Roadmap to Achieve 25% Hypertension Control in Africa by 2025

Abstract

Background and aim: The Pan-African Society of Cardiology (PASCAR) has identified hypertension as the highest area of priority for action to reduce heart disease and stroke on the continent. The aim of this PASCAR roadmap on hypertension was to develop practical guidance on how to implement strategies that translate existing knowledge into effective action and improve detection, treatment and control of hypertension and cardiovascular health in sub-Saharan Africa (SSA) by the year 2025. Methods: Development of this roadmap started with the creation of a consortium of experts with leadership skills in hypertension. In 2014, experts in different fields, including physicians and non-physicians, were invited to join. Via faceto-face meetings and teleconferences, the consortium made a situation analysis, set a goal, identified roadblocks and solutions to the management of hypertension and customised the World Heart Federation roadmap to Africa. Results: Hypertension is a major crisis on the continent but very few randomised, controlled trials have been conducted on its management. Also, only 25.8% of the countries have developed or adopted guidelines for the management of hypertension. Other major roadblocks are either government and health-system related or healthcare professional or patient related. The PASCAR hypertension task force identified a 10-point action plan to be implemented by African ministries of health to achieve 25% control of hypertension in Africa by 2025. Conclusions: Hypertension affects millions of people in SSA and if left untreated, is a major cause of heart disease and stroke. Very few SSA countries have a clear hypertension policy. This PASCAR roadmap identifies practical and effective solutions that would improve detection, treatment and control of hypertension on the continent and could be implemented as is or adapted to specific national settings.

Prevalence, awareness, treatment, and control of hypertension in Cameroonians aged 50 years and older: A community‐based study

“…However, despite the high rates of awareness and treatment, the control rates remained low. The Pan‐African Society of Cardiology recently identified roadblocks against the effective control of HTN in Africa, amongst which were lack of established national policies for controlling HTN, low prioritization of noncommunicable diseases with a reluctance to implement policies on noncommunicable diseases by government officials, shortage of health care professionals (physicians, nurses, and trained health workers) at primary care level with very low physician/patient ratio, lack of quality and affordable anti‐HTN medications, low mastery of the effects of HTN and its consequences by health care professionals and patients alike, poor patient education with a resultant difficulty in changing lifestyles, and false health beliefs that HTN is curable . Effectively addressing these roadblocks could improve the treatment and control rates of HTN in Africa in general, and in Cameroon in particular.…”

“…Furthermore, HTN has been associated with the development of cognitive impairment, which could explain failure to take antihypertensive medication, and account for the poor adherence to antihypertensive medication and the resulting poor control rates . Proposed solutions to these problems include adopting and implementing national guidelines and policies for the effective detection, treatment, and control of HTN; recognizing HTN as a public health priority and allocating appropriate resources for effective detection, treatment, and control of HTN; designing and implementing training courses for community health workers and health care personnel to improve the quality of anti‐HTN treatment; improving access to affordable and high‐quality antihypertensive treatment; improving patient education on the consequences of HTN; and investing in population‐level interventions for preventing HTN such as reducing salt intake and obesity levels, increasing fruit and vegetable intake, and encouraging physical exercise . In addition, home BP monitoring has been suggested as a potential strategy to improve treatment compliance and, consequently, optimal BP control .…”

Predictive capacity of obesity indices for high blood pressure among southern Ethiopian adult population: a WHO STEPS survey

“…An urgency was recognized to develop and share best practices, including affordable and effective community-based programs to screen and treat hypertension during a meeting held in African Union member states in Addis Ababa. During the meeting, it was stated that hypertension as one of the continent’s greatest health challenges after HIV/AIDS [ 22 ]. Anthropometric indicators may be an efficient strategy for the detection and control of high blood pressure mainly because these measures can be implemented without specialized technical apparatus and easy to set goals for interventions [ 23 , 24 ].…”

Low uptake of hypertension care after community hypertension screening events in Lagos, Nigeria

“…Consequently, antihypertensive treatment coverage and hypertension control are both low [7,8]. The Pan-African Society of Cardiology presented a roadmap that aims to achieve 25% hypertension control by 2025 [9]. Identifying individuals with hypertension, increasing awareness and referral to hypertension care are important first steps in improving hypertension control.…”