Early identification of prehypertension as a preventive measure can avert associated morbidity and death

As Kenya joined the world in marking World Hypertension Day on Saturday, a new study has revealed an overall burden of 54.5% and 20.8% for prehypertension and hypertension respectively, out of a sample size of 5.9 million participants.

Collected from the Healthy Heart Africa programme, the study also reveals that men have a higher prevalence of prehypertension at 59% compared to women who have a 52% prevalence rate. The highest rate of prehypertension was recorded among those aged 65 years and above, with a greater proportion attributed to rural populations – at 57% compared to urban dwellers at 55% respectively.

Prehypertension occurs when blood pressure values are above normal levels but are still below hypertension levels. The World Health Organization (WHO) defines prehypertension as a blood pressure reading that lies between 120/80 and 139/89. Persons identified with prehypertension are vulnerable to transitioning to hypertension and are also associated with a higher risk of cardiovascular diseases.

Emerging challenges such as COVID-19 have shown the need for continuity and ongoing action to tackle non-communicable diseases.

This has been highlighted by reports linking hypertension, cardiovascular diseases or their risk factors such as obesity, smoking and physical inactivity with a greater risk of being severely impacted by COVID-19.

To ensure continuity of care for persons living with NCDs, the Government has continued to provide guidance on access to preventive and treatment services for NCDs during the pandemic. As part of these efforts, an NCD and National COVID-19 working group has been established, chaired by the Ministry of Health and NCD Alliance Kenya and consisting of various partners, to ensure that NCD care is not disrupted during the pandemic.

Dr Rashid A. Aman, Chief Administrative Secretary, Ministry of Health said: “COVID-19 has posed new challenges to NCD service delivery not just in Kenya but throughout the world. We wish to re-assure hypertension and NCD patients that we are doing as much as possible to limit disruption of essential healthcare services at this time.

We have put in place guidelines to facilitate continuity of services while still ensuring the safety of both patients and healthcare workers including telemedicine and or e-visits options and creating self-management plans and guidelines covering treatment of NCD patients with COVID-19.

On this occasion, I am also pleased to mark six years of a programme that tackles hypertension by driving awareness and providing screening, training and affordable medicines.

The Healthy Heart Africa programme has proven to be an effective primary healthcare intervention solution and our partnership has continued to serve Kenyans across the country, even as we push to achieve universal health coverage.”

COVID-19 has highlighted that partnership and investment in healthcare needs to be targeted towards prevention and sustainable treatment provision in order to build resilient health systems.

Since launching in Kenya six years ago and subsequently expanding to Ethiopia in 2016, Tanzania in 2018, Ghana in 2019 and Uganda in 2020, HHA has conducted over 15.5 million blood pressure screenings in the community and in healthcare facilities; trained over 7,290 healthcare workers, to provide education and awareness, screening and treatment services for hypertension; activated 800 healthcare facilities in Africa to provide hypertension services, and identified over 2.8 million elevated blood pressure readings.

Ashling Mulvaney, Vice President, Sustainability & Access to Healthcare, Global Sustainability at AstraZeneca said: “We are delighted to mark six years of bringing healthcare closer to people through community and national interventions, and strengthening health systems on the continent as well as in creation of sustainable solutions for life changing treatment and prevention.

Our partnership with the Ministry of Health in Kenya, the KCCB and AMPATH Kenya, as well as other Ministries of Health and partners in Africa, has proven to be an effective model in building infrastructure, removing barriers and supporting collaboration within local healthcare systems to improve outcomes for patients.”

In support of SDG 17, best practices such as partnerships with public, private and faith-based facilities, supported by our joint global and local knowledge and expertise, have over the years been helping to integrate blood pressure screening and hypertension treatment into routine care in Africa.

Through our partnership with AMPATH, we have used hypertension as a less stigmatizing disease to increase male participation in HIV screening and care in Bungoma.

Prof. Sylvester Kimaiyo, AMPATH Executive Director-Care/Chief of Party, AMPATHPlus said: “Through our partnership with the County Government of Bungoma, USAID and Healthy Heart Africa, we have integrated HIV and hypertension services to reach those outside of the traditional entry points to care, with a particular emphasis on men.

Implemented through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the Bungoma HIV/Hypertension Integrated Model has been working to integrate screening, care, treatment and retention activities to the community and has worked well to increase male participation in HIV screening and care.”

Since the first case of COVID-19 was declared in Kenya, modified implementation strategies were put in place to ensure protection of staff and the patients against risks of COVID-19 and continuity of services to the patients.

Sister. Dr. Carren Owuor, the CEO & Medical Director of St Mary’s Mission Hospitals and a Medical Doctor with KCCB said: “HHA has helped us to identify gaps in reaching people who are in dire need yet were not targeted before. When we started the programme, we only screened patients, but we now screen both patients and their relatives for hypertension when they visit the hospital.

This has increased the chances of identifying more people with mild or overt hypertension. Some of our clinicians have also been trained and are now adding value to the screening team. Thanks to the programme, we have been able to support our Community Health Volunteers who are our brand ambassadors in community education and linkage to treatment.”