Prevalence and associated risk factors for elevated blood pressure in young adults in South Africa

Cardiovasc J Afr. 2022 Aug 17;33:1-7. doi: 10.5830/CVJA-2022-036. Online ahead of print.


Background: Sub-Saharan Africa has been shown to have a high prevalence of hypertension (58% in rural black South Africans) with an accelerated course ending in end-stage renal disease. We sought to determine whether the prevalence of elevated blood pressure (EBP) in early adulthood was associated with any risk factors and/or renal target-organ damage in young adulthood, which could prevent development of these cardiorenal sequelae.

Methods: Data including risk factors for hypertension and markers of kidney damage were collected from young adults (n = 933; age 28 years; 52% female) participating in the Birth to Twenty Plus (BT20) cohort in Soweto, South Africa. Blood pressure was measured on one occasion.

Results: Fifty-four per cent of the study sample had EBP with more men affected (62%) than women (47%) (p < 0.001). Body mass index (BMI), hyperuricaemia and albuminuria had significant associations with EBP in men. In women, BMI, hyperuricaemia and a self-reported history of gestational hypertension had significant associations.

Conclusions: Our findings suggest that the pathophysiology of EBP in young adults differs between the genders and highlights a number of modifiable factors in its development.

Keywords: hypertension; risk factors; target‐organ damage; young adults.