Key result
Higher BMI, male gender, and smoking linked to elevated upper-quantile BP in South African adolescents.
Why the study?
Childhood hypertension is a global public health concern and precursor to adult hypertension and non-communicable diseases, warranting comprehensive modeling of risk factors and interactions in South Africa.
Cross-Sectional (n=1,812)
In South African adolescents, higher BMI, male gender, and smoking, along with complex interactions like race and smoking, are significant risk factors for severe elevations in blood pressure.
These associations should not yet change practice in adolescents; hypothesis-generating and requires longitudinal confirmation of causality.
Background Childhood hypertension has become a major global public health concern. It is not only an indicator of poor cardiovascular health in children and adolescents, but also a precursor to adult hypertension and other non-communicable diseases. Therefore, this study aims to apply frequentist quantile regression to model both main effects and interaction terms, thereby obtaining a comprehensive understanding of child hypertension in South Africa. Methods The current study employed a nationally representative sample drawn from the 2017–2018 Wave 5 Household survey of the South African National Income Dynamics Study (NIDS). A final data set of 1812 respondents was found from 1900 originally observed and used for data analysis. The frequentist quantile regression was implemented to model both main effects and interaction terms. Results The findings revealed that higher BMI, male gender, cigarette consumption, race (coloured) and perceived health status significantly contribute to elevated blood pressure at either the upper ends of the DBP or SBP distributions in adolescents. Notably, interaction effects such as age with gender, race African with cigarette consumption, BMI with gender and Cigarette Consumption with Depression (Occasionally or All of the Time) highlighted the complex and multifactorial nature of hypertension risk. Conclusion This study confirms that childhood hypertension is a significant public health issue in South Africa. By using frequentist quantile regression, specific risk factors and how they interact were identified, providing a more detailed understanding of the problem. By understanding these specific risk patterns and vulnerable subgroups, more effective strategies can be designed to address childhood hypertension and mitigate its long-term health consequences.
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Kuhudzai et al. (2026) conducted a cross-sectional in Adolescent hypertension (n=1,812). Risk factors (BMI, male gender, cigarette consumption, race) vs. Unexposed/reference groups was evaluated on Elevated systolic and diastolic blood pressure at the 75th and 95th percentiles. Higher BMI, male gender, cigarette consumption, and specific interaction effects significantly contributed to elevated systolic and diastolic blood pressure at the upper quantiles in South African adolescents.
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