Background: The prevalence of hypertension and obesity is predicted to increase in developing countries particularly in South Africa. Recent literature indicates that rural dwelling South African black women have the higher prevalence of obesity in subSaharan Africa. The determinants of obesity and hypertension in rural black South African women are still not yet determined. Therefore the purpose of this study was to determine whether behavioural factors and covariates such as socioeconomic status (SES) were associated with body composition and blood pressure in a cohort of women living in the Tshino Nesengani rural village, Limpopo province. Methods: A cross-sectional study involving 200 African women aged ≥18 years living in the Tshino Nesengani (Mukondeleli) village was conducted. Data Collection included, anthropometry (weight, height, waist circumference, and hip circumference); systolic blood pressure and diastolic blood pressure and standardized self-reported questionnaires: Global physical activity questionnaire was used for physical activity and sitting time, Beverage intake Questionaire-15 was used to determine sugar-sweetened beverage intake, Pittsburgh sleep questionnaire index was used to determine sleeping index, and socioeconomic status was determined using SES household questionnaire. Pearson’s correlation was used to determine the correlation between body composition and blood pressure with lifestyle behaviours. Multivariable linear regression models were used to determine the association of lifestyle behaviours with body composition and blood pressure. Results: The prevalence of overweight was 25%, obesity 40%, and the prevalence of hypertension was 26%. The prevalence of cigarette smokers was 3%, snuff use was 5%, and alcohol consumption was 14.5%. Age showed a positive correlation with systolic blood pressure, diastolic blood pressure and pulse pressure. Body mass index was positively associated with waist circumference (r=0.75, p<0.0001). Total work physical activity was positively correlated with diastolic blood pressure (r=0.14, p<0.05) and total leisure moderate to vigorous physical activity, total moderate physical activity and total moderate to vigorous physical activity were positively correlated with waist circumference. In a multivariable linear regression model, body mass index was positively associated with age (β: 0.20, p<0.001), socioeconomic status (β: 0.16, p<0.02) and hypertension (β: 0.21, p<0.0001). Waist circumference was positively associated with body mass index (β: 0.67, p<0.0001), and negatively associated with completion of high school education (β:-0.14, p<0.001). Systolic blood pressure showed a positive of association with age (β: 0.40, p<0.0001) while, diastolic blood pressure was positively related to age (β: 0.21, p<0.0001) and body mass index (β: 0.24, p<0.0001), and negatively associated with hours of sleep/night (β: -0.16, p<0.02). Conclusion: The findings show that the majority of the study population were obese and hypertensive, and this confirms the urgency of these diseases to be addressed in rural-dwelling black South African women. Our findings also indicate that longer sleep may protect against hypertension. However, this finding needs to be confirmed with objective measurement of sleeping patterns.

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Association of lifestyle and sleep behaviours with blood pressure and body composition: a cross-sectional study of rural black South African women living in Tshino Nesengani	10

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