Hypertension a silent killer that is not easily detected

Dar es Salaam/Upcountry. Regional and referral hospitals across the country report receiving one to two patients daily suffering complications from prolonged undiagnosed or untreated high blood pressure.

The complications, which often manifest suddenly, include stroke, heart attack, heart failure, and chronic kidney disease leading to kidney failure.

According to medical experts, this marks an increase compared to previous years when hospitals received one or two such cases weekly or monthly.

An internal medicine specialist at Benjamin Mkapa Hospital, Dr Edwin Ochina,  said "Yesterday (January 22), we admitted three patients who suffered complications from high blood pressure, including stroke, which occurred suddenly."

"We receive two to three patients daily. Sometimes, up to four. This means we manage five to ten cases weekly involving hypertension-related complications," Dr Ochina says.

Most of these patients arrive with stroke, heart attack, or heart failure, with stroke being the leading condition.

"Most cases involve stroke. In a month, we may have one heart attack patient and one with kidney failure. Some kidney damage cases do not show immediate symptoms, but we notice reduced urine output upon examination. Others suffer from eye pressure issues," he explains.

The scope of the problem

Statistics from the Jakaya Kikwete Cardiac Institute (JKCI) reveal that out of 100,025 patients who sought treatment, 52 percent were diagnosed with high blood pressure.

A cardiology specialist at JKCI, Dr Tulizo Shemu reveals that three to five adults out of ten in Tanzania have hypertension, with over 60 percent unaware of their condition.

"This disease has serious consequences, including stroke, kidney failure, heart attack, sudden death, difficulty breathing, swollen legs, vision loss, eclampsia, and miscarriage," Dr Tulizo explains.

Between July 2023 and March 2024, Tanzania’s Ministry of Health recorded that 5.9 percent of outpatient cases under five years old were related to hypertension, affecting 737,730 patients.

Health experts raise alarm

Some patients lose their lives or suffer permanent complications due to delayed treatment.

Frank Oswald, 47, is one such patient. He suffered a sudden stroke at work after unknowingly living with hypertension for years.

"I collapsed while working in Dar es Salaam. Luckily, a coworker recognized the signs and rushed me to Muhimbili Orthopedic Institute (MOI) Within 30 minutes, I was in surgery," he recalls.

Frank explains that while it took time to recover, doctors warned him that any further delay would have been fatal.

"I often experienced headaches and rapid heartbeats but would just rest or take painkillers. I hadn’t visited a hospital for nearly three years, so I never checked my blood pressure," he says.

Frank is among the many daily cases of hypertension complications in Tanzania, unaware of their health conditions until it’s too late.

State of awareness

Regional and referral hospitals report that many Tanzanians lack awareness of their health, often living with untreated hypertension until permanent complications arise.

At Morogoro Regional Referral Hospital, one or two patients arrive daily with hypertension-related complications.

An internal medicine specialist and head of the internal medicine department at the hospital, Dr Kessy Ngarawasays they frequently treat stroke patients who delayed seeking care or ignored treatment instructions.

"Stroke caused by untreated hypertension is now a common issue. Patients arrive unable to speak and too late for effective intervention. We receive one or two cases daily and five to six weekly," Dr Ngarawa explains.

Proposed solutions

Dr Kessy emphasizes the need for regular health checkups to detect hypertension early and prevent complications.

"Early detection allows for timely advice and management. Simple health checks twice a year—eye exams, blood sugar tests, or general checkups—can save lives," he says.

Government campaigns and free blood pressure tests are also underway to encourage early diagnosis and treatment.

According to a Manager of the National Program for Non-Communicable Disease Prevention and Control at the Ministry of Health, Dr Omary Ubuguyu,  says statistics show an increase in diagnosed hypertension cases, from 1,112,704 in 2019 to 1,482,911 in 2023.

"People aged 40 and above are advised to check their blood pressure, sugar levels, prostate health, and screen for breast and cervical cancers annually to ensure early detection and treatment," Dr Ubuguyu concludes.

High blood pressure is a growing global health issue and a leading cause of death and disability, including heart attacks, strokes, and kidney failure.

According to a report by the World Health Organization (WHO) released by the Population Reference Bureau (PRB), the number of people living with high blood pressure doubled between 1990 and 2019, rising from 650 million to 1.3 billion.

A study on 87 behavioral, environmental, occupational, and metabolic factors identified high blood pressure as the most significant cause of premature deaths worldwide, accounting for an estimated 10.8 million deaths annually.

High blood pressure causes more deaths than other major risk factors, including tobacco use and high blood sugar. Currently, among adults aged 30–79 with high blood pressure, only 54 percent have been diagnosed with the condition, 42 percent receive treatment, and 21 percent are considered to have controlled blood pressure.