High blood pressure, also called hypertension, is quietly causing serious health problems in Uganda. Many people don’t even know they have it until it’s too late. It’s now one of the top causes of early death and disability in the country.
Hypertension can lead to heart attacks, strokes, kidney failure, and blood clots. It is much more common than many people think. According to a 2023 national health survey, about 22 percent of Ugandans have high blood pressure, that is more than four times the number of people living with HIV (five percent).
Many don’t know they have it
Experts at UMC Victoria Hospital and the Uganda Heart Institute (UHI) are especially concerned because most Ugandans have never had their blood pressure checked, especially men. Over 70 percent of men have never tested their blood pressure and don’t know if they have hypertension. Take John (not his real name), a 33-year-old who went for a routine check-up at UMC Victoria Hospital. He felt mostly fine but sometimes had irregular heartbeats after exercising, occasional headaches, and had gained a lot of weight in the past six months. He didn’t think anything was wrong.
But when his blood pressure was measured, it read 131/88, a sign of Stage 1 hypertension, and doctors found that some of the blood vessels in his heart were narrowing, increasing his risk of a heart attack. ‘I was shocked,’ he said. ‘The doctor advised me to start exercising more and eating healthier food, including more fruits and vegetables.’ John also shared that several family members, including his sister and relatives on his mother’s side, have had high blood pressure, one even died from complications.
Importance of early detection
Dr Barbara Kakande, a heart specialist at UMC Victoria Hospital, says it’s critical to detect high blood pressure early. ‘Normal blood pressure is about 120/80,’ she says. ‘If it goes above 130/80, that’s considered high.’ Even young people can have serious issues. ‘Sometimes people come in with normal blood pressure, but we find their kidneys are failing, or their heart is enlarged, or they’ve already had a stroke,’ she explains. To find hidden cases, doctors sometimes use 24-hour monitors that give a fuller picture than one-time checks.
What high blood pressure does
If left untreated, high blood pressure can harm nearly every part of the body. The brain can cause strokes, eyes may lead to blindness, heart can cause heart attacks, kidneys may stop working, in legs , poor blood flow can lead to amputation. Dr Kakande says each patient is different, so they investigate which organs are affected and adjust treatment accordingly.
What causes it?
One common cause of heart problems is atherosclerosis, when fat, cholesterol, and other substances build up in blood vessels. This can block blood flow, cause clots, and trigger heart attacks or strokes. According to the STEPS survey, the prevalence of hypertension is 22 percent. Grading the prevalence of hypertension according to the International Society of Hypertension, the proportion of normal blood pressure was 64 percent, high normal blood pressure 14.7 percent, grade 1 hypertension 14.8 percent, and grade 2 hypertension 6.6 percent.
Signs and symptoms
Dr John Omagino, director of UHI, says symptoms may include: Headaches, dizziness, chest pain, blurred vision, shortness of breath But many people don’t have any symptoms at all. That’s why regular check-ups are so important. If a general doctor hears something unusual, like a heart murmur, they may refer patients for further tests like an echo-cardiogram, which uses sound waves to show how the heart is working.
Your genes might play a role
Dr Kakande says Africans are more likely to develop high blood pressure due to genetics. Some people naturally produce more harmful substances that tighten blood vessels, or fewer protective ones that relax them. Also, people born with small kidneys or low birth weight have a higher risk. Many individuals are also more sensitive to salt, which raises blood pressure.
Lifestyle
Our diets today are part of the problem. Dr Kakande says modern eating habits, like fried foods, chips, and fatty meats, are increasing the risk of hypertension.
She recommends going back to traditional meals: boiled foods, vegetables, and fruits, just like our parents used to prepare. Use healthy oils like olive or sunflower oil and avoid deep-frying. Cutting back on salt is also key because it increases water in the body, raising blood pressure and straining the heart.
Prevention and management
Dr Omagino, on the other hand, also emphasises exercising regularly, avoiding tobacco and limiting alcohol, and maintaining a healthy weight and managing stress. ‘For those already diagnosed, proper treatment prescribed by a qualified doctor, combined with healthy living, helps control blood pressure and protect vital organs. There is no miracle pill or single cure. Treatment is lifelong, and it must be individualised,’ he adds.