Hiding in the shadows of the HIV epidemic: obesity and hypertension in a rural population with very high HIV prevalence in South Africa (original) (raw)

Journal of Human Hypertension volume 22, pages 236–239 (2008)Cite this article

We conducted a large population-based survey of body mass and blood pressure nested within an HIV survey in rural KwaZulu-Natal, South Africa, to measure the prevalence of obesity and hypertension in a community with very high HIV prevalence and to investigate the effect of HIV on body mass and blood pressure in a general population in rural Africa before antiretroviral treatment was widely available. Crude prevalence of overweight, obesity, stage-I and stage-II hypertension was 58% (95% confidence interval (CI) 56–60%), 32% (95% CI 30–33%), 24% (95% CI 22–26%) and 9% (95% CI 8–10%), respectively. Controlling for age, sex, education, household wealth, marital status and rural vs urban residence in multiple regression (after multiple imputation of missing values), HIV infection reduced body mass index by 1.9 units ( P <0.001) and––when additionally controlling for body mass––systolic blood pressure by 3.0 mm Hg ( P =0.005).

While 80% of deaths due to cardiovascular disease occur in low- and middle-income countries,1 reliable data on the main cardiovascular risk factors—obesity and hypertension— from developing countries are scarce, particularly from rural Africa. Only two published studies report on the relationship between HIV infection and cardiovascular risk factors in Africa, both facility-based in large cities (in hospital in-patients in Bujumbura, Burundi2 and in antenatal services in Dar es Salaam, Tanzania3).

This is a preview of subscription content, access via your institution

Access options

Subscribe to this journal

Receive 12 digital issues and online access to articles

$119.00 per year

only $9.92 per issue

Buy this article

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Additional access options:

References

  1. Strong K, Mathers C, Leeder S, Beaglehole R . Preventing chronic diseases: how many lives can we save? Lancet 2005; 366(9496): 1578–1582.
    Article Google Scholar
  2. Niyongabo T, Henzel D, Ndayishimyie JM, Melchior JC, Ndayiragije A, Ndihokubwayo JB et al. Nutritional status of adult inpatients in Bujumbura, Burundi (impact of HIV infection). Eur J Clin Nutr 1999; 53(7): 579–582.
    Article CAS Google Scholar
  3. Villamor E, Msamanga G, Urassa W, Petraro P, Spiegelman D, Hunter DJ et al. Trends in obesity, underweight, and wasting among women attending prenatal clinics in urban Tanzania, 1995–2004. Am J Clin Nutr 2006; 83(6): 1387–1394.
    Article CAS Google Scholar
  4. Welz T, Hosegood V, Jaffar S, Bätzing-Feigenbaum J, Herbst K, Newell ML . Continued very high prevalence of HIV infection in rural KwaZulu-Natal, South Africa: a population-based longitudinal study. Aids 2007; 21(11): 1467–1472.
    Article Google Scholar
  5. WHO. STEPS Field Manual Guidelines for Field Staff. World Health Organization: Geneva, 2003.
  6. European Society of Hypertension–European Society of Cardiology. 2003 guidelines for the management of arterial hypertension. J Hypertens 2003; 21(6): 1011–1053.
    Article Google Scholar
  7. Rubin DB . Multiple Imputation for Nonresponse in Surveys. Wiley: New York, 1987.
    Book Google Scholar
  8. Collins L, Schafer JL, Kam CM . A comparison of inclusive and restrictive strategies in modern missing data procedures. Psychol Methods 2001; 6(4): 330–351.
    Article CAS Google Scholar
  9. Seedat YK, Seedat MA, Hackland DB . Biosocial factors and hypertension in urban and rural Zulus. S Afr Med J 1982; 61(26): 999–1002.
    CAS PubMed Google Scholar
  10. Colhoun HM, Hemingway H, Poulter NR . Socio-economic status and blood pressure: an overview analysis. J Hum Hypertens 1998; 12(2): 91–110.
    Article CAS Google Scholar
  11. Filmer D, Pritchett LH . Estimating wealth effects without expenditure data-or tears: an application to educational enrollments in states of India. Demography 2001; 38(1): 115–132.
    CAS PubMed Google Scholar
  12. Omran AR . The epidemiologic transition. A theory of the epidemiology of population change. Milbank Mem Fund Q 1971; 49(4): 509–538.
    Article CAS Google Scholar

Download references

Author information

Authors and Affiliations

  1. Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Mtubatuba, South Africa
    T Bärnighausen, V Hosegood, F Tanser, K Herbst, C Hill & M-L Newell
  2. Department of Population and International Health, Harvard School of Public Health, Boston, MA, USA
    T Bärnighausen
  3. Department of HIV and Genitourinary Medicine, King's College London School of Medicine at Guy's, King's College and St Thomas' Hospitals, London, UK
    T Welz
  4. Centre for Population Studies, London School of Hygiene & Tropical Medicine, London, UK
    V Hosegood
  5. Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
    J Bätzing-Feigenbaum
  6. Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, University College London, London, UK
    M-L Newell

Authors

  1. T Bärnighausen
  2. T Welz
  3. V Hosegood
  4. J Bätzing-Feigenbaum
  5. F Tanser
  6. K Herbst
  7. C Hill
  8. M-L Newell

Corresponding author

Correspondence toT Bärnighausen.

Additional information

Supplementary Information accompanies the paper on the Journal of Human Hypertension website (http://www.nature.com/jhh)

Supplementary information

Rights and permissions

About this article

Cite this article

Bärnighausen, T., Welz, T., Hosegood, V. et al. Hiding in the shadows of the HIV epidemic: obesity and hypertension in a rural population with very high HIV prevalence in South Africa.J Hum Hypertens 22, 236–239 (2008). https://doi.org/10.1038/sj.jhh.1002308

Download citation

This article is cited by