An inter-racial study of the prevalence of hypertension in an urban South African population

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Abstract
This study was done to compare and contrast the prevalence of hypertension in the three racial groups of Durban, namely the Africans (Zulus), Indians and Whites, and was a random house-to-house study of 1,000 of each group. The prevalence of hypertension according to World Health Organization (WHO) criteria was highest in the African (25%), intermediate in the White (22·8%) and lowest in the Indian (19%). Age-corrected prevalence rates were: African 25%, Whites 17·2% and Indians 14·19%. Prevalence of hypertension was more common in females than in males in the African and Indian population, unlike the Whites. In all racial groups the mean arterial pressure rose with age. Unlike the White study, African females between the ages of 35 and 40 years had a higher prevalence than males. There was an association between hypertension and diabetes mellitus in the Indian population. This study showed that all three population groups had hypertension which was undiagnosed, undetected or inadequately treated. The high prevalence of hypertension in the White and Indian population could explain the high incidence of ischaemic heart disease (IHD) in South Africa. In the African population, whilst they are spared IHD, hypertension is a major factor for the high incidence of cerebrovascular episodes. The lower prevalence of hypertension in the rural Zulu population and the difference in the years of residence between the hypertensive and normotensive urban Zulu suggests that urbanization plays an important part in the aetiology of hypertension in the Zulu.