[Particularities and management of arterial hypertension in sub-saharan Africa].

More than 25% of adults worldwide have high blood pressure, and this proportion is expected to rise in coming years. In sub-Saharan Africa, it is estimated that 150 million persons will be hypertensive by 2025. This increase appears to be related to the growth and aging of the population, as well as to the growing number of overweight and obese persons. The association with type-2 diabetes is frequent and deleterious. These trends are associated with urbanization and lifestyle westernization. Hypertension presents several etiopathogenic particularities in sub-Saharan Africa, especially with respect to sodium sensitivity and low renin activity. Target organ damage is more common, due to delayed and inadequate therapeutic management and to a likely genetic predisposition. Heart failure, stroke and renal failure often occur in young people. The mainstay of treatment is the use of thiazide diuretics and calcium channel blockers, combined with lifestyle and dietary measures (especially sodium restriction). Because of logistic and economic difficulties, recommendations issued by international societies may not be applicable at the community level.