Abstract:
BACKGROUND : As a response to the growing burden of noncommunicable
diseases, the South African government has set
targets to reduce the prevalence of people with raised blood
pressure, through lifestyle changes and medication, by 20% by
the year 2020. It has also recognised that the prevalence varies
at local administrative level. The study aim was to determine
the geographical variation by district of the prevalence of
hypertension among South African adults aged 15 years and
above.
METHODS : Data from all five waves of the National income
Dynamics Study, a panel survey, were used for estimation
by both design-based and multilevel analysis methods. In
the multilevel analysis, a three-level hierarchy was used with
panel participants in the first level, repeated measurements
on patients in the second level, and districts in the third level.
RESULTS : After accounting for demographic, behavioural,
socio-economic and environmental factors, significant variation
remained in the prevalence of hypertension at the
district level. Districts with higher-than-average prevalence
were found mostly in the south-western part of the country,
while those with a prevalence below average were found in the
northern area. Age, body mass index and race were the individual
factors found to have a strong effect on hypertension
prevalence for this sample.
CONCLUSIONS : There were significant differences in hypertension
prevalence between districts and therefore the method
of analysis and the results could be useful for more targeted
preventative and control programmes.
