Recent advances in understanding hypertension development in sub-Saharan Africa

Schutte, Alta and Botha, Shani and Carla, Fourie and Lebo, Gafane and Ruan, Kruger and Leandi, Lammertyn and Leoné, Malan and Catharina, Mels and Rudolph, Schutte and Wayne, Smith and Johannes, van Rooyen and Lisa, Ware and Hugo, Huisman (2017) Recent advances in understanding hypertension development in sub-Saharan Africa. Journal of Human Hypertension. ISSN 0950-9240

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Official URL: http://dx.doi.org/10.1038/jhh.2017.18

Abstract

Consistent reports indicate that hypertension is a particularly common finding in black populations. Hypertension occurs at younger ages and is often more severe in terms of blood pressure levels and organ damage than in whites, resulting in a higher incidence of cardiovascular disease and mortality. This review provides an outline of recent advances in the pathophysiological understanding of blood pressure elevation and the consequences thereof in black populations in Africa. This is set against the backdrop of populations undergoing demanding and rapid demographic transition, where infection with the Human Immunodeficiency Virus predominates, and where under and over-nutrition coexist. Collectively, recent findings from Africa illustrate an increased lifetime risk to hypertension from foetal life onwards. From young ages black populations display early endothelial dysfunction, increased vascular tone and reactivity, microvascular structural adaptions, as well as increased aortic stiffness resulting in elevated central and brachial blood pressures during the day and night, when compared to whites. Together with knowledge on the contributions of sympathetic activation and abnormal renal sodium handling, these pathophysiological adaptations result in subclinical and clinical organ damage at younger ages. This overall enhanced understanding on the determinants of blood pressure elevation in blacks encourages (a) novel approaches to assess and manage hypertension in Africa better, (b) further scientific discovery to develop more effective prevention and treatment strategies, and (c) policymakers and health advocates to collectively contribute in creating health-promoting environments in Africa.

Item Type: Journal Article
Keywords: Hypertension, Sub-Saharan Africa, Review
Faculty: Faculty of Medical Science
Depositing User: Unnamed user with email Rudolph.Schutte@anglia.ac.uk
Date Deposited: 20 Mar 2017 08:46
Last Modified: 23 Sep 2017 01:02
URI: http://arro.anglia.ac.uk/id/eprint/701590

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