The strange story of hypertension in Africa, and its relationship with drylands, migration and conflict

HYPERTENSION, otherwise known as high blood pressure, is a disease of rich Western countries whose people eat greasy hamburgers all day, or rich Africans who just ape “Western lifestyles” right?

The just-released World Health Statistics 2015 turns this commonly held assumption in Africa completely on its head, showing that Africa is a complete outlier in the world’s hypertension story.

In the first place, Africa’s hypertension rate among adults aged 18+ is far higher than the global average.

The average prevalence of hypertension among African adult men is 29.7%, while the corresponding global prevalence is 24%; the average rate in women is 29.5%, while globally the prevalence is 20.5%.

The data from the World Health Organisation also suggests that if you want to avoid hypertension, don’t live in a poor desert country in Africa.

Seven of the top ten countries with the highest hypertension rates in men are all in the Sahel, and two – Somalia and Cape Verde – are just as arid.

Mauritanian men have the highest high blood pressure rates in Africa, at an astonishing 35%. Somalia is second at 34.6%, Cape Verde third at 33.7%, Mali comes in fourth at 33.2%, and Chad is fifth at 33.1%.

It suggests that eking a living life in the scrubby Sahel has a debilitating effect on health, even if traditional, non-Western, “healthy” foods constitute the main part of the diet.

The lowest rates are in rich Seychelles, Mauritius, Libya, Tunisia and Gabon, whose rates are closer to the global average.

What is even more surprising is that in half of African countries, women have a higher hypertension prevalence than men, which goes completely counter to the global trends, and even to evolutionary biology.

The effect of conflict, family disruption and possibly, the strain of being a woman in a poor, deeply patriarchial society, on high blood pressure in women is so striking that African governments should consider using WHO hypertension data as a proxy indicator for social well being.

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