Cardiovascular Journal of Africa: Vol 30 No 1 (January/February 2019)

26 / 78

CARDIOVASCULAR JOURNAL OF AFRICA • Volume 30, No 1, January/February 2019 24 AFRICA
Ellisras Longitudinal Study 2017: The relationship
between waist circumference, waist-to-hip ratio,
skinfolds and blood pressure among young adults in
Ellisras, South Africa (ELS 14)
RB Sebati, KD Monyeki, MS Monyeki, B Motloutsi, AL Toriola, MJL Monyeki
Abstract
Background: Obesity and hypertension are major risk factors
for non-communicable diseases in the world today. The rela-
tionship between indicators of obesity and blood pressure
needs attention in the rural South African population.
Aim: This study examined the relationship between anthro-
pometric parameters and blood pressure (BP) among young
adults in the Ellisras rural area of South Africa.
Methods: A total of 742 (365 females and 377 males) young
adults aged 22 to 30 years, who were part of the Ellisras
Longitudinal Study (ELS), participated in the research.
Anthropometric and BP measurements were taken using the
protocol of the International Society for the Advancement
of Kinanthropometry (ISAK). Linear regression was used to
determine the relationship between anthropometric param-
eters and BP. The risk of developing hypertension among
young Elisras adults was evaluated using logistic regression.
Results: The results indicted a higher but non-significant
prevalence of hypertension in men (2.7%) than women
(2.4%). Linear regression showed a significant positive (p <
0.05) association between waist circumference and systolic BP
(beta = 0.273, 95% CI: 0.160–0.386), even after being adjusted
for age and gender (beta = 253, 95% CI: 0.127–0.343). The
risk for developing hypertension was significant (p < 0.05) for
waist circumference (OR = 2.091, 95% CI: 1.129–3.871) after
adjustment for age and gender.
Conclusion: Of all anthropometric parameters, waist circum-
ference was most significantly associated with BP (p < 0.05).
Anthropometric indicators of obesity were strong predictors
of hypertension among young adults in the Ellisras rural area.
Keywords: hypertension, skinfolds, waist circumference, waist-to-
hip ratio, central obesity, adults
Submitted 10/4/18, accepted 24/10/18
Published online 18/9/18
Cardiovasc J Afr 2019; 30: 24–28
DOI: 10.5830/CVJA-2018-056
Hypertension is a significant global challenge that contributes to
high risk of cardiovascular and kidney disease.1 The prevalence
of hypertension continues to increase in low- and middle-income
countries,2 and is mainly due to population growth, aging and
behavioural risk factors such as unhealthy diet, which lead to
obesity.3
Obesity usually refers to excessive storage of energy in the
form of adipose tissue,4 and remains a strong predictor for the
risk of developing hypertension.5 Moreover, a high prevalence
of hypertension is found in individuals who are more obese or
overweight than normal individuals, thus further increasing the
risk for cardiovascular disease.6 Studies have also shown that
obesity increases fatty tissue, which heightens vascular resistance
and overworks the heart to pump blood throughout the body,
thereby elevating blood pressure.7
Studies have established that anthropometry is an easy and
reliable method to use for predicting cardiovascular diseases
(CVDs), including hypertension. 8,9 However, such studies were
mostly conducted in children and fewer in adults, especially in
rural areas.10,11 In the same rural population, Monyeki et al .12
reported skinfold thickness, waist circumference (WC) and body
mass index (BMI) to have a significant positive association
with blood pressure at a younger age (seven to 13 years).
However, little is known about the association between WC,
waist-to-hip ratio (WHR) and skinfold thickness with BP in
young adults. Therefore, the aim of this study was to assess the
relationship between anthropometric (WC, skinfold thickness,
WHR) parameters and BP among young Ellisras adults aged
between 22 and 30 years.
Methods
Ellisras, now known as Lephalale, is a rural area based in
Limpopo province, South Africa. Ellisras has approximately 42
settlements, with a population of about 5 000 people.13 Ellisras
village (23° 40’S, 27° 44’W) is about 70 km from the nearest
settlement on the Botswana border.
In Ellisras, the Iscor coal mine and Matimba electricity
station are the main sources of employment for the people,
while other sources of livelihood include crop farming and cattle
rearing, as few individuals are educated. Unemployment and
Department of Physiology and Environmental Health,
University of Limpopo, Sovenga, South Africa
RB Sebati, BSc Hons
KD Monyeki, PhD, MPH,
MS Monyeki, MPhil
B Motloutsi, BSc Hons
MJL Monyeki
Department of Sport, Rehabilitation and Dental Sciences,
Tshwane University of Technology, Pretoria, South Africa
AL Toriola, PhD