Factors associated with the early onset of hypertension: insights from the South African General Household Survey, 2024

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.