Hypertension in sub-Saharan Africa: a massive and increasing health disaster awaiting solution

Increased blood pressure is the leading risk for death globally. While this is also true in sub-Saharan Africa, there are many hypertension issues that are unique to the region. A prime and important example is that in most countries in the region, population blood pressure is increasing, while in most countries in the rest of the globe, population blood pressure is decreasing. Currently hypertension prevalence rates in some sub-Saharan African countries are among the highest in the world, while a few short decades ago, several countries in sub-Saharan Africa had among the lowest blood pressure levels. Importantly, several sub-Saharan African countries still have hypertension prevalence rates below the global average, providing an important opportunity for prevention. Recently, a needs assessment of hypertension organisations in sub-Saharan Africa also showed important and different needs from hypertension organisations in other regions of the world. Dr Seedat has comprehensively outlined relevant issues in his article ‘Why is control of hypertension in sub-Saharan Africa poor?’ (page 193) He concludes by quoting Nelson Mandela ‘We must face the matter squarely ... We know that we have it in ourselves as Africans to change all this’. In my opinion, defining and acknowledging the problem is the most important step, but it is also just the first step in a long journey to improving hypertension prevention and control. That the solution to hypertension in sub-Saharan Africa is within sub-Saharan Africa is another critical observation to start that journey. What are the potential next steps?