Blood pressure and the hypertension care cascade in The Gambia: Findings from a nationwide survey

Area of Science:

• Cardiovascular epidemiology
• Public health
• Hypertension research

Background:

• Community treatment of hypertension in sub-Saharan Africa is hindered by care cascade gaps.
• Understanding blood pressure (BP) levels across different hypertension and treatment statuses is crucial.

Purpose of the Study:

• To compare blood pressure (BP) levels (systolic, diastolic, and pulse pressures) in individuals based on hypertension and treatment status.
• To identify disparities in BP control within a sub-Saharan African population.

Main Methods:

• A nationally representative survey of adults aged 35+ in The Gambia was conducted.
• Blood pressure was measured thrice, with the average of the last two readings used for analysis.
• Systolic and diastolic BP levels were compared across normotensive, hypertensive unaware, hypertensive treated, and hypertensive untreated groups.

Main Results:

• 53.1% of participants were normotensive (mean SBP 119.2 mmHg, DBP 78.1 mmHg).
• Hypertensive individuals showed elevated SBP: 148.7 mmHg (unaware), 152.2 mmHg (treated), and 159.3 mmHg (untreated).
• Similar trends were observed for diastolic BP, with untreated individuals having the highest levels (99.1 mmHg). BP was higher in men and older adults (≥55 years).

Conclusions:

• High blood pressure levels are prevalent in individuals with hypertension, including those undergoing treatment in The Gambia.
• Addressing the significant health burden of hypertension requires interventions across all stages of the care cascade.
• Further research and targeted interventions are needed to improve hypertension control rates in the region.