Dr Bonface Onsongo of Equity Afya.
High blood pressure remains one of the fastest growing public health threats globally, with health experts warning that millions of people are living with the condition without knowing it — often until it is too late to prevent serious complications such as stroke, heart disease, or kidney failure.
According to the World Health Organization (WHO), an estimated 1.4 billion people worldwide are living with hypertension, making it one of the leading causes of premature death globally. The WHO describes hypertension as a “silent killer” because many people show no symptoms until severe damage has already occurred.
The burden is especially heavy in low- and middle-income countries, where nearly two-thirds of cases are recorded. WHO data further shows that only about one in five people living with hypertension have the condition under control, despite the availability of effective treatment and prevention strategies.
As the world marked World Hypertension Day 2026 on May 17 under the theme “Controlling Hypertension Together,” health experts renewed calls for routine screening, lifestyle changes, and stronger community-based interventions to improve prevention and management.
In this interview, Dr Bonface Onsongo of Equity Afya highlights the growing shift toward preventive healthcare and explains why early detection and lifestyle modification are central to controlling the disease.
He says one of the biggest challenges is that hypertension develops silently, leaving many people unaware they are already at risk.
“One of the biggest challenges in hypertension management is that many people do not know they have high blood pressure because the condition often develops silently without obvious symptoms,” he said. “In recent years, there has been a noticeable shift from hospital-centred care to more community-led interventions.”
Dr Onsongo adds that community programmes are changing how people understand and respond to the condition.
“Programmes such as local screenings, wellness campaigns, and public sensitisation initiatives are encouraging people to take greater responsibility for their health through routine monitoring, preventive care, and healthier lifestyles,” he said. “Previously, many patients only sought treatment after developing complications such as stroke, severe headaches, or heart disease.”
He noted that awareness is gradually improving, especially on the importance of early testing.
“Today, more people understand that hypertension can silently damage the heart, kidneys, and blood vessels long before symptoms appear,” he said. “That awareness has made regular screening increasingly important.”
Despite this progress, many people in Kenya still remain undiagnosed. Dr Onsongo says several barriers continue to delay early detection.
“In daily practice, the biggest barriers include lack of routine medical check-ups, low public awareness, busy lifestyles, financial limitations, and the common misconception that hypertension only affects older people,” he said.
To address this, he explains that screening is now being integrated into routine care.
“To address this, routine blood pressure screening has been integrated into standard patient care during clinic visits, regardless of the patient’s primary complaint,” he said. “The goal is to normalise routine blood pressure monitoring in the same way people routinely check temperature or weight.”
Hypertension is also closely linked to other chronic illnesses such as diabetes and kidney disease, making comprehensive care essential.
“Hypertension rarely exists in isolation. Managing it effectively requires a comprehensive and integrated healthcare approach that addresses all risk factors together rather than treating one condition at a time,” Dr Onsongo said.
He added that integrated care should include multiple health checks and support systems. “This includes blood pressure monitoring, blood sugar testing, cholesterol screening, kidney function assessment, nutritional counselling, exercise guidance, medication management, and mental wellness support under one roof,” he said. “Once risk factors are identified, a multidisciplinary approach helps improve overall health outcomes and increases healthy life expectancy.”
While medication plays a role in treatment, Dr Onsongo stressed that long-term control depends heavily on lifestyle changes.
“Lifestyle modification remains the foundation of hypertension prevention and management,” he said. “While medication is necessary for some patients, long-term control largely depends on healthy daily habits.”
He explained that dietary changes are central to prevention efforts.
“Patients are guided on dietary changes such as reducing salt intake and adopting the DASH diet, which emphasises fruits, vegetables, whole grains, lean proteins, and low-fat dairy products,” he said.
He also highlighted the importance of physical activity and behaviour change.
“Physical activity such as jogging, cycling, swimming, or brisk walking for at least 30 minutes daily can significantly improve cardiovascular health,” he said. “Healthcare providers also support patients dealing with smoking, alcohol use, stress, and poor sleep through counselling and behavioural support programmes.”
Community engagement, he noted, is becoming a key pillar in prevention efforts.
“Community partnerships are becoming increasingly important in preventive healthcare,” he said. “Outreach programmes in schools, churches, markets, workplaces, and residential areas have helped increase awareness about hypertension and the importance of regular screening.”
He cited recent screening efforts as an example of collaboration in action.
“This year, Equity Afya, in collaboration with the Ministry of Health, the County Government of Kitui, and the Kenya Cardiac Society, organised free voluntary blood pressure screening activities at Kitui Stadium as part of World Hypertension Day commemorations,” he said. “The initiative aimed to bring healthcare services closer to communities.”
As the world reflects on hypertension awareness, Dr Onsongo urges the public to take personal responsibility for their health.
“Hypertension is preventable, detectable, and manageable when identified early,” he said. “People should not wait for symptoms because complications can develop silently over many years.”
He encourages routine checks and healthier lifestyles as simple but powerful tools.
“The public is encouraged to know their blood pressure numbers, attend regular health check-ups, maintain a balanced diet, exercise regularly, manage stress, and avoid smoking and excessive alcohol consumption,” he said.
He concluded that collective action remains key to reducing complications linked to the disease. “Through collective action, education, and healthier living, we can truly achieve the goal of controlling hypertension together.”