Hypertension and Obesity in Adults Living in a High HIV Prevalence Rural Area in South Africa

 Title: Hypertension and Obesity in Adults Living in a High HIV Prevalence Rural Area in South Africa Author: Malaza, Abraham; Mossong, Joel; Newell, Marie-Louise; Baernighausen, Till Winfried Note: Order does not necessarily reflect citation order of authors. Citation: Malaza, Abraham, Joel Mossong, Till Bärnighausen, and Marie-Louise Newell. 2012. Hypertension and obesity in adults living in a high HIV prevalence rural area in South Africa. PLoS ONE 7(10): e47761. Full Text & Related Files: 3474786.pdf (229.3Kb; PDF) Abstract: Hypertension and excess body weight are major risk factors of cardiovascular morbidity and mortality in developing countries. In countries with a high HIV prevalence, it is unknown how increased antiretroviral treatment and care (ART) coverage has affected the prevalence of overweight, obesity, and hypertension. We conducted a health survey in 2010 based on the WHO STEPwise approach in 14,198 adult resident participants of a demographic surveillance area in rural South Africa to investigate factors associated with hypertension and excess weight including HIV infection and ART status. Women had a significantly higher median body mass index (BMI) than men (26.4 vs. 21.2 kg/$$m^2$$, p<0.001). The prevalence of obesity (BMI≥30 kg/$$m^2$$) in women (31.3%, 95% confidence interval (CI) 30.2–32.4) was 6.5 times higher than in men (4.9%, 95% CI 4.1–5.7), whereas prevalence of hypertension (systolic or diastolic blood pressure≥140 or 90 mm Hg, respectively) was 1.4 times higher in women than in men (28.5% vs 20.8%, p<0.001). In multivariable regression analysis, both hypertension and obesity were significantly associated with sex, age, HIV and ART status. The BMI of women and men on ART was on average 3.8 (95% CI 3.2–3.8) and 1.7 (95% CI 0.9–2.5) kg/$$m^2$$ lower than of HIV-negative women and men, respectively. The BMI of HIV-infected women and men not on ART was on average 1.2 (95% CI 0.8–1.6) and 0.4 (95% CI -0.1–0.9) kg/m2 lower than of HIV-negative women and men, respectively. Obesity was a bigger risk factor for hypertension in men (adjusted odds ratio (aOR) 2.99, 95% CI 2.00–4.48) than in women (aOR 1.64, 95% CI 1.39–1.92) and overweight (25≤BMI<30) was a significant risk factor for men only (aOR 1.53 95% CI 1.14–2.06). Our study suggests that, cardiovascular risk factors of hypertension and obesity differ substantially between women and men in rural South Africa. Published Version: doi:10.1371/journal.pone.0047761 Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3474786/pdf/ Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:10587989 Downloads of this work: