Hypertensive Black South Africans Need
Black South Africans, a population greatly at risk for
high blood pressure, need comprehensive, multilevel
interventions addressing socioeconomic challenges,
lifestyle behaviors and health care delivery approaches to
improve high blood pressure treatment and outcomes,
according to a study conducted by researchers from Johns
Hopkins and the Medical Research Council of Tygerberg,
High blood pressure, or HPB, control is poor in
general among black South Africans and is frequently
complicated by characteristics of age, unemployment,
limited education, alcohol and tobacco use and excessive
weight. According to study results presented in a poster
session at the American Heart Association 2005 Scientific
Sessions in Dallas, the Johns Hopkins and South African
researchers found that despite making regular visits to
primary health care facilities for treatment and receiving
HBP medications, the majority of the study participants
continued to have uncontrolled blood pressure.
Two hundred and twenty women and 183 men who received
public or private primary care services in three South
African Cape Peninsula townships participated in the study.
The sample had spent the majority (67 percent on average)
of their lives in an urban setting. Eighty-one percent had
less than 10 years of schooling, and 61 percent were
unemployed. All had a high prevalence of lifestyle risk
factors, particularly alcohol and tobacco use and physical
inactivity, and the majority were overweight or obese.
While rates were somewhat lower among women, nearly
one-third of the men reported regular tobacco and alcohol
use, and more than one-half were at high risk for
alcoholism. Thirty-eight percent of men and 15 percent of
women were overweight, and an overwhelming 36 percent of
men and 78 percent of women were obese.
"These findings lead us to conclude that hypertension
care for black South Africans is inadequate. The data
reinforces our view that hypertension must be approached at
the policy, care setting, provider and patient levels. We
must consider a wider array of techniques and approaches in
addition to pharmaceutical intervention, including
significant policy-level changes that support
provider-level and patient-level changes to improve blood
pressure control and reduce cardiovascular morbidity and
mortality," said lead investigator Cheryl Dennison, an
assistant professor at the
Johns Hopkins School of
Dennison's co-investigators were Krisela Steyn, Jean
Fourie, Lulama Kepe, Carl Lombard and Martha N. Hill.
Funding was provided by the National Institutes of Health
and Novartis Pharmaceutical.
— Lynn Schultz-Writsel
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