Biosocial factors and hypertension in urban and rural Zulus.

A study of 1,000 urban and 1,000 rural Zulus was carried out to determine the biosocial factors associated with hypertension. The prevalence of hypertension was 25% in the urban Zulu (males 23%, females 27%) and 10.5% in the rural Zulu (males 10%, females 10.75%). The mean arterial pressure was higher in the urban Zulu than in the rural Zulu at all ages and for both sexes (greater in females than in males). In both the urban and the rural Zulu the following factors were found to be significantly associated with hypertension: age, sex, obesity, marital status, urbanization and number of dependents. In the urban Zulu other parameters absent in the rural Zulu were associated with hypertension: insomnia due to anxiety, cigarette smoking, alcohol intake, conditions of work, educational status, income, number of children not working, lack of recreation or sport activity, and overcrowding. Likewise, in the rural Zulu other parameters absent in the urban Zulu were associated with hypertension: having a family member with hypertension and the educational status of the children. There was a relationship between hypertension and social variables which were observed to be stressful. Unlike the rural Zulu, the urban Zulu is exposed to a different lifestyle, acculturation, detribalization and various political ideologies. This could explain the difference in the prevalence of hypertension in urban and rural Zulus.