WORLD HEART DAY: SA’s hypertension crisis is leaving millions at risk of heart disease and stroke

Cardiovascular disease, encompassing heart disease and strokes, remains the leading cause of death worldwide, claiming an estimated 18 million lives each year. In South Africa, around 225 people die from cardiovascular disease daily. Hypertension, or high blood pressure, is considered a key risk factor for these conditions, responsible for 10 million deaths globally, or 17.5% of all annual fatalities.

Currently, an estimated one in three South Africans lives with high blood pressure. However, approximately 50% of the population remain undiagnosed, highlighting a significant public health concern. The Heart and Stroke Foundation South Africa has been actively involved in community-based screening programs to identify individuals with elevated blood pressure and link them to the healthcare system for proper treatment.

Data from the foundation's health risk assessment of 4,510 participants, collected between 2023 and March 2026, revealed that 1,570 individuals had elevated blood pressure, indicating that at least a third of the participants were at risk for developing cardiovascular disease. Despite the prevalence of hypertension, only 50% of South Africans are diagnosed, leaving a considerable number of people at risk unaware of their condition.

To combat the issue, guidelines have been developed by medical research clinicians in South Africa to ensure consistent treatment approaches nationwide. The national Department of Health's Non-Communicable Diseases Strategy 2022-2027 also emphasizes the importance of reducing hypertension as a risk factor for cardiovascular disease through screening and behavioral modifications.

The foundation's Heart Mark Endorsement Programme plays a crucial role in promoting healthier dietary choices by endorsing food products that meet specific criteria, such as low sodium content. While hypertension can be influenced by genetic factors, behavioral choices play a more significant role in its development and complications.

Factors such as obesity, high salt intake, physical inactivity, tobacco use, excessive alcohol consumption, and diets low in fruits, vegetables, and whole grains contribute to both the likelihood of developing hypertension and the risk of associated complications like stroke, heart attack, and kidney disease.

Given the high rate of undiagnosed and uncontrolled hypertension in South Africa and globally, a combination of evidence-based strategies is essential to address the issue. These strategies must consider socioeconomic disparities and unequal access to healthcare. Public education campaigns, community screening initiatives, and partnerships with health non-profits are crucial to improving detection and management of hypertension, ultimately reducing the burden of cardiovascular disease and stroke.