The clinical pattern of hypertension in the South African Black population: a study of 1000 patients

Abstract

This study consisted of 1000 South African Black hypertensive patients (500 Africans and 500 Indians) seen over a period of 12 years in the hypertension clinic at King Edward VIII Hospital. Essential hypertension in the African occurs at a younger age group in females, with death occurring in cerebrovascular episode, congestive cardiac failure or uraemia. Accelerated hypertension was seen in 7% of the African hypertensives with death occurring frequently in uraemia. The absence of ischaemic heart disease in the African hypertensive patient even though they developed congestive cardiac failure was noted. Predisposing factors for hypertension in the African population group was urbanization, obesity and excessive salt intake. In the Indian hypertensive patient, the age pattern resembled that seen in the white population of South Africa. The complications were those of cerebrovascular episode, congestive cardiac failure including ischaemic heart disease and uraemia. Predisposing factors in the Indian hypertensive patient were excessive salt intake and obesity; a close relationship between diabetes mellitus and gout was present. Whereas a family history of hypertension was common in the Indian hypertensive patient it was uncommon in the African hypertensive patient. It appears that hypertension is an emerging disease in the urbanized African which is increasing in incidence