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Hypertension Awareness Month

17 May was the Hypertension awareness day, in addition to raising awareness, the Faculty of Health Sciences Would like to recognise and highlight research that is conducted by our students and staff members that contributes to Hypertension.

We would therefore like to reflect on one of the studies conducted by Mr Tokwe, a Masters in Nursing Graduate.  Mr Tokwe has published two articles, entitled Lived Experiences of human immunodeficiency virus and Hypertension in the Eastern Cape, South Africa, AND Nursing Recommendations for the Management of HIV and Hypertension in a rural Primary Health Care Setting, Eastern Cape, South Africa published in 2020 and 2021, respectively. We will have a look at the fist article mentioned above.

 

Article 1 (Read the article here)

From the study immerged four themes and 14 sub-themes based on the participants’ description of living with HIV and hypertension.  The data from this study also showed that living with HIV and hypertension required participants to make healthier lifestyle changes – which was the focus of theme 4 and to ensure that they take medication to treat both illnesses.  ‘The participants expressed that to continue to live with the two chronic illnesses, they had to start taking good care of themselves towards developing a new normal of HIV and hypertension. This meant that the participants had to change the way they were eating and follow instructions given:’

The sub-themes of theme 4 revealed the following from the data obtained from participants that took part in study:

  1. They should have a plan to assist them with living with both chronic illnesses, by preparing meals before having to take their medication so that they can take pills on time and promote a healthy lifestyle.
  2. Making sure they take medication daily for both HIV and Hypertension.
  3. Prepare to travel long distances sometimes to obtain the necessary medication they need.
  4. The participants sometimes had to compare which of the two diseases were the most life threatening, some indicated that hypertension was worse for them and required more monitoring/care.
  5. The intake of all the pills for HIV and Hypertension led to fatigue for some participants.

The participants indicated that they acquired unhealth addictions, such as smoking and drinking excessive alcohol, as a coping mechanism to live with HIV and Hypertension which was in contradiction of how they should be living.

Statistics highlighted in the article:

  • “…13 hypertension trends in people living with HIV are increased than in people not infected with HIV, and the predisposing factors leading to this burden include lifestyle factors, genetics, use of highly active antiretroviral and environmental factors. Supporting this, Medina-Thorne et al.8 discussed that there was an increased prevalence of hypertension of 31% amongst people living with HIV in both male and female participants with a median age of 41 years. South Africa is encountering a dual burden of HIV and hypertension.”
  • “Recent empirical evidence by Statistics South Africa highlights that South Africa is the leading country in the world with 7.97 million people living with HIV reported, thus making 13.5% of the total population. Whilst HIV continues to rise, hypertension is reported to be highly prevalent amongst people living with HIV in South Africa, thus increasing the burden of living with the comorbidity of HIV and hypertension”.
  • “Hypertension has been reported to be the cause of death across the world and approximately 1.13 billion people are hypertensive especially in the low- and middle-income countries.  According to the National Department of Health (NDOH),17 46% of women and 44% of men are living with hypertension in South Africa”.

 

Article 2 (Read the article here)

Dr Siphesihle Nqweniso, who graduated in April 2023 with PhD Human Movement Sciences has contributed to the conversation around Hypertension by highlighting the importance of the promotion of physical education and physical activity in school children to help prevent non-communicable diseases hypertension amongst others. Specifically, in the published study entitled Prevention of Overweight and Hypertension through Cardiorespiratory fitness and extracurricular sport participation among South African School lchildren , 2020 . We reflect here on the estimation of the prevalence of hypertension and overweight/obesity in South African children attending primary schools in disadvantaged areas and examining whether cardiorespiratory fitness and extracurricular sport involvement contributes to the distinction of children who are overweight and hypertensive vs those who are not.

  • From existing literature, hypertension and its prevalence in childhood is increasing.
  • From lifestyle perspectives, physical activity has been shown to have beneficial effects on children metabolic risk profile including BP
  • Children were recruited from grade 4 classes in eight quantile 3 schools around Port Elizabeth
  • To assess BP, a validated oscillometric digital BP monitor was used.  It is interesting to highlight that for normal and Hypertension BP, South Africa doesn’t have existing reference values  for children ; therefore  reference tables from a nationally representative sample of German children which used standardized BP assessment using comparable automated oscillometric devised was used in this study to explain BP readings.
  • Table 1 (page 6) reflects the statistics of the study variables including that of BP readings and hypertension classification
  • A total of 13.5% of 842 children were classified as hypertensive for both systolic and diastolic BP. Based on combined BP index, both boys and girls were similarly represented in the groups classified as hypertensive (45% and 52% respectively).
  • Sport participation was associated with low levels of Hypertension. Results showed that having having adequate cardiorespiratory fitness and Physical activity levels may have the potential to extent normal BP thus delaying the development of hypertension in adulthood.

In summary, this study highlighted the existence of hypertension and overweight in South African School children from disadvantaged areas. In lieu of the study results, early identification if children with elevated BP is important, and is thus recommended that future research investigate other factors that might contribute to high BP in children.

 

More Reading:

  1. Physical Activity, Cardiorespiratory Fitness and Clustered Cardiovascular Risk in South African Primary Schoolchildren from Disadvantaged Communities: A Cross-Sectional Study (Nqweniso et al, 2021) (Read the article here)
  2. Nursing Recommendations for the Management of HIV and Hypertension in a rural Primary Health Care Setting, Eastern Cape, South Africa (Tokwe et al, 2020 (Read the article here)