High blood pressure - hypertension, “BP” - is one of the commonest serious health problems among adults in Accra. Studies in Ghana have found it in roughly a fifth to almost half of adults, depending on age and place, and many of them did not know.
It is called silent for a reason: most people feel completely well until it causes a stroke, a heart attack or kidney failure.
Getting checked
- Free, once a year, through the NHIA’s annual health check - for adults, whether or not you are on NHIS.
- At a pharmacy, any day, for a quick reading.
- At any clinic visit - ask for it to be taken even if you came for something else.
One high reading is not a diagnosis. Stress, a rushed walk, coffee, or the white coat itself raise it. A doctor diagnoses hypertension from repeated readings, sometimes on different days.
— The free annual health check
Who is most at risk
- Anyone with a parent or sibling who has it.
- People who are overweight, especially around the waist.
- People who eat a lot of salt. Much of the salt in a Ghanaian diet is hidden: stock cubes, salted and smoked fish, shito, instant noodles, and the salt added at the chop bar.
- People who drink a lot of alcohol, smoke, or get little exercise.
- Pregnant women - pre-eclampsia, high blood pressure in pregnancy, is a leading danger to mothers in Ghana, which is why every antenatal visit checks it.
Treatment, and NHIS
Treatment is usually daily tablets, for life, alongside less salt, more movement and less alcohol. The NHIS benefit package covers the diagnosis and treatment of hypertension, and common blood pressure medicines are on its medicines list. In practice:
- Not every brand is covered. If a pharmacy says your medicine is “not on NHIS”, ask whether an equivalent that is would do - the doctor can say.
- Stock-outs happen at public facilities, and patients then buy the medicine themselves. Keep a few days in hand, not your last tablet.
- Keep your NHIS card active. A lapsed card turns a free prescription into a monthly bill.
— NHIS — Renewing NHIS — Pharmacies and medicines
The mistake people make
Stopping the tablets because they feel fine, or because the reading came back normal. The reading is normal because of the tablets. Stopping often sends it back up, without symptoms, and strokes in Accra are often in people who stopped their medicine or switched to an herbal remedy instead.
Herbal products sold on trotros and in markets as cures for “BP” are not cures. If you want to try one, tell your doctor, and do not stop the prescribed medicine to do it.
A home monitor
An automatic upper-arm blood pressure monitor is sold in pharmacies and medical shops in Accra, and is worth having once you are diagnosed. Take readings at the same time of day, seated and rested, and bring the record to your appointments.
When it is an emergency
A sudden severe headache, weakness or numbness on one side of the body, a drooping face, slurred speech, chest pain or difficulty breathing: get to a hospital emergency unit at once. In a stroke, hours matter.