Blood pressure and social support observations from Mamre, South Africa, during social and political transition

Objective: Social support, by moderating cardiovascular reactivity, has bee n demonstrated to attenuate the effects of stress on blood pressure in Amer ican communities.. This is the first report to examine the relationship bet ween social support and blood pressure in a South African context, during a period of infrastructure modernisation and political change. Methods: A total of 1240 residents (542 men, 698 women) of mixed ethnic ori gin, older than 14 years and stratified by age and sex, participated in a s urvey Po determine risk factors for hypertension and cardiovascular disease s. Social support was assessed by a questionnaire developed in consultation with the community. It was defined by interactions that may threaten famil y harmony (score 1) and by networking between relatives, friends, colleague s and neighbours (score 2). Results: Mean blood pressure of the sample was 130/79 mm Hg (s.d. 25/14 mm Hg). Hypertension prevalence was 26.9%. Only 36% of women compared to 57.3% of men (P < 0.0001) were employed. More women (29%) than men (22%) reporte d threats to family harmony, but social support networks were similarly per ceived by both sexes. Systolic and diastolic blood pressure correlated weak ly with score 1 (r = 0.096, p < 0.0007) but no association was observed wit h score 2. Score 1 was not associated with blood pressure by multiple regre ssion analysis, that included confounding by age, sex, BMI, alcohol consump tion and smoking status. Conclusions: Neither threats to family harmony nor networking between relat ives, friends or neighbours, significantly influences blood pressure in thi s community. Measures of social support thought to moderate blood pressure may have limited cross-cultural application. Attitudinal changes during soc io-political transition may impact on the generalisability of instruments f or measurement.