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ACHIEVE experts include members of the hypertension societies and/or cardiologists, nephrologists, public health physicians, researchers (including clinical trialists), evidence-based medicine specialists, statisticians, policy makers, and guideline developers across Africa. They were included based on their expertise and leadership in hypertension. It also included international advisory panel of experts in hypertension control from WHL, WHO and Resolve to Save Lives (RTSL).

African Control of Hypertension through Innovative Epidemiology and a Vibrant Ecosystem ( ACHIEVE)

Hypertension is a leading preventable and controllable risk factor for cardiovascular and cerebrovascular diseases and the leading preventable risk for death globally. By 2025, the adult population with hypertension is predicted to increase by about 60% to a total of 1.56 billion, with a disproportionate increase in sub-Saharan Africa. Hypertension is defined by an average systolic BP (SBP) ≥ 140mm Hg, diastolic BP (DBP) ≥ 90 mm Hg, or taking antihypertensive medication, and Africa has the highest prevalence of adults with hypertension (46%) compared to any other part of the world. Worse still, less than a third of African adults are aware of their hypertension status, and only 18% are on medications. Furthermore, BP is controlled in just 7%, leaving a substantial proportion of Africans at risk for complicating cerebrovascular and cardiovascular events. The call for action to control hypertension in Africa has been proposed by the World Hypertension League (WHL).

As a follow-up and to assist in implementing the call to action, a team of experts from Africa was assembled to examine an implementation strategy. These experts acknowledged the lack of effective and efficient continental implementation strategies to address the escalating burden of the hypertension crisis. Therefore, a decision was taken to develop the key action points, among others, for the accelerated screening, detection, and control of hypertension in Africa as a matter of urgency to stop the attendant lethal complications. The core group of experts from Africa performed a narrative review of the barriers and facilitators of hypertension control in Africa through implementation of the WHO hypertension guidelines and the HEARTS technical package. This led to the development of a list of recommended key points for accelerated hypertension control which were shared with the WHO, RTSL, WHL experts, and other stake-holders in most hypertension societies across Africa. The key actions for enhancing hypertension control were developed in a series of reviews. The Team members also determined the prioritization of the key actions. Suggestions on their expansion, relevance, customization and implementation were included. The task force members, hypertension experts, and leaders of hypertension societies reviewed and discussed a detailed presentation of the recommendations. Finally, on the 17th of November 2022, all the experts independently assessed and ranked ten key points for effective hypertension control in Africa.

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