title: Cardiovascular risk and comorbid conditions among Black South Africans with hypertension in public and private primary care settings: the HiHi study.
abstract: OBJECTIVE
  To describe the HiHi Study and assess cardiovascular disease (CVD) risk profile and comorbid conditions of Black patients receiving hypertension (HTN) care.
  
  
  METHODS
  Cross sectional, descriptive.
  
  
  METHODS
  Public and private primary care sites in three townships near Cape Town, South Africa.
  
  
  METHODS
  403 hypertensive Black patients (183 men, 220 women), ages 35-65 years.
  
  
  METHODS
  Self-reported sociodemographic, lifestyle, and medical history factors were assessed. Height, weight, and blood pressure (BP) were measured and 12-lead electrocardiogram recorded. Blood and urine were collected to assess lipid profile, diabetes, and renal impairment. Type and number of medications were abstracted from medical records.
  
  
  RESULTS
  Antihypertensive medication was prescribed for all participants, with HTN controlled (BP<140/90 mm Hg) for 36% of public and 51% of private patients. Mean systolic and diastolic BP were higher in the public than private sector (148/90 +/- 28/13 and 138/ 86 +/- 21/13 mm Hg) as was LVH (37% and 30%) but diabetes (18% and 29%) and obesity (55% and 75%) were less common in the public sector. There were no significant differences between public and private settings in use of antihypertensive medications, total cholesterol > or =5 mmol/L, daily tobacco use, or total CVD risk. More men than women smoked tobacco daily (30% and 6%) and used alcohol excessively (53% and 15%).
  
  
  CONCLUSIONS
  Despite attending HTN primary care, CVD risk factors were addressed inadequately. Differences in risk factor prevalence and control were identified by healthcare sector and sex. A critical need exists to improve HTN care and CVD risk management programs for this high risk group.
authors.affiliation: The Johns Hopkins University School of Nursing; 525 N. Wolfe Street, Room 419, Baltimore, MD 21205, USA. cdennis4@jhmi.edu
authors.forename: Cheryl R
authors.initials: CR
authors.lastname: Dennison
authors.forename: Nasheeta
authors.initials: N
authors.lastname: Peer
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Lombard
authors.forename: Lulama
authors.initials: L
authors.lastname: Kepe
authors.forename: Naomi S
authors.initials: NS
authors.lastname: Levitt
authors.forename: Krisela
authors.initials: K
authors.lastname: Steyn
authors.forename: Martha N
authors.initials: MN
authors.lastname: Hill
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000208:ethnology* / Q000209:etiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D054624:Health Status Disparities; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D017149:Private Sector; D017150:Public Sector; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology