Epidemic Hypertension in Sub-Saharan Africa

Abstract

The article “Hypertension in Sub-Saharan Africa” by Addo et al has documented both the high prevalence of hypertension, especially in urban areas, and poor control of hypertension in sub-Saharan Africa.1 In 1992, we reported the high prevalence of hypertensive disease in a population sample from Benin, Nigeria and the strong association with higher socioeconomic class and body weight.2 Previous reports from the World Health Organization (WHO) and other groups have warned of the growing epidemic of hypertension and vascular disease and, most important, the need for both population-based approaches to reduce the epidemic, including the reduction of salt in the diet and treatment of BP using inexpensive drug therapies.3,4 There is a need for better data on the prevalence of hypertension and risk factors related to both hypertension and vascular disease in sub-Saharan Africa. The most important imperative at the present time is to effectively blunt this growing epidemic of vascular disease. This epidemic of vascular disease is following the path characteristic of many other countries and especially in the United States, with initial high rates of hypertension and vascular disease among the upper socioeconomic groups and then explosive epidemics of both hypertension and vascular disease among lower income populations, especially the black population in the United States.5 The key variables that drive the epidemics are the greater use of processed foods, higher intake of calories, decreased physical activity leading to weight gain, and the reduction of foods high in potassium.6 The epidemic, as noted, has begun in the upper social classes and in urban …