Recent advances in hypertension in sub-Saharan Africa

BACKGROUND: Hypertension was once considered rare in sub-Saharan Africa (SSA), but currently it has become a widespread problem with immense socioeconomic importance. The purpose of this review is to summarise new information on hypertension in SSA that has been published since the last major review in 2008. METHODS AND RESULTS: A literature search was performed in Pubmed, Embase, WHO Global Cardiovascular Infobase, African Journal On-Line, and African Index Medicus using the following search criteria: hypertension, high blood pressure, and Africa/SSA. Epidemiological surveys that used the WHO STEPS approach or similar methods were also included. The overall prevalence of hypertension in SSA was estimated at 16.2% (95% CI 14.2% to 20.3%) with an estimated number of hypertensive individuals to be 74.7 million. The prevalence of hypertension varies widely from country to country. It is projected that the number of affected individuals will increase by 68% (125.5 million) by 2025. Mass migration of rural Africans to urban areas and rapid changes in lifestyle and risk factors account for the rising prevalence of hypertension. CONCLUSIONS: Proactive public health interventions at a population level need to be introduced to control the growing hypertension epidemic, and there needs to be a major improvement in access to hypertensive care for the individual. There is an important need for better epidemiological data and hypertension related outcome trials in SSA.