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Review
. 2017 Jul/Aug;28(4):262-272.
doi: 10.5830/CVJA-2017-040.

Roadmap to achieve 25% hypertension control in Africa by 2025

Anastase Dzudie  1 , Brian Rayner  2 , Dike Ojji  3 , Aletta E Schutte  4 , Marc Twagirumukiza  5 , Albertino Damasceno  6 , Seringe Abdou Ba  7 , Abdoul Kane  8 , Euloge Kramoh  9 , Jean Baptiste Kacou  9 , Basden Onwubere  10 , Ruth Cornick  11 , Karen Sliwa  12 , Benedict Anisiuba  10 , Ana Olga Mocumbi  13 , Elijah Ogola  14 , Mohamed Awad  15 , George Nel  16 , Harun Otieno  17 , Ali Ibrahim Toure  18 , Samuel Kingue  19 , Andre Pascal Kengne  20 , Pablo Perel  21 , Alma Adler  21 , Neil Poulter  22 , Bongani Mayosi  23 ; PASCAR task force on hypertension
Affiliations
Review

Roadmap to achieve 25% hypertension control in Africa by 2025

Anastase Dzudie et al. Cardiovasc J Afr. 2017 Jul/Aug.

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.

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Figures

Fig. 1.
Fig. 1.
PASCAR recommendations for blood pressure measurement, thresholds and action required following appropriate office measurement.
Fig. 2.
Fig. 2.
PASCAR hypertension treatment algorithm
Fig. 3.
Fig. 3.
Prevalence, awareness, treatment and control of hypertension in Africa. Numbers are from Ataklte et al. Burden of undiagnosed hypertension in sub-Saharan Africa: A systematic review and meta-analysis.
Fig. 4.
Fig. 4.
2015 map of African countries with evidence of existing clinical practice guidelines for hypertension management and 10 actions to reduce the hypertension burden in Africa
See this image and copyright information in PMC

References

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