Mapping the hypertension prevalence, treatment, and control profile in sub-Saharan Africa: A scoping review

Hypertension, a risk factor for cardiovascular disease (CVD), remains one of the main public health concerns worldwide, as the leading contributor to premature death. In sub-Saharan Africa (SSA), the prevalence of hypertension is estimated to be 48% in women and 37% in men in 2019. This high prevalence is due, among others, to sociodemographic factors and behavioural risk factors such as poor diet, physical inactivity, alcohol consumption, and smoking habits. However, these reported data display large and growing disparities in hypertension prevalence and control and therefore require national stakeholders to implement improved innovative, cost-effective, and sustainable programmes for hypertension prevention and control as a high priority. Despite multiple studies on the prevalence and determinants of hypertension in SSA, information on awareness, treatment and control of hypertension is limited. One way to examine the care of hypertension is by applying a care cascade. The hypertension care cascade (HCC) offers a visual illustration of the losses in the care continuum and tracks the progress in hypertension screening, diagnosis, and treatment to close the gaps in hypertension management which has been used to investigate the burden of hypertension. There are limited studies in SSA where the HCC was applied to represent the percentage of people with uncontrolled/untreated hypertension. SSA countries in comparison with other low-income countries (LICs) and low-middle-income counties (LMICs), have the lowest number of patients reaching each stage of the HCC. This highlights a critical gap in the management of hypertension and supports the need for targeted interventions to improve patient retention and continuity of care at each stage. Therefore, the objective of this scoping review is to map the hypertension prevalence, awareness, treatment, and control across various determinants of health such as socio-economic status, geographical area and population (urban and/or rural setting) in SSA.