Prevalence and associated factors of hypertension among South African adults: findings from the Demographic and Health Survey 2016

The data of South Africa Demographic and Health Survey 2016 were analyzed to find out the prevalence and associated factors of hypertension according to the 2017 American College of Cardiology / American Heart Association (ACC/AHA 2017) and the Joint National Committee 7 (JNC7) guidelines. A weighted sample of 4799 adults aged ≥ 18 years were included in the final analyses. After conducting bivariate analyses to identify the differences in prevalence according to both the guidelines, multilevel multivariable logistic regression was applied to obtain adjusted odds ratio (AOR) along with 95% confidence interval (CI). According to the JNC7 and the ACC/AHA 2017 guidelines, the prevalence of hypertension was 50.4% (95% CI: 48.3%, 52.5%) and 75.0% (95% CI: 73.1%, 76.7%) respectively. The significant factors positively associated with hypertension according to the ACC/AHA 2017 guideline were: age-groups of ≥ 70 years, 50–69 years (AOR: 6.6, 95% CI: 5.2, 8.3) and 30–49 years (AOR: 2.3, 95% CI: 1.9, 2.7), being overweight (AOR: 1.2; 95% CI: 1.0, 1.5) and obese (AOR: 2.1; 95% CI: 1.7, 2.6), residing in urban area (AOR: 1.4, 95% CI: 1.1, 1.7), and belonging to the Free State province (AOR: 1.6, 95% CI: 1.0, 2.5) and the KwaZulu–Natal province (AOR: 1.8, 95% CI: 1.2, 2.7). No statistically significant association was found between hypertension and sex and wealth index as per the new guideline. The health promotion programs of South Africa should focus on the abovementioned factors in order to prevent and control hypertension irrespective of sex and wealth index.