ArticleBMJ open2022
Hypertension in the South African public healthcare system: a cost-of-illness and burden of disease study.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Projected burden and distribution of elevated blood pressure levels and its consequence among adolescents in sub-Saharan Africa.Journal of global health · 2024Pooled it
- Care Cascades for Hypertension in Low-Income Settings: A Systematic Review and Meta-Analysis.International journal of public health · 2023Pooled it
- Economic Burden of Human Immunodeficiency Virus and Hypertension Care Among MOPHADHIV Trial Participants: Patient Costs and Determinants of Out-of-Pocket Expenditure in South Africa.International journal of environmental research and public health · 2025Trial
- Food insecurity and mental health in South Africa: Structural pathways linking socioeconomic position, behavioural risk factors and comorbidity.Preventive medicine reports · 2026Article
- The longitudinal care cascade for hypertension in people with and without HIV in South Africa: A clinic-based observational study.PLoS medicine · 2026Observational
- A Targeted Review of Available Data Sources to Support Evidence-Informed Decisions: Implications for Health Technology Assessment in South Africa.PharmacoEconomics - open · 2026Review
- Acceptability of Hypertension Quality Indicators in Primary Care in South Africa: Exploratory Implementation Research.Healthcare (Basel, Switzerland) · 2026Article
- Prevalence and Determinants of Uncontrolled Hypertension Among Treated Adults in a Rural Primary Health Care Facility in South Africa: A Cross-Sectional Study.Epidemiologia (Basel, Switzerland) · 2026Article
- The Global Burden of Chronic Kidney Disease Attributable to Hypertension in Young Adults From 1990 to 2021 and Projections to 2050.Balkan medical journal · 2026Observational
- The economic cost of outpatient primary care of adults with multimorbidity (HIV, diabetes, and hypertension) in rural South Africa.Health policy and planning · 2026Article
- Hypertension pharmacogenetics and limitations in Africa - a focus on the ACE, AGTR1 and CYP2C9 genes.Journal of human hypertension · 2026Review
- The longitudinal care cascade for hypertension: a clinic-based study of people with and without HIV in South Africa.medRxiv : the preprint server for health sciences · 2026Article
- Factors contributing to uncontrolled hypertension in Ekurhuleni District, South Africa: the community health workers' perspectives. A qualitative analysis.Primary health care research & development · 2025Article
- Quality of Care for Hypertension in Primary Health Care in South Africa: Cross-Sectional Feasibility Study.Healthcare (Basel, Switzerland) · 2025Article
- "We don't care because we are not sick": understanding youths perceptions of hypertension in urban South Africa.BMC public health · 2025Article
- Hospital costs attributable to obesity, diabetes, and hypertension in COVID-19 patients in South Africa.Journal of public health research · 2025Article
- Examining the Relationship Between Consumption of a Protein-Based Diet and Hypertension Among Urban Households: A Cross-Sectional Study.Health science reports · 2025Article
- Elevated isoleucine may be a protective factor for primary hypertension: A pooled causal effect study.Medicine · 2025Article
- Development of quality indicators for hypertension management at the primary health care level in South Africa.Journal of human hypertension · 2025Article
- Hypertension guideline implementation and blood pressure control in Matlosana, South Africa.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo quantify the health and economic burden of hypertension in the South African public healthcare system.
settingAll inpatient, outpatient and rehabilitative care received in the national public healthcare system.
participantsAdults, aged ≥20 years, who receive care in the public healthcare system. OUTCOMES: Worksheet-based models synthesised data from multiple sources to estimate the burden of disease, direct healthcare costs, and societal costs associated with hypertension. Results were disaggregated by sex.
resultsApproximately 8.22 million (30.8%, 95% CI 29.5% to 32.1%) South African adults with no private health insurance have hypertension. Hypertension was estimated to cause 14 000 (95% CI 11 100 to 17 200) ischaemic heart disease events, 13 300 (95% CI 10 600 to 16 300) strokes and 6100 (95% CI 4970 to 7460) cases of chronic kidney disease annually. Rates of hypertension, hypertension-related stroke and hypertension-related chronic kidney disease were greater for women compared with men.The direct healthcare costs associated with hypertension were estimated to be ZAR 10.1 billion (95% CI 8.98 to 11.3 billion) or US$0.711 billion (95% CI 0.633 to 0.793 billion). Societal costs were estimated to be ZAR 29.4 billion (95% CI 26.0 to 33.2 billion) or US$2.08 billion (95% CI 1.83 to 2.34 billion). Direct healthcare costs were greater for women (ZAR 6.11 billion or US$0.431 billion) compared with men (ZAR 3.97 billion or US$0.280 billion). Conversely, societal costs were lower for women (ZAR 10.5 billion or US$0.743 billion) compared with men (ZAR 18.9 billion or US$1.33 billion).
conclusionHypertension exerts a heavy health and economic burden on South Africa. Establishing cost-effective best practice guidelines for hypertension treatment requires further research. Such research will be essential if South Africa is to make progress in its efforts to implement universal healthcare.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.