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Current and projected prevalence of arterial hypertension in sub-Saharan Africa by sex, age and habitat: an estimate from population studies

Twagirumukiza, Marca,c; De Bacquer, Dirkb; Kips, Jan Gc; de Backer, Guyb; Stichele, Robert Vanderc; Van Bortel, Luc Mc

doi: 10.1097/HJH.0b013e328346995d

Introduction In sub-Saharan Africa (SSA), data on hypertension prevalence in terms of urban or rural and sex difference are lacking, heterogeneous or contradictory. In addition, there are no accurate estimates of hypertension burden.

Objective To estimate the age-specific and sex-specific prevalence of arterial hypertension in SSA in urban and rural adult populations.

Methods We searched for population studies, conducted from 1998 through 2008 in SSA. We extracted data from selected studies on available prevalences and used a logistic regression model to estimate all age/sex/habitat (urban/rural)/country-specific prevalences for SSA up to 2008 and 2025. On the basis of the United Nations Population Fund data for 2008 and predictions for 2025, we estimated the number of hypertensives in both years.

Results Seventeen studies pertaining to 11 countries were analysed. The overall prevalence rate of hypertension in SSA for 2008 was estimated at 16.2% [95% confidence interval (CI) 14.1–20.3], ranging from 10.6% in Ethiopia to 26.9% in Ghana. The estimated prevalence was 13.7% in rural areas, 20.7% in urban areas, 16.8% in males, and 15.7% in women. The total number of hypertensives in SSA was estimated at 75 million (95% CI 65–93 million) in 2008 and at 125.5 million (95% CI 111.0–162.9 million) by 2025.

Conclusion The estimated number of hypertensives in 2008 is nearly four times higher than the last (2005) estimate of the World Health Organization Regional Office for Africa. Prevalences were significantly higher in urban than in rural populations. Population data are lacking in many countries underlining the need for national surveys.

aFaculty of Medicine, National University of Rwanda, Butare, Republic of Rwanda, Belgium

bDepartment of Public Health, Belgium

cHeymans Institute of Pharmacology, Ghent University, Ghent, Belgium

Received 12 May, 2010

Revised 1 March, 2011

Accepted 9 March, 2011

Correspondence to Professor Luc M. Van Bortel, Heymans Institute of Pharmacology, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, UZ Gent, Block B, 1st Floor, 9000 Gent, Belgium Tel: +32 9 332 58 00; fax: +32 9 332 8800; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.