Silent Threat: Unveiling Risks of Hypertension in Kenya

By Thomas Opiyo Okumu

What is hypertension?

Hypertension, also known as high blood pressure, is a common medical condition characterized by elevated pressure in the blood vessels.

When an individual has hypertension, the force exerted by the blood against the walls of the arteries is consistently higher than normal.

This places additional strain on the heart as it works harder to pump blood throughout the body.

Blood pressure readings are typically measured in millimeters of mercury (mmHg), with hypertension generally defined as a blood pressure reading of 130/80 mmHg or higher.

The American College of Cardiology and the American Heart Association categorize blood pressure into four main groups:

Normal Blood Pressure: Blood pressure is 120/80 mmHg or lower.

Elevated Blood Pressure: The top number ranges from 120 to 129 mmHg, and the bottom number is below 80 mmHg.

Stage 1 Hypertension: The top number ranges from 130 to 139 mmHg, or the bottom number falls between 80 and 89 mmHg.

Stage 2 Hypertension: The top number is 140 mmHg or higher, or the bottom number is 90 mmHg or higher.

Blood pressure readings exceeding 180/120 mmHg are considered a hypertensive emergency or crisis, necessitating immediate medical attention.

If left untreated, high blood pressure can significantly increase the risk of serious health complications such as heart attacks, strokes, and other cardiovascular issues.

It is recommended that individuals have their blood pressure checked at least every two years starting from age 18, with some individuals requiring more frequent monitoring.

Adopting healthy lifestyle habits like regular exercise, maintaining a balanced diet, and avoiding smoking can help prevent and manage high blood pressure.

In some cases, medication may be necessary to effectively treat hypertension.

Is Hypertension Prevalent Among Kenyans? The study conducted by Supa Pengpid, Karl Peltzer and their colleagues in Kenya found that the prevalence of hypertension among adults was 28.6%.

This prevalence was higher among older adults, with 58.3% of those aged 60-69 years having hypertension.

Among those with hypertension, only 12.5% had controlled their blood pressure (< 140/90 mmHg). 

Awareness of hypertension was also low, with only 29.4% of hypertensives being aware of their condition.

Treatment was even lower, with only 6.5% of those with hypertension currently using antihypertensive medication.

The study identified several risk factors for hypertension, including older age, higher education, overweight and obesity, past month binge drinking, and type 2 diabetes.

Being underweight was negatively associated with hypertension. In terms of awareness, treatment, and control of hypertension, the study found that only 44.1% of the population had ever had their blood pressure measured by a healthcare worker.

Of those aware of their hypertension status, only 22.1% were currently taking antihypertensive medication.

The odds for treatment were higher among older adults, women, and those who were underweight or obese.

The odds for controlled hypertension decreased with age and were lower among men, while individuals with type 2 diabetes were more likely to have controlled hypertension.

Overall, the study highlights the need for public health response in the form of integrated and comprehensive action targeting major noncommunicable diseases in Kenya due to the high prevalence of hypertension and low awareness, treatment, and control rates. 

Risks of Hypertension in Kenya: Hypertension poses significant risks to the population in Kenya, particularly in urban areas such as Nairobi.

Some of the key risks associated with hypertension in Kenya include: Increased Cardiovascular Disease Risk: Hypertension is a major risk factor for cardiovascular diseases such as heart attacks, strokes, and heart failure.

In Kenya, where hypertension is prevalent, individuals with high blood pressure are at a heightened risk of developing these serious cardiovascular conditions.

End-Organ Damage: Untreated or poorly managed hypertension can lead to damage in various organs of the body.

In sub-Saharan Africa, including Kenya, hypertensive end-organ damage is a significant source of morbidity and mortality.

This damage can affect organs like the heart, kidneys, and brain, leading to complications and reduced quality of life. Stroke Risk: Hypertension is a primary cause of stroke, both hemorrhagic and ischemic, which can have devastating consequences on individuals’ health and well-being.

The prevalence of stroke mortality in some African countries has been reported to be higher than in developed nations, emphasizing the importance of managing hypertension effectively to reduce stroke risk.

Coronary Artery Disease: Individuals with hypertension are at an increased risk of developing coronary artery disease, which can lead to heart attacks and other cardiac complications.

In Kenya, where hypertension rates are significant, the burden of coronary artery disease among hypertensive individuals is a concern for public health.

Kidney Complications: Hypertension is also a leading cause of kidney failure.

In Kenya, where access to advanced healthcare services may be limited for many individuals, managing hypertension effectively becomes crucial to prevent or delay the onset of hypertensive kidney complications. 

Increased Mortality: Uncontrolled hypertension significantly raises the risk of premature death due to cardiovascular events or complications arising from end-organ damage.

The high prevalence of hypertension in Kenya underscores the importance of early detection and management to reduce mortality rates associated with this condition.

The risks associated with hypertension in Kenya are multifaceted and pose a considerable burden on public health systems and individual well-being.

Efforts to raise awareness about hypertension, improve access to healthcare services for screening and management, and promote healthy lifestyle behaviors are essential in mitigating these risks and improving health outcomes for the population.

Awareness, Treatment, and Control of Hypertension in Kenya.

The study by Supa Pengpid and Karl Peltzer (2020) reported that the prevalence of hypertension in Kenya was 28.6%, with higher rates among older adults, individuals with higher education levels, and those who were overweight or obese.

Among hypertensives, only 29.4% were aware of their condition, 6.5% were currently using antihypertensive medication, and 12.5% had controlled their BP below 140/90 mmHg.

According to a more recent study published in BMC Public Health in 2018 by Shukri F Mohamed et al., the age-standardized prevalence of hypertension in Kenya was 24.5%.

Study also found that only 15.6% of those with hypertension were aware of it, and among those aware, only 26.9% were on treatment and 51.7% had achieved control.

The determinants of hypertension included older age, higher body mass index (BMI), and harmful use of alcohol, while factors associated with awareness were older age and being male.

Previous studies have shown that awareness and control of hypertension are low in sub-Saharan Africa, including Kenya.

From 2000 to 2013, the predicted prevalence of hypertension at mean ages of 30, 40, 50 and 60 years in sub-Saharan Africa was 16%, 26%, 35% and 44%, respectively. 

In Kenya specifically, a study conducted in Kibera found an age-standardized prevalence of hypertension of 22.8%, with only 20% awareness.

Hypertension is a major risk factor for cardiovascular diseases and the leading cause of death worldwide.

It is preventable through lifestyle modifications such as healthy diet, regular physical activity, and avoiding tobacco smoking.

Various risk factors have been linked to hypertension, including sociodemographic factors such as older age, female or male gender, lower education level, and lower household income.

Other risk factors include body weight status (higher BMI is positively associated with hypertension), health risk behaviors such as tobacco smoking and alcohol consumption, urban residence, and psychosocial stress and support.

In Kenya, studies have shown that hypertension is a significant public health concern with high prevalence rates among adults.

The awareness, treatment, and control of hypertension in the country are areas that require urgent attention based on the available data.

In conclusion, while there is a high prevalence of hypertension among adults in Kenya, there are low levels of awareness, treatment, and control.

Public health efforts should focus on improving education about hypertension, increasing access to treatment services, and enhancing strategies for managing and controlling high blood pressure to reduce the burden of cardiovascular diseases in the population.

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About the Author: Thomas Opiyo Okumu is currently the Chief Executive Officer at The Heart to Action Organization.

He also serves as the President of Global Empowerment Christian Center and the Executive Director of Eltofam Foundation. 

He holds a Bachelor of Development Studies from Mount Kenya University, and a Master of Arts in International Development Studies (with concentration on Health and Development) from Ohio University, USA.

 He can be reached at opiyothomas@gmail.com