Socioeconomic status and hypertension in South African adolescents

Abstract

Background. Hypertension, a consistent elevation in both systolic and diastolic blood pressure, poses a global health challenge and likely develops early in life. Research suggests that socioeconomic status (SES) is associated with hypertension in childhood and adolescence. However, pathways through which SES leads to hypertension in adolescents remain unclear. Objective. To examine the relationship between SES and hypertension among adolescents in South Africa (SA) and identify possible pathways linking SES and hypertension in this demographic. Methods. We analysed cross-sectional data from the South Africa Demographic and Health Survey 2016 comprising 1 062 adolescents aged between 15 and 19 years. SES was based on wealth quintiles. Multivariable logistic regression models and generalised structural equation modelling (GSEM) were employed to examine the relationship between SES and hypertension in adolescents. Results. The unadjusted and adjusted relationships between SES and hypertension were not statistically significant. According to the GSEM, age (OR 0.72, 95% CI 0.63 - 0.82) and BMI (OR 1.06, 95% CI 1.02 - 1.11) were the only factors directly associated with hypertension. Being female had a significant indirect effect on hypertension (OR 1.18, 95% CI 1.03 – 1.36). Conclusion. Although no association was observed between SES and hypertension, sex-specific patterns emerged among the correlates of hypertension. This emphasises a need for further social epidemiology research on hypertension in this age group, ideally incorporating other proxies of socioeconomic status besides the wealth index.