to reach out to community members for prevention and management of hypertension.ConclusionThis study highlights the need for improved health promotion efforts to increase knowledge of hypertension in rural communities, and to address poverty as a major obstacle to healthy life-style choices.Electronic supplementary materialThe online version of this article (10.1186/s12889-019-6642-3) contains supplementary material, which is available to authorized users.

Hypertension Prevalence and Determinants among Black South African Adults in Semi-Urban and Rural Areas

“…Moderate exercise, in contrast to mild exercise, was found to be significant at reducing the high risk of being hypertensive among women in the semi-urban area. This finding is consistent with the results of previous studies conducted in South Africa and elsewhere [ 20 , 22 , 23 ], as they found that a lack of physical activity was significantly associated with hypertension. Some studies have shown that doing 30 min of physical activity five times per week reduces the risk of hypertension [ 24 , 25 ].…”

Cross-sectional study of prevalence and determinants of uncontrolled Hypertension among South African adult residents of Mkhondo municipality

“…South Africa has the highest prevalence of hypertension in Southern Africa [4]. Despite the high prevalence, the level of awareness and control of the disease is low among impoverished communities [3]. In the current study, the overall prevalence of uncontrolled hypertension was 56.83%.…”

“…In the year 2000, 972 million people were living with hypertension and a large burden was borne by economically disadvantage countries [2], where awareness and treatment often falls short. In South Africa, the prevalence of hypertension has been estimated at 27.4% for men and 26.1% for women [3], whereas an overall prevalence of up to 54% has been reported [4]. In the absence of effective intervention strategies to control this epidemic, the prevalence of hypertension is likely to increase in the next decade [2,4].…”

“…Furthermore, only 25% of individuals undergoing antihypertensive treatment appear to be well controlled [9], while the majority of studies conducted in Africa have shown show that less than a third of patients reach their treatment goals [13]. In South Africa, the prevalence of uncontrolled hypertension has been estimated at between 13.5-75.5% [12,14], whilst figures ranging between 19.0-56.0% have been reported for hypertension control [3]. On the other hand, hypertension control among individuals residing in high-income countries has been reported to be as high as 82.0% [3,15], whereas a number as low as 28.4% has also been reported in high-income countries [16].…”

“…In South Africa, the prevalence of uncontrolled hypertension has been estimated at between 13.5-75.5% [12,14], whilst figures ranging between 19.0-56.0% have been reported for hypertension control [3]. On the other hand, hypertension control among individuals residing in high-income countries has been reported to be as high as 82.0% [3,15], whereas a number as low as 28.4% has also been reported in high-income countries [16]. Those who fail to reach therapeutic targets continue to be at a higher risk for cardiovascular events, kidney diseases [9,17], stroke [18], metabolic syndrome, hypertensive retinopathy [19] and dementia [20].…”