Abstract
D.Litt. et Phil.
A problematic aspect of the latter half of the twentieth century in the South African health context, has been the change of the incidence of hypertension amongst black South
Africans from being barely. endemic to being a virtual epidemic. This change in hypertension has had several negative components, notably the development of malignant hypertension wherein a markedly accelerated rate of development in
hypertension has led to severely high incidences of morbidity and mortality amongst black South Africans notably in urban areas. Many researchers have cited the rapid process of urbaniztion as being the major cause, of this rapid rise in the relative
incidence of hypertension amongst black South Africans. Whereas previously, the rapid rise of hypertension in urbanizing black South Africans has been attributed to the
social readjustment, associated with urbanization, recent research have suggested that it is not only stressrelated, but also related to a change in basic lifestyle. Basic lifestyle
changes have been found to include a change in work ethic from being a rural, cooperative work ethic, to being an urbanized firstworld type A, aggressive, competitive workstyle. This has led also to changes in eating habits with the ingestion of more
salt, fats and oils, and has led to a hurried, but non exercised lifestyle. Because of the rapid increase of incidence of hypertension amongst black South Africans, the treatment of this condition has become problematic~ While black South Africans do not
respond as well to traditional pharmacological interventions in this condition, they also show side-effects which make it very difficult for them to continue taking this medication.
The cost aspects have also been noted to be prohibitively high and the availability of medicines because of the cost aspects has been projected to decline in the coming century. For this reason it would be "important to address other adjunctive measures to treat hypertension amongst black South Africans. In addition to standard harmacological interventions , it appears that there has been mention in the Iiterature of.
lifestyle changes to be an efficacious intervention method in stabilizing and reducing blood pressure amongst hypertensives. This has however not been investigated individually or systematically amongst black South Africans. It was therefore the purpose of this study to investigate the effectiveness of lifestyle intervention programs, notably an aerobic exercise intervention, a dietary intervention, and an intervention to
increase assertiveness and therefore reduce the aggressiveness associated with the competitive working style acquired by black South Africans. In order to test the efficacy of these treatment measures, a large group of black mineworkers were selected on a basis of meeting the diagnostic criteria for essential hypertension. These black mineworkers were then systematically sUbjected to an aerobic exercise intervention, a dietary intervention, and anger management by means of assertiveness training. Various measures were performed on a pretest and posttest basis. All three interventions were shown to have moderate efficacy. It was found that aerobic exercise, the dietary intervention and the anger management to be associated with a decline in
both systolic and diastolic blood pressure, and to be associated with a reduction in the taking of hypertensive medication as ordered by the attending physicians. The aerobic exercise intervention also indicated that black South African mineworkers are relatively unfit and a ch~nge in fitness resulted in a decline in systolic and diastolic blood
pressure. The dietary intervention proved to be efficient in terms of changing lifestyle eating habits. Of note is the fact that there was a substantial decrease in the taking of
medication when compared to a· control group. It would appear from this research that the specific forms of lifestyle change in black hypertensives noted in this study
would be an efficient adjunct or even a substitute for present treatment of hypertension amongst black mineworkers.