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

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).

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

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

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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

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