Objective This study aimed to examine the prevalence of hypertension and risk factors associated with hypertension amongst 35-70 years old enrolled in the PURE study in North West province, South Africa.

Methods This study’s analysis is based on the South Africa arm of the Prospective Urban Rural Epidemiology (PURE) Study data of 2015. The bivariate analysis was used to generate the prevalence of hypertension according to the participants’ characteristics. In addition, the Chi-square test was used to examine the relationships between reported hypertension and characteristics of participants. Lastly, a multivariate logistic regression analysis was employed to estimate risk of hypertension, with 95% confidence interval.

Results Result shows that the prevalence of hypertension was higher among male, those who are 60 years and above, not employed, not educated, HIV negative, and overweight and obese. Further, the multivariate analysis showed the risk of hypertension is significantly lower among HIV-positive participants (OR: 0.45, CI: 0.31-0.64) and higher among obese participants (OR: 1.67, CI: 1.01-2.75).

Discussion Hypertension is an important health problem accounting for about 45.3% in the studied province in South Africa. Our study contributes to literature on the risk factors of hypertension in sub-Saharan African. Specifically, this study found that hypertension is relatively high in North West province and shows that the prevalence of hypertension is evident in the sociodemographic inequalities of the study population, as well as the modifiable factors used in the study. This study’s findings suggest that interventions should be directed at the identified factors found to be associated with hypertension. In addition, more emphases should be placed on sensitizing people on major lifestyles that may increase the risk of hypertension.