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Stressful life events, neighbourhood characteristics, and systolic blood pressure in South Africa


The relationship between negative events, neighbourhood characteristics, and systolic blood pressure in developing countries is not well-documented, particularly using longitudinal data. To explore this relationship, we analysed panel data from the first three waves of the South African National Income Dynamics Study using a correlated random effects model adjusted for confounding risk factors. Our sample comprised of 15,631 respondents in 2008, 14,443 respondents in 2010/2011, and 14,418 respondents in 2012, all aged above 15 years. The prevalence of at least one negative household event across the three waves was approximately 30%. In any of the three waves, the adjusted prevalence of hypertension was 23.84%. This share was 21.75% in 2008 (95% CI 18.06–25.44), 23.16% in 2010/11 (95% CI 19.18–27.14), and 18.39% in 2012 (95% CI 16.03–20.75). In our adjusted correlated random effects model, we found that systolic blood pressure was significantly higher among respondents from households that reported death of a household member (0.85 mmHg; p =  0.02) and a reduction in grant income and remittances (2.14 mm Hg; p = 0.01). We also found no significant association between systolic blood pressure and neighbourhood income level. In a country with social and economic challenges, our results indicate that grief and negative financial events are adversely associated with blood pressure, which may explain in part the significant burden of hypertension in low- and middle-income countries.

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Fig. 1: Distribution of adjusted systolic blood pressure.

Data availability

Data analysed during this study can be accessed at the DataFirst website (, upon registration. Dofiles for data analyses are available from the corresponding author.


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Authors and Affiliations



TG was responsible for formulating research question and developing the concept, extracting and analysing data, interpretating results, summarising findings, and writing of first and final draft. MvF contributed to the formulation of the research question, data analysis, and providing feedback on the drafts. AES provided inputs on literature and data analysis and interpretation, and reviews of the drafts. RB was the project leader and supervisor, contributed to formulation of research question, data analysis, and feedback on the drafts.

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Correspondence to Trust Gangaidzo.

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The authors declare no competing interests.

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No ethical approval needed for this study because it used publicly available data, which is not sensitive and not linked to person or household identifiers. The present study, therefore, did not involve direct interaction with, or data gathering from human or organisational participants.

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Gangaidzo, T., von Fintel, M., Schutte, A.E. et al. Stressful life events, neighbourhood characteristics, and systolic blood pressure in South Africa. J Hum Hypertens (2022).

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