Association between body mass index, demographics, and hypertension risk in South African university students

Background: High blood pressure (BP) is becoming increasingly common among young adults, with university students representing a particularly vulnerable group, posing a growing public health challenge worldwide. The study explores the relationship between BMI and demographic characteristics related to elevated BP in this group, the study addresses a critical gap in local data and supports broader efforts to reduce the future burden of hypertension in South Africa. Objectives: This study aimed to examine the association between BMI, demographic data, and elevated BP among university students in South Africa. Methods: A cross-sectional research study was conducted with university students. The researchers measured the participants' anthropometrics and BP and obtained their demographic data. Binary logistic regression was used to identify factors associated with elevated BP whilst descriptive statistics, t-tests and chi-square tests were used to profile the study’s variables. Results: The prevalence of elevated BP was 46.4%. Elevated BP was more common among males (51.2%) and among students aged 25 years and older (58.9%). There was a significant association between BMI category and elevated BP, with students who were overweight showing an adjusted odds ratio (OR) of 1.98 (95% CI: 1.37—2.87), and students living with obesity showing an adjusted OR of 4.45 (95% CI: 2.73—7.27), compared to those with normal BMI. Additionally, pursuing a postgraduate degree and residing off campus were associated with increased odds of elevated BP. In contrast, being female was associated with lower odds of elevated BP (adjusted OR = 0.22, 95% CI: 0.16—0.31). Conclusion: BMI, gender, educational level, and residence are significant predictors of high BP among university students. Early intervention is necessary to prevent hypertension in students.