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2026 ISH guidelines for the management of hypertension in Africa: the International Society of Hypertension (ISH) African Regional Advisory Group and the Pan African Society of Cardiology (PASCAR)

In brief

New Africa-focused hypertension guidelines give non-physician clinicians step-by-step treatment protocols

The International Society of Hypertension and the Pan African Society of Cardiology released simplified, primary-care protocols designed for nurses and community health workers to diagnose and manage high blood pressure across sub-Saharan Africa. The guidance stresses opportunistic screening in schools, markets and places of worship and calls for investment in training and equipment to overcome the region's unique cultural and resource challenges.

Journal
Journal of hypertension (Q1)
Published
28 July 2026
Study design
Practice guideline / consensus
Evidence level
Level 1, High (CEBM 1c)
Authors
Alfred Doku, Ruan Kruger, Kofi T Asamoah, Florence K Akumiah, Tangeni Auala, Hind Beheiry, et al.
PMID
42554264
DOI
10.1097/HJH.0000000000004411

Why clinicians should know about it

  • Picked for Internal Medicine (top studies of the week, 9 August 2026): 2026 ISH guidelines provide Africa‑specific hypertension protocols

Abstract

Hypertension in sub-Saharan Africa is escalating, with many cases undiagnosed and poorly controlled, even among children, despite its significant contribution to cardiovascular disease. Poor blood pressure control is largely due to limited national guidelines, underfunded programs, and a shortage of trained health professionals. Simplified protocols for non-physician health workers, who deliver most of the primary care, are essential. Cultural myths and misconceptions further delay care, underscoring the need for community-based education. Early and opportunistic screening, including in schools, markets, and places of worship, is vital across the life course. Sustainable progress depends on tailored strategies, investment in equipment and training, and leveraging existing infrastructure to improve hypertension detection and management. Africa-centred hypertension guidelines are now a priority because international models fail to address the continent's unique clinical, cultural and resource realities. The African Regional Advisory Group of the International Society of Hypertension worked with the Pan African Society of Cardiology to develop simplified protocols for primary care, particularly for non-physician health care workers, by considering the special situation and condition for managing the vast majority of cases within hypertension in Africa.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.