HYPERTENS ERTENSION ION IN AF AFRICA CA IN 10 10 SIMP MPLE LE - - PowerPoint PPT Presentation

HYPERTENS ERTENSION ION IN AF AFRICA CA IN 10 10 SIMP MPLE LE SLI LIDES ES

• Prof. Gerald Yonga FRC

RCP (Edin in), , MBA BA, FESC SC, , FACC CC Visitin isiting g Profes fessor

• r, Schoo

hool l of Medicin dicine, e, Univer iversity ity of Nairo irobi bi Chai air, East t Africa rica Non

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Communi unicabl cable e Disease seases (NCDs) NCDs) Allia iance nce

Ou Outline tline

 Prev eval alence ence in Afr frica a (ag age, e, gen ender er, , rural/ al/urban urban, , sev ever erity) y) - 3  Awar areness, eness, on

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eatment, tment, con

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trolle

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d - 1  Aet etiology logy/p /patho athophysi physiol

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frican ans s – 1 (CR CREOLE LE study) y)  Co Compli plicatio cations/ ns/Bur Burden en - 2  Hyp yperte ertensi nsion

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Contr trol

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ategies ies , Framew amework rk & Programs rams - 3  ( ( PASCA CAR/WHO /WHO road ad map ap, , HHA HHA, , SSA SSA sal alt red eductio tion n proje ject) ct)

Partnerships in CVD Preventio ion and d care in Africa

Prevalence of hypertension awareness, treatment and control in 18 countries (154,000 people)

Aware

Figure 2. Epidemiological model showing distribution of hypertension prevalence according to age in both sexes, with size of bubble corresponding to respective sample size (A: 1990, B: 2000, C: 2010).

Adeloye D, Basquill C (2014) Estimating the Prevalence and Awareness Rates of Hypertension in Africa: A Systematic Analysis. PLOS ONE 9(8):

• e104300. https://doi.org/10.1371/journal.pone.0104300

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0104300

Prevalence, Awareness, Treatment and Control of Hypertension in Africa

Prevalence 30 % (27-34%) Awareness 27 % (7-56%) Not aware 73 % Treated 18 % (14-22%) Untreated 72 % Controlled* 7 % (5-8%) Uncontrolled 93 %

* BP < 140/90 mmHg Adapted from original publication by Anastase DZUDIE; Chair, PASCAR task force on hypertension

BP REGULATORY MECHANISM.(Summary)

Relationship of Obesity, with HTN, DM, RENAL.

• Heart
• Brain
• Eye
• Blood vessels
• Kidney

COMPLICATIONS OF HTN.

DATA FOR HYPERTENSION CONTROL IN IN AFRICA

• Risk factors/associated factors (behavioural/upstream drivers, age)
• health burden – prevalence, attributable morbidity & mortality (missed

work, complications, admissions, DALYs lost, death rates)

• Economic burden (Direct costs, indirect costs, cost of inaction)
• Health system data (WHO SARAM data & PEN packages,HRH, EMTs, supply

chain studies- “No Empty Shelves” – PATH)

• Feasibility and impact of interventions– HHA, AMPATH, MSF Belgium,

APHRA (Methods & levels of intervention and evaluation methods- ?implementation science)

• Costs of various intervention, comparative cost-effectiveness of

intervention – “best-buys”)

• Targets and Surveillance Systems/HIS (community, patient, facility level

data – 25 by 25 goals, WHF/PASCAR HTN Road Map?”90-90-90 targets”)

HHA HHA Since nce October tober 2014 14 HHA HHA has to date…

Activ tivate ated over r 675 health facil ilities ities1 Trained over 5,000 health workers rs1

5,000

Conducted ted over 5.7 million scre reeni enings1 Identifi ified ed over 1 million living with high blood press ssure re1

Partner Partner

Gove vern rnment nt Heath h Facilities Faith Based d Health h System Urban setti ting ng Large Faith Based Health h System Integrating into HIV services

Ref 5. AstraZeneca data on file: Total Programme KPIs – Programme start to 31 October2017

PASCAR HYPERTENSION ROADMAP PASCAR has identified the fight against hypertension as N°1 priority action to achieve WHO/WHF 25 x 25 goal A Hypertension Task Force of continental experts:-

• plan a 15% control rate of BP in the next 10 years,
• Three successful meetings held.
• Final document after 4th meeting 2016

Approach to Hypertension control in SSA

• There are significant health and economic gains in to early

detection, adequate treatment and good control of hypertension.

• Treating the complications of hypertension is costly and less

effective.

• Addressing behavioural risk factors, e.g. unhealthy diet,

tobacco consumption, harmful use of alcohol and physical inactivity can ameliorate hypertension burden.

• Hypertension remains number one risk factor for increased

morbidity and mortality in Africa

Th Than ank yo you