Clinical Report: Hypertension Prevalence and Blood Pressure in Sub-Saharan Africa Adults
Overview
A systematic review and meta-analysis of 533,167 adults across 26 sub-Saharan African countries found a pooled hypertension prevalence of 30.5%. Blood pressure levels and hypertension prevalence increased steeply with age and were higher in males and overweight individuals.
Background
Hypertension is a leading preventable cause of cardiovascular morbidity and mortality worldwide, with a rising burden in low-to-middle income regions such as sub-Saharan Africa (SSA). Unlike high-income countries, hypertension-related cardiovascular events in SSA often affect younger adults and disproportionately impact women. Previous studies have reported varying hypertension prevalence estimates in SSA, highlighting the need for updated, comprehensive data. This study aimed to provide robust, age-, sex-, and region-specific estimates of hypertension prevalence and blood pressure levels in SSA adults using contemporary data.
Data Highlights
Parameter
Estimate (95% CI)
Pooled Hypertension Prevalence
30.5% (28.4–32.6%)
Mean Systolic BP
128 mmHg (127–129)
Mean Diastolic BP
80 mmHg (79–80)
Hypertension Prevalence Age 21–30
10.6% (8.2–13.0%)
Hypertension Prevalence Age 41–50
30.9% (27.8–34.0%)
Hypertension Prevalence Age 71–80
66.4% (64.2–68.7%)
Hypertension Prevalence Healthy Weight
28.4% (26.1–30.6%)
Hypertension Prevalence Overweight
35.8% (31.4–40.1%)
Hypertension Prevalence Eastern Africa
27.2% (24.8–29.7%)
Key Findings
The pooled prevalence of hypertension among adults in SSA was 30.5% (95% CI 28.4–32.6%).
Mean systolic/diastolic blood pressure was 128/80 mmHg, with males having higher mean BP than females by approximately 3.1/0.7 mmHg.
Hypertension prevalence increased markedly with age, rising from 10.6% in those aged 21–30 years to 66.4% in those aged 71–80 years.
Overweight adults had a higher prevalence of hypertension (35.8%) compared to those with healthy weight (28.4%).
Regionally, Eastern Africa had the lowest hypertension prevalence at 27.2%.
The data indicate a steep age-related increase in blood pressure and hypertension risk, portending a growing cardiovascular disease burden in SSA.
Clinical Implications
Clinicians should be aware that approximately one in three adults in sub-Saharan Africa have hypertension, with risk increasing substantially with age and overweight status. Early identification and management of elevated blood pressure, especially in middle-aged and older adults, is critical to reduce the risk of cardiovascular events. Regional differences suggest targeted public health interventions may be needed, particularly in higher prevalence areas.
Conclusion
This large meta-analysis highlights the high and age-dependent prevalence of hypertension in sub-Saharan Africa, underscoring the urgent need for enhanced screening, prevention, and treatment strategies to mitigate the impending cardiovascular disease burden in the region.
References
Oliveira et al. 2023 -- Hypertension Prevalence and Blood Pressure Measurements in 533,167 Adults from Sub-Saharan Africa: A Systematic Review and Meta-Analysis
