---
title: "SA’s hypertension crisis is leaving millions at risk of heart disease and stroke"
description: "Cardiovascular disease (CVD) claims 18 million lives globally each year, accounting for one in three deaths. It is estimated that one in three South Africans live with high blood pressure, yet about 50% of people remain undiagnosed."
type: "NewsArticle"
publisher: "Daily Maverick"
site: "https://www.dailymaverick.co.za"
section: "WORLD HEART DAY"
author: "Pamela Naidoo"
author_url: "https://www.dailymaverick.co.za/author/pamela-naidoo/"
canonical_url: "https://www.dailymaverick.co.za/article/2026-09-29-sas-hypertension-crisis-is-leaving-millions-at-risk-of-heart-disease-and-stroke/"
published: "2026-09-29T11:48:37"
lang: "en-ZA"
word_count: 1133
---

# SA’s hypertension crisis is leaving millions at risk of heart disease and stroke

> Cardiovascular disease (CVD) claims 18 million lives globally each year, accounting for one in three deaths. It is estimated that one in three South Africans live with high blood pressure, yet about 50% of people remain undiagnosed.

By Pamela Naidoo · Published 29 September 2026, 13:48 SAST

## Key points
- Heart and stroke foundation ceo
- Cardiovascular disease kills 18 million people globally each year – including about 225 South Africans every day.
- Hypertension is a major, largely preventable driver, yet nearly one in three South African adults has high blood pressure and half remain undiagnosed.
- Obesity, salt-heavy diets, inactivity, tobacco, vaping and alcohol all raise the risk – with medium-risk groups often missed by prevention efforts.
- Community screening, earlier nutrition education, consistent medication and stronger public-private action could prevent millions of deaths. The time to act is now.

## Content

Each year 18 million people die from cardiovascular disease (CVD) globally. Cardiovascular disease includes heart disease and strokes.

In essence, one in three deaths is due to CVD. In South Africa an estimated 225 individuals die from CVD each day. The case for examining what is driving the heart disease and stroke burden could not be more convincing, given the statistics.

While there are some risk factors that are passed down through family genetics, and many that can be changed, hypertension is one of the key risk drivers of CVD. Worldwide, raised blood pressure is estimated to cause 10 million deaths, which is about 17.5 % of the total of all annual deaths. The number of people with uncontrolled hypertension has risen to an estimated 1 billion from 600,000 in 2008.

The World Health Organization’s reports on hypertension indicate that out of 1.4-billion adults between 30 and 79 years who are diagnosed with the condition, about 80% do not have it under control. In sub-Saharan Africa, males over the age of 25 years have a prevalence of hypertension of between 48% and 55.5%, and females in this age group have a prevalence of between 43% and 50%.

Data from the Heart and Stroke Foundation South Africa further highlights the scale of the challenge. In a health risk assessment of 4,510 participants collected from 2023 until end-March 2026, 1,570 were found to have elevated blood pressure, meaning that at least a third of participants are already at risk for developing CVD. The urgency of improving detection and management is clear. It is estimated that nearly one in three adults in South Africa lives with hypertension, yet about 50% of South Africans remain undiagnosed.

### Guidelines

It is encouraging to know that medical research clinicians in South Africa are striving to provide a set of guidelines for the diagnosis of hypertension to enable consistent treatment modalities across the country. Moreover, the national Department of Health’s Non-Communicable Diseases Strategy 2022-2027 also emphasises reducing hypertension as a risk factor for CVD through screening and behavioural modification.

Hypertension is driven by genetics to a lesser extent, and behavioural choices to a greater extent. Obesity, high salt intake, physical inactivity, tobacco use and vaping, excessive alcohol use, and diets low in fruits, vegetables and whole grains increase both the likelihood of developing the condition and the risk of complications such as stroke, heart attack, and kidney disease.

![Professor Pamela Naidoo is the Chief Executive Officer (CEO) of the Heart and Stroke Foundation South Africa. She has a Masters’ Degree in Clinical Psychology (MA, Clin Psych) and a Masters’ degree in Public Health (MPH). She also holds a Doctorate in Philosophy in Behavioural Medicine (DPhil) from the University of Natal (now UKZN). 
(Photo: Supplied / Source)](https://cdn.dailymaverick.co.za/i/r0xZ13HJ_U0RRgIejEpYbXuzDTg=/200x100/smart/filters:strip_exif\(\)/file/attachments/orphans/MC-PamelaNaidoo-OpEdMAIN_141734.jpg)

*Professor Pamela Naidoo is the Chief Executive Officer (CEO) of the Heart and Stroke Foundation South Africa. (Photo: Supplied / Source)*

The Heart and Stroke Foundation South Africa recognises the fact that hypertension is a silent killer, and has over the past four decades been committed to community- based screening so that individuals with elevated blood pressure are linked to the healthcare system through a referral linkage to care pathway.

The healthcare team uses the International Society of Hypertension, the SA Hypertension Society, the World Health Organization, and South Africa’s national Department of Health diagnostic guidelines. Hypertension is clinically diagnosed when blood pressure readings are consistently elevated, typically confirmed through multiple measurements taken on separate occasions at or above 140/90 mmHg in clinical settings.

A strong pillar of work implemented by the Heart and Stroke Foundation South Africa is in nutrition. Using the national and global criteria for what constitutes a healthy food product, the foundation has a well- recognised Heart Mark Endorsement Programme with its own trademark logo.

This food endorsement programme is vital to the reduction of salt intake, as products that meet the criteria have low sodium ingredients. Dietary salt intake is an important, changeable factor that influences blood pressure, as high sodium consumption contributes to fluid retention and increased vascular pressure over time.

Analysis of Heart and Stroke Foundation South Africa data by risk profile found 70% of individuals with a high-risk for developing CVD had a self-reported normal salt intake, with only 10% reporting a high intake. The medium-risk group reported the highest proportion of high salt intake at 12.4%. This may indicate that people in the high-risk group had previously received education about what is healthy to eat, whereas those in the medium-risk group had not.

Medium-risk groups are often overlooked in prevention efforts, revealing a gap where unhealthy habits persist before people are diagnosed. Heart and Stroke Foundation South Africa is urging earlier dietary education and community screening to act before the onset of hypertension, heart disease and strokes.

### Evidence-based strategies

Given that there is a high rate of undiagnosed and uncontrolled hypertension in South Africa and globally, a combination of evidence-based strategies needs to be considered and implemented. This needs to be done against the backdrop of inequalities and unequal access to the healthcare system.

While being a member of a private medical aid allows the advantage of high-end medical intervention, it is not a guarantee to reduce the risk of hypertension and uncontrolled hypertension. Individuals in lower socioeconomic groups are disproportionately affected by ill health, although the inability to abide by healthy behaviours is also a risk.

This means that individuals from all socioeconomic levels need to also be mindful, need to self-manage and need to empower themselves by knowing their blood pressure measure.

The Department of Health needs to facilitate and fund mass education campaigns encouraging population-level uptake of screening for blood pressure. Health non-profits should be the department’s and other sectors’ partners of choice. Moreover, there has to be a closer coordinated effort to bring relevant stakeholders together in the private and public sectors to ensure a greater coverage of hypertension detection and prevention. The public has to be educated about the importance of consistently taking medication to control hypertension.

Time is not on our side due to the high rate of morbidity and mortality. By addressing hypertension alone, globally, 100 million lives can be saved by 2050. **DM**

*Professor Pamela Naidoo is the Chief Executive Officer (CEO) of the Heart and Stroke Foundation South Africa. She has a Master’s Degree in Clinical Psychology (MA, Clin Psych) and a Master’s degree in Public Health (MPH). She also holds a Doctorate in Philosophy in Behavioural Medicine (DPhil) from the University of Natal (now UKZN). She became a professor at the University of the Western Cape in 2008, and worked as the Research Director at the South African Human Sciences Research Council until 2016. She also holds an Extraordinary Professorship in the Faculty of Community and Health Sciences at the University of the Western Cape, and is Professor Extraordinary in the Faculty of Medicine and Health Sciences (Psychiatry) at Stellenbosch University. Prof Naidoo is also the Past President of the African Heart Network, a member of the Expert Advisory Committee of the World Heart Federation, a Research Committee member of the World Stroke Organization, and an Executive Committee member of the African Stroke Organization.*