Raised blood pressure continues to be one of the strongest predictors of cardiovascular morbidity and mortality with an estimated 1.38 billion people worldwide suffering with hypertension.
It is also estimated that less than half of the adults with hypertension are aware of it or on treatment. Extensive public health measures including screening programmes in the western world have resulted in a plateauing of the prevalence of hypertension, with better levels of control and indeed even a downward trend in hypertension related deaths in these countries
However, in many developing and low and middle income countries (LMIC), the prevalence is increasing along with poor control in those diagnosed with hypertension. It is estimated that almost two thirds of patients with hypertension worldwide, are living in these countries [3, 4]. This could be explained in part by better access to health care and better diagnosis, where higher proportions of the population are being screened for high blood pressure. However, this alone cannot explain this high prevalence, as the proportion of patients being screened who have high blood pressure is also increasing.
The continent of Africa is vast and diverse in terms of economy, ethnicity, culture, climate and geography. It is the second largest continent and covers around 20% of the land mass.
Keep up with the latest headlines on WhatsApp | LinkedIn
The UN Statistics Division has subdivided the African continent into five regions, Northern Africa, Central or Middle Africa, Southern Africa, East Africa, and Western Africa.
Apart from Northern Africa, which is mainly the countries around the Mediterranean (Egypt, Libya, Algeria, Morocco, Tunisia, Sudan and Western Sahara), the other four regions are often grouped together and referred to as “sub-Saharan Africa”. North Africa is considered to be more economically rich as compared to sub-Saharan Africa and accounts for around a third of Africa’s GDP.
The North and the sub-Saharan region also differ racially, with the populations of the countries in the north being predominantly of Arab descent, while countries in the rest of the continent are of indigenous black African descent. Additionally, many countries especially South Africa and Namibia in the south and the countries surrounding the Mediterranean sea towards the north of the continent, have substantial populations, who are of white European origin reflecting their eventful histories. Besides this, there are many local tribes, with their own diverse customs, and traditions and unique genetic identity.
As a continent, Africa often struggles as a whole in terms of health policies. There are many countries ravaged by civil war, while others are still recovering from the effects of past wars, political instability and the legacy of colonial rule. Extreme weather phenomenon such as severe drought are common and also contribute to worsening health and famine. Transmissible diseases and vector borne infectious diseases such as guinea worm, Malaria, chikungunya still continue to be a major health issue, despite advances in their control.
A study by Oleribe et al. identified inadequate human resources, inadequate budgetary allocation to heath and poor leadership and management as three challenges to better healthcare in Africa.
They suggested that radical solutions with innovative initiatives should be sought along with private sector investment in public health are required.
Alongside this, many countries in the continent have recorded positive economic growth over the last few years.
This has been accompanied by an improvement in most health indices over the last two decades.
However, along with economic growth, non-communicable diseases are also on the rise. According to data from the WHO, non communicable diseases accounted for 37% of the deaths in 2019, rising from 24% in 2000. Of these, cardiovascular diseases were the cause of 13% of all cause mortality and 37% of all non communicable disease deaths.
The prevalence of hypertension is increasing in all countries of Africa.
The rates range from country to country and the May Measurement Month survey in 2019 revealed rates of 33.6% in Angola, 32.8% in Botswana 26.1% in the Democratic republic of Congo, 34.1% in Ghana, 36.4% in Nigeria 34.5% in South Africa and 28.2% in Sudan.
Sign up for free AllAfrica Newsletters
Get the latest in African news delivered straight to your inbox
Overall, it is estimated that around 48% of women and 34% of men in Africa have hypertension, with very low levels of control.
In view of this, the Pan-African Society of Cardiology (PASCAR), identified hypertension as the highest area of priority for reducing cardiovascular disease on the continent with an aim to achieve 25% control of hypertension in Africa by 2025.
More recently, the world hypertension league had issued a “call to action” to improve awareness, treatment and control of hypertension in Africa.
Their goals were to diagnose 80% of adults with hypertension, treating 80% of diagnosed hypertensives and control 80% of the treated hypertensives by 2030.
In this special issue, we aim to turn the spotlight on the diagnosis and management of hypertension in the African continent, by studying the scale of the problem and review innovations and processes that have been adopted to improve its management in the region.