Anastase Dzudie1, Brian Rayner2, Dike Ojji3, Aletta E Schutte4, Marc Twagirumukiza5, Albertino Damasceno6, Seringe Abdou Ba7, Abdoul Kane8, Euloge Kramoh9, Jean Baptiste Anzouan Kacou9, Basden Onwubere10, Ruth Cornick11, Karen Sliwa12, Benedict Anisiuba10, Ana Olga Mocumbi13, Elijah Ogola14, Mohamed Awad15, George Nel16, Harun Otieno17, Ali Ibrahim Toure15, Samuel Kingue18, Andre Pascal Kengne19, Pablo Perel20, Alma Adler20, Neil Poulter21, Bongani Mayosi22. 1. Department of Internal Medicine, Yaounde Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon; Department of Medicine, University of Cape Town, Cape Town, South Africa; Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa. Electronic address: aitdzudie@yahoo.com. 2. Division of Nephrology and Hypertension, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa. 3. Department of Medicine, Faculty of Health Sciences, University of Abuja Gwagwalada, Abuja, Nigeria; Cardiology Unit, Department of Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria. 4. Hypertension in Africa Research Team (HART), MRC Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa. 5. College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda; African Society of Hypertension (AfSoH) Initiative, Heymans Institute of Pharmacology, Gent University, Ghent, Belgium. 6. Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique. 7. Le Dantec University Teaching Hospital, Dakar, Senegal. 8. Service de cardiologie, Hôpital Général de Grand Yolf, Dakar, Senegal. 9. Institut cardiologique d'Abidjan, Abidjan, Cote d'Ivoire. 10. Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria. 11. Knowledge Translation Unit, University of Cape Town Lung Institute, University of Cape Town, Cape Town, South Africa; Department of Medicine, University of Cape Town, Cape Town, South Africa. 12. Department of Medicine, University of Cape Town, Cape Town, South Africa; Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa. 13. National Health Institute, Maputo, Mozambique; University Eduardo Mondlane, Maputo, Mozambique. 14. Department of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya. 15. Division of Cardiology, University of Khartoum, Khartoum, Sudan. 16. Pan-African Society of Cardiology (PASCAR), Cape Town, South Africa. 17. Section of Cardiology, Department of Medicine, Aga Khan University Hospital, Nairobi, Kenya. 18. Department of Internal Medicine, Yaounde Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon. 19. Medical Research Council, Cape Town, South Africa. 20. Science Advisory Unit, World Heart Federation, Geneva, Switzerland; London School of Hygiene and Tropical Medicine, London, United Kingdom. 21. International Centre for Circulatory Health, Imperial College, London, United Kingdom. 22. Department of Medicine, University of Cape Town, Cape Town, South Africa.
Abstract
BACKGROUND: The Pan-African Society of Cardiology (PASCAR) has identified hypertension as the highest area of priority action to reduce heart disease and stroke on the continent. OBJECTIVES: 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 nonphysicians, were invited to join. Via face-to-face meetings and teleconferences, the consortium made a situation analysis, set a goal, identified roadblocks and solutions to the management of hypertension and customized the World Heart Federation roadmap to Africa. RESULTS: Hypertension is a major crisis on the continent but very few randomized controlled trials have been conducted on its management. Also, only 25.8% of the countries have developed or adopted guidelines for management of hypertension. Other major roadblocks are either government and health-system related or health care 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.
BACKGROUND: The Pan-African Society of Cardiology (PASCAR) has identified hypertension as the highest area of priority action to reduce heart disease and stroke on the continent. OBJECTIVES: 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 nonphysicians, were invited to join. Via face-to-face meetings and teleconferences, the consortium made a situation analysis, set a goal, identified roadblocks and solutions to the management of hypertension and customized the World Heart Federation roadmap to Africa. RESULTS:Hypertension is a major crisis on the continent but very few randomized controlled trials have been conducted on its management. Also, only 25.8% of the countries have developed or adopted guidelines for management of hypertension. Other major roadblocks are either government and health-system related or health care 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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