Inadequate blood pressure control in African hypertensives. Who is responsible: patient, physician or government?

Hypertension is quite common in Africa and recent reports suggest that its prevalence might be rising with many patients not receiving treatment. It appears the majority of those receiving medical attention present at the stage of severe complications. The issue of management appears quite complex as a result of several militating factors, including ignorance of the implications of hypertension, uneven economic resources and physicians, as well as governmental factors. The result of these is inadequate blood pressure control even among the few who present fairly early to physicians. This review examines, partly based on previous studies among hypertensives and physicians, the role of the patient, the physician and the government with a view to identifying where the greatest responsibility lies. Suggestions for improvement in blood pressure control in African hypertensives are given.