oa South African Journal of Clinical Nutrition - Determinants of obesity and perception of weight in hypertensive patients in rural South Africa : original research



The objective of the study was to identify factors associated with being overweight or obese, and perceptions of weight by hypertensive patients living in rural South Africa.

This was a nested cross-sectional study.
The setting was primary healthcare clinics close to Manguzi Hospital, KwaZulu-Natal.
Subjects were 109 males and 391 females, prescribed at least one antihypertensive medication aged ≥ 18 years.
The primary outcome measure was body mass index (BMI) ≥ 25 kg/m2. The secondary outcome measure was recognition of being overweight by those with a BMI ≥ 25 kg/m2.
The mean age was 58 years. Three hundred and ninety-one (78%) participants were female, and the majority had never been to school or had attended primary school only. Three hundred and eleven (62%) participants were overweight or obese, with a BMI ≥ 25 kg/m2. Factors associated with being overweight or obese included having high cholesterol [adjusted odds ratio (OR) 10.62, 95% confidence interval (CI): 1.22-92.4, -value 0.032], and having never smoked (adjusted OR 3.22, 95% CI: 1.38-7.52, -value 0.007. Human immunodeficiency virus (HIV) was associated with a lower risk of being overweight or obese (adjusted OR 0.52 for BMI ≥ 25, 95% CI: 0.31-0.89, -value < 0.0001). Only 12% of participants who were overweight or obese perceived that they were overweight. Participants with a BMI ≥ 25 kg/m2 were most likely to recognise they were overweight if they had high cholesterol, diabetes or HIV.
Almost two thirds of participants were overweight or obese, and of these, only 12% perceived that they were overweight. Educating patients about obesity, particularly when they have other cardiovascular risk factors such as hypertension, is of public health importance.


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