Hypertension treatment and control in sub-Saharan Africa: the epidemiological basis for policy

Although enormous challenges persist in the control of infection in sub-Saharan Africa, non-communicable diseases are also important threats to the health of adult Africans. 1 2 Controversy exists, however, over the priority these conditions deserve in the competition for scarce resources. It has recently been argued that hypertension treatment, for example, should not be attempted in sub-Saharan Africa given the high costs.3 Unfortunately, these discussions take place in an information vacuum, since it is impossible to define the burden of chronic conditions in societies where health statistics are unavailable.4 Cohort studies may serve as a proxy for vital statistics and give approximate answers to questions on the usefulness of treatment for chronic disease.5 Hypertension is particularly suited to this model because it is easily diagnosed, highly prevalent, and information on outcomes is plentiful.