High Blood Pressure: A Silent Killer Amongst Africans

Research suggests that COVID- 19 impacts those with hypertension more severely

This is a time of shockingly rapid change; Africa remains a huge opportunity and challenge for research. We need to continue to evaluate our health care facilities and provisions during and following the pandemic.

Where do we stand with vaccine recovery from COVID- 19? What health innovations can we investigate to safeguard our future?

Innovative healthcare does not necessarily mean expensive healthcare; simplicity is the most effective and inexpensive way to better health. Recently in London, a study was commenced to get barbershops to help lower high blood pressure in the community by conducting blood pressure checks on their customers. This study was steered by one of the universities in London aiming at Black and Asian men, as they are statistically more likely to have undiagnosed high blood pressure ( hypertension). There was a similar study conducted a couple of years ago in the U. S, where blood pressure checking/ testing services were provided in the barbershops, to test whether this approach could significantly lower high blood pressure in the black community. The results demonstrated that when guidance was used with the medication, high blood pressure was successfully lowered in over 60 percent of men who participated in the study programme. High blood pressure is reported more often in black communities in western society; it has also been suggested that Africa has the highest rate of high blood pressure in the world, affecting over 45 percent of adults according to the World Health Organisation ( WHO). Many things can be attributed to that, including race and ethnicity, genetics, and unhealthy lifestyles influenced by modernisation. High blood pressure increases the risk of heart- related diseases as well as potentially fatal diseases like, kidney failure, heart attacks and strokes. Across the globe, it is estimated to cause about 7.5 million deaths ( over twelve percent of all deaths) per year. Before COVID- 19, the global average for the number of people suffering from high blood pressure was about 40 percent. In regards to the statistical disparity of black people suffering most from this disease, there is no one simple answer as to the potential causes. Socioeconomic disadvantages are a potential factor; in the developed world, studies have reported that monitoring socioeconomic issues vividly reduces the ethnic disparities in the occurrence of high blood pressure. Lifestyle modification is recommended; managing and maintaining a healthy weight should be an important focus for everyone, but especially within the black population, given the higher prevalence of high blood pressure. = Additionally, African people and blacks in general tend to be salt- sensitive due to a mixture of widespread over- weightness, abnormalities in their kidney salt handling, and a mere tendency to eat food with high amount of salts and other potentially “unsafe” substances if over- consumed. In countries like Botswana, the semi- desert landscape results in the diets being richer with meats, particularly red meats like beef. Studies have shown that eating more open- flame ( braai) or high- flame ( well- cooked) meat have a direct link to the risk of developing early onset high blood pressure. Though red meat is an important nutritional source of protein and other essential nutrients, its high intake and the tendency for Batswana to overcook it can be linked with higher rates of heart disease. With this in mind, Batswana and other African nations will benefit from the reduction of high blood pressure by lowering dietary salt intake and generally improving their dietary quality. It is often seen that treating high blood pressure can in turn prevent other potential diseases and complications; however, the treatments must be assessed between ethnic populations, as it is known that even the types of medication used to treat it have different responses in different races.

Black people with high blood pressure are not only likely to have more severe forms of the illness, but treatments often may not completely stabilise fluctuations of blood pressure. Continuous monitoring is crucial to tackling this silent killer; blood pressure- measuring machines and devices should be readily accessible both in public and private spaces, as well as in ambulatory spaces to help improve the accuracy of diagnosis, help improve treatment and health outcomes, spot undiagnosed abnormalities, and reduce both individual and governmental healthcare costs. Being active and partaking in physical exercise has a good value in countering high blood pressure. For black men in western countries, it is shown that exercise and fitness is more prevalent than with black women, white men, and white women. However, black men tend to be prone to developing high blood pressure in later stages of life once exercise is not as frequent. The reasons for these ethnic differences are still unclear to date, but treatments should include both lifestyle modifications and the use of proper recommended medication from practitioners and prescribers. The focus on improving health at the community level should be the priority of African nations, and this should be done by investing in tools, policies, meaningful partnerships and engaging the public health work force. The public health in particular should benchmark and embark on research based innovative solutions. The suggestion of barbershops and salons checking blood pressure of their clients is just one example of simplicity in public health research and approach. Botswana and many other African countries should encourage the use of entrepreneurial problem- solving, with the aim to improve practical evidence for the public health approach. The current COVID- 19 pandemic calls for individuals to take the lead in their own health. Universities and research institutions should use their platforms to assess gaps and provide practical tools to address unmet needs. Governments should explore a portfolio of initiatives designed to build healthier communities to achieve their best possible health and be resilient against future epidemics, endemics and pandemics. Given the overrepresentation of high blood pressure among critically ill COVID- 19 patients in Europe and the US, this should serve as a wakeup call for Africa. This pandemic is taking an enormous toll on human life globally, and efforts to better understand how to prevent and reduce the severity of the disease remain paramount. = While clear connections of high blood pressure and the severity of the disease has been observed among critically ill COVID- 19 patients, research is still skewed towards the west, and there remains a lack of studies within the context of African populations. Therefore, African countries should play a role in engaging in more research and solutions to protect its citizens rather than wait for studies that are done elsewhere, as this might not truly represent our unique health and dietary cultural needs. For Batswana, and the world at large the message from research is that blood pressure control remains an important consideration in order to reduce Covid disease burden among other things. This article simply highlights the need for routine measurement as part of routine physical check that will add value in preventing health care calamities relating to raised blood pressure which is undetected in many people.