Key result
Age ≥50 linked to ~5-fold higher odds of elevated blood pressure in substance users.
Why the study?
Elevated blood pressure is a major cardiovascular risk factor attributable in part to substance use, prompting this study to describe the prevalence of elevated blood pressure and associated factors among individuals with self-reported substance use.
Cross-Sectional (n=2,148)
Yes
Among healthcare-seeking individuals reporting substance use in urban South Africa, over one-third had elevated blood pressure—with fewer than half of those affected receiving antihypertensive therapy—and increasing age and comorbidities were the primary independent risk factors.
Supports BP screening in older substance users with comorbidities; hypothesis-generating and requires prospective validation before practice change.
Elevated blood pressure is a major risk factor for cardiovascular diseases like hypertension and leading cause of death in sub-Saharan Africa. Substance use such as alcohol, tobacco and drugs, is one of various factors attributable to elevated blood pressure This study describes the prevalence of elevated blood pressure and associated factors among individuals who self-reported to substance use. This descriptive cross-sectional study involved use of secondary data from the Integrating HIV and Heart Health in South Africa study collected between August 2022 to May 2024. Primary outcome, elevated blood pressure was classified as systolic blood pressure ≥ 140 mmHg, and diastolic blood pressure ≥ 90 mmHg. Data was analysed using STATA version 17. Logistic regression analysis was performed to identify factors associated with elevated blood pressure. Of the 2148 participants included, 57.3 % (1230/2148) were males. The participants' median age was 41 years, and 35.9 % (772/2148) had elevated blood pressure, however only 16,9 % of the participants were receiving anti-hypertensive treatment. Independent factors associated with elevated blood pressure were increasing age - 30-39 years old (adjusted odds ratio (aOR) 2.78 [95 %CI 1.42–5.41], 40–49 years old (aOR 3.81 [95 %CI 1.95–7.46]), 50+ years (aOR 5.00 [95 %CI 2.45–10.20] and having comorbidities (aOR 2.35 [95 %CI 1.31–4.22]). Prevalence of elevated blood pressure was high and only a few of these were on anti-hypertensive treatment. Most participants reported using alcohol, including both alcohol and tobacco concurrently. Findings highlight the need for substance use interventions as part of cardiovascular disease management strategies. • Elevated blood pressure is a signal of hypertension – a risk factor for heart disease • In 2019 hypertension climbed by 48 % in men and 34 % in women in sub-Saharan Africa • In South Africa 30 % of hypertensive people use drugs; we report 64 % alcohol use • In Africa there is limited evidence linking substance use and cardiovascular diseases • We show a link between substance use and elevated blood pressure - warranting focus
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Oladimeji et al. (2025) conducted a cross-sectional in Self-reported substance use and elevated blood pressure (n=2,148). Increasing age (50+ years vs 18-29 years) and comorbidities among substance users vs. Age 18-29 years / No comorbidities was evaluated on Elevated blood pressure (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg from a single reading) (aOR 5.00, 95% CI 2.45-10.20, p=<0.05). Among adults reporting substance use, 35.9% had elevated blood pressure, with age ≥50 years (aOR 5.00, 95% CI 2.45-10.20) and comorbidities (aOR 2.35) as independent predictors.
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