Key result
Older age, female sex, and poor health are linked to higher early-onset hypertension risk.
Why the study?
Early-onset hypertension, defined as high blood pressure diagnosed before age 55, is an emerging public health concern associated with adverse cardiovascular outcomes.
Cross-Sectional (n=32,717)
In a South African cohort aged 20-54, early-onset hypertension was self-reported by 5.3% of participants and was strongly associated with older age, female sex, urban residence, and comorbid chronic illnesses.
Answers are grounded in this paper and cite their sources.
May inform targeted screening in older South African females with poor health; leaves open causal inference and generalizability.
Early-onset hypertension, defined as high blood pressure diagnosed before age 55, is an emerging public health concern associated with adverse cardiovascular outcomes. This cross-sectional study used data from the 2024 South African General Household Survey. Descriptive statistics were used to summarise sample characteristics. The Pearson Chi-Square Test of Independence was used to assess differences in the prevalence of early-onset hypertension across sample characteristics. A bivariate Generalised Linear Model (GLM) with a binomial distribution and log link function identified significant individual associations, and significant variables were included in a multivariate GLM to determine factors associated with the early onset of hypertension. Of the 32,717 participants aged 20–54 years, 5.3% (95% CI: 5.1–5.6) self-reported having hypertension. The final model showed the factors associated with a higher prevalence of the early onset of hypertension were being aged 35–44 years (aOR= 4.02 [95% CI: 3.32–4.86], p<0.001) and 45–54 years (aOR= 10.13 [95% CI: 8.39–12.24], p<0.001) compared to 20–34 years; females (aOR= 2.23 [95% CI: 2.05–2.64], p<0.001) compared to males; married (aOR= 1.45 [95% CI: 1.27–1.64], p<0.001) compared to never married; Other races (aOR= 1.56 [95% CI: 1.34–1.82], p<0.001) compared to Black African; those who reside in urban areas (aOR= 1.37 [95% CI: 1.19–1.57], p<0.001) compared to rural areas; self-reporting good (aOR= 2.21 [95% CI: 1.73–2.84], p<0.001) and fair or poor health status (aOR=5.74 [95% CI: 4.64–7.11], p<0.001) compared to excellent/very good; having at least one other chronic illness (aOR= 2.04 [95% CI: 1.73–2.41], p<0.001) compared to no other chronic illness. These findings highlight the need for early prevention and screening efforts targeting young adults, with a specific focus on the high-risk groups identified in this study. Public health interventions should be tailored to address these demographic and health-related risk factors to halt the rising burden of hypertension among younger populations in South Africa.
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Human Sciences Research Council (2026) conducted a cross-sectional in Early-onset hypertension (n=32,717). Older age (45-54 years; aOR 10.13), female sex (aOR 2.23), and fair/poor health (aOR 5.74) were significantly associated with early-onset hypertension among South African adults aged 20-54 years.
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