Hypertension

Hypertension is persistently elevated blood pressure and a major risk factor for stroke, heart disease, and kidney disease. It is often called a “silent” condition because it usually causes no symptoms, and it is increasingly common among adults in Tanzania.

• Usually no symptoms, especially in early stages.
• Occasionally headache or dizziness when blood pressure is very high.
• Often detected incidentally during routine screening, or only once a complication such as stroke or heart disease has occurred.

• Family history of hypertension.
• Increasing age.
• Overweight and obesity.
• High dietary salt intake.
• Physical inactivity.
• Excessive alcohol use and tobacco use.
• Chronic stress and, in some cases, an underlying kidney or hormonal condition (secondary hypertension).

• Confirmed by repeated elevated blood pressure readings (systolic ≥140 mmHg and/or diastolic ≥90 mmHg) on at least two separate occasions, measured with a properly calibrated device.
• Assessment for target-organ damage (heart, kidneys, eyes) and other cardiovascular risk factors is carried out once hypertension is confirmed.

Lifestyle modification — reducing dietary salt, achieving a healthy weight, regular physical activity, limiting alcohol, and stopping tobacco use — is recommended for everyone with hypertension.

Where blood pressure remains elevated, first-line medicine options include a calcium channel blocker such as amlodipine or a thiazide-type diuretic such as hydrochlorothiazide.

An ACE inhibitor such as enalapril is used as an alternative or add-on option, and combination therapy is used when a single medicine does not achieve control.

Regular follow-up is needed to monitor blood pressure and adjust treatment as required.

• Reduce salt intake in cooking and processed foods.
• Maintain a healthy body weight.
• Engage in regular physical activity.
• Limit alcohol consumption.
• Avoid tobacco use.
• Attend routine blood pressure screening, especially from middle age onward.