Hypertension in goldminers

Abstract

BACKGROUND: Reliable information about the prevalence of hypertension, which is a major contributor to cardiovascular disease in general and to coronary heart disease in particular, in different geographical regions is essential for its prevention and optimal control. In the mining industry, which comprises mainly urbanised black African men, the prevalence, impact, treatment and control of hypertension remains unexplored. METHODS: We conducted a retrospective, descriptive 1-year hypertension prevalence study in Gauteng Harmony Mine Operations in South Africa. Patient profiles and blood pressure (BP) measurements were retrieved from the company electronic data systems. Follow-up entries made at all the different health facilities that serve this population were examined. Continuous variables were summarised using means or medians with standard deviations. Categorical deviations, including ethnicity, were summarised using percentages and/or frequencies. RESULTS: Of the 4 297 subjects (100% of the mining population in the study period), 4 286 (99%) were black Africans; 90% were men; mean age was 44.62 years; and 39.5% (N=1 696) had hypertension, for which 42% (N=719) received pharmacological treatment, of which 31% (13% of the total hypertensive population) achieved an adequate BP control target of <140/90 mmHg. Pharmacological treatment included diuretics (38.5%), angiotensin-converting enzyme inhibitors (30.16%), calcium channel blockers (26%), beta-blockers (4.47%), angiotensin-receptor blockers (0.17%) and centrally acting agents (0.07%), usually taken in combination. CONCLUSION: We confirmed that hypertension is an important health challenge for the mining industry in South Africa. Detection, treatment and adequate control of hypertension should receive high priority from the mining authorities.