Zimbabwe’s hypertension epidemic: Why a country that mastered HIV testing still struggles to detect a silent killer

By Elizabeth Sitotombe.

WHEN Sharon Moyo, 54, collapsed while hanging laundry outside her home in Mbare, she assumed she was simply exhausted.
For months, the grandmother of four had ignored recurring headaches and ringing in her ears, dismissing them as signs of ageing.
At Parirenyatwa Group of Hospitals, a routine check revealed dangerously high blood pressure.
“You are a walking time bomb,” she recalls being told.
Moyo had never been diagnosed with hypertension.
“I had no idea my blood pressure was that high,” she said. “I thought it was just stress and tiredness.”
Her case reflects a wider public health challenge in Zimbabwe.
Data from the May Measurement Month (MMM) 2021 campaign found that 37.3% of adults screened were hypertensive. Among those diagnosed, only 49.7% were aware of their condition, while 45% were receiving treatment.
If the MMM 2021 screening results reflect national trends, then a significant proportion of adults may be living with high blood pressure, with nearly half unaware of their condition and many not receiving treatment. This makes hypertension one of the country’s most under-detected chronic health risks.
The findings raise a central question: Why is a country that successfully scaled up HIV testing still struggling to routinely detect hypertension?
Hypertension in Zimbabwe is clearly no longer a marginal health issue.
A national estimate by the Ministry of Health and Childcare in Zimbabwe reported hypertension prevalence of approximately 27 percent among adults, while a meta-analysis of studies conducted across five provinces found prevalence approaching 30 percent. More recent blood pressure screening campaigns have reported prevalence levels above 37 percent.
In practical terms, this means hypertension is not rare it is common, often silent, and frequently undiagnosed until complications occur.
Health experts warn that this makes it particularly dangerous. Unlike infectious diseases, hypertension can progress for years without symptoms, damaging the heart, kidneys, and blood vessels before suddenly presenting as stroke or heart failure.

Taken together, the evidence suggests that between one-third and four in every ten Zimbabwean adults may be living with hypertension.

Prevalence of hypertension in Zimbabwe

Nearly 1 in 3 adults screened were found to have high blood pressure. Among those with hypertension, only 49.7% were aware of their condition.

At the Wilkins Hospital Hypertension Clinic in Harare, many patients arrive seeking treatment for unrelated ailments only to discover that their blood pressure is dangerously high.
Dr Chimuka, a general practitioner at Eastview Medical Centre, says hypertension often remains undetected until serious complications develop. “You can feel perfectly healthy while the damage is happening internally,” he said. “Many patients only discover they have hypertension after a medical emergency.”
The increase mirrors a wider trend across sub-Saharan Africa, where non-communicable diseases are becoming increasingly prominent as populations urbanise and lifestyles change. While prevalence figures are concerning, health professionals say the bigger problem is that many people do not know they have the condition.
The MMM 2021 survey found that fewer than half of participants with hypertension were aware of their diagnosis.
This means many Zimbabweans may be living with uncontrolled high blood pressure without receiving treatment or regular monitoring.
Health experts attribute the gap to limited routine screening, shortages of equipment in some facilities and low public awareness about the importance of regular blood pressure checks.

Awareness and treatment gap among Zimbabweans with hypertension.

Nearly half of people found to have hypertension were unaware of their condition, highlighting major gaps in routine screening and diagnosis.

Zimbabwe’s HIV response is frequently cited as one of the country’s greatest public health successes. Routine HIV testing is available in most health facilities, supported by years of investment in community outreach, screening programmes and treatment services.
Health specialists argue that this difference explains why HIV detection has improved
Hypertension, however, has not received the same level of attention.
At Edith Opperman Clinic in Mbare, nurse clinician Sister Grace Ncube says blood pressure screening is not always conducted consistently.
“We routinely test for HIV because the systems are established,” she said. “Blood pressure screening often depends on available equipment, staff and time.”
The contrast between HIV and hypertension is striking. Over the past two decades, Zimbabwe built an extensive HIV testing network supported by community health workers, routine screening programmes and sustained donor funding. Public health specialists argue that a similar approach to hypertension screening could help identify thousands of undiagnosed cases before patients develop life-threatening complications.

Indicator HIV Programme Hypertension Care
Awareness of status 97% know status 49.7% aware
Treatment coverage 98% on ART Inconsistent
Viral control 96% suppressed No national system
Routine screening Universal Irregular
Community outreach Strong Limited

Source: National AIDS Council Zimbabwe HIV Cascade Data; MMM 2021.

That contrast lies at the centre of Zimbabwe’s hypertension challenge. The country has demonstrated that large-scale screening programmes can work, yet many patients continue to discover they have hypertension only after developing serious complications.
What Experts Say About Risk

Unlike HIV services, hypertension care is not consistently integrated into standard health checks. Health experts argue that routine blood pressure measurement at every clinic visit could significantly improve early detection.
Health experts also point out that changes in diet and lifestyle are contributing to the growing burden of hypertension.
The increased consumption of processed foods high in salt, sugar and unhealthy fats, coupled with declining levels of physical activity, has increased the risk of hypertension and other non-communicable diseases.
In many urban communities, traditional diets rich in vegetables and whole foods are increasingly being replaced by cheaper processed alternatives.
Economic pressures also play a role.
Many Zimbabweans face chronic stress linked to unemployment, rising living costs and economic uncertainty. Medical experts say prolonged stress can contribute to elevated blood pressure and other cardiovascular risks.
Yet hypertension is not only a problem in the urban areas.
In rural communities, limited access to health facilities and infrequent screening opportunities mean many residents may go years without having their blood pressure checked.
Health workers say some people wrongly assume they are not at risk because they are physically active or not overweight, despite hypertension affecting people of different body types and ages.

GRAPHIC 3: Major risk factors contributing to hypertension in Zimbabwe.

High salt consumption, physical inactivity, unhealthy diets and chronic stress are among the leading contributors to rising hypertension rates.
It is a mistake to think this is only an urban problem. Health workers say outreach screenings reveal the scale of undiagnosed cases. In Masvingo Province, a mobile clinic screening conducted in 2025 tested 500 adults in remote villages. More than 170 of the 500 adults screened were found to have hypertension, representing approximately 34% of those tested.
“They told me I was fine because I am thin,” says Amai Charamba, 62, who was found to have a reading of 180/110. “No one told me that thin people can also have this disease.”Health workers point to several factors that contribute to missed diagnoses.
The first is limited routine screening. Many patients visit clinics for unrelated illnesses and leave without having their blood pressure measured.
The second is resource constraints. While HIV programmes have benefited from substantial international funding and investment, non-communicable diseases often compete for limited resources within the health sector.”
The third is awareness. Because hypertension often develops without noticeable symptoms, many people do not seek testing unless they become ill.
Questions sent to the Ministry of Health and Child Care regarding hypertension screening, medicine availability and funding for non-communicable disease programmes had not been answered by the time of publication.
However, the Ministry has previously identified non-communicable diseases as a growing public health concern and has committed to strengthening prevention, screening and treatment services through national health strategies.
Health experts say greater investment in routine blood pressure screening, community awareness campaigns and reliable medicine supplies could help reduce preventable complications associated with hypertension.
Most BP medications such as Nifedipine and Atenolol costs less than $10 per month. But those pills must be taken for life, and the supply chain is erratic. In public clinics, stockouts of antihypertensives are common and occasionally in private pharmacies as well. BP testing machines also cost around $US18 to $US20.
“We have treated HIV successfully because we made testing routine and drugs free and reliable,” says Dr. Chimuka. “We need the same donor energy for hypertension. Despite growing concern, major questions remain unanswered. Zimbabwe still lacks publicly available national data showing which provinces have the highest hypertension burden, how many clinics have functioning blood-pressure machines, how frequently antihypertensive medicines run out of stock, and how much funding is allocated specifically to hypertension programmes.
The absence of this information makes it difficult for the public to assess whether existing resources are sufficient to address a growing national health challenge. Without these figures, it is also difficult for policymakers to accurately measure the scale of the crisis and target interventions where they are most needed.
Back in Mbare, Sharon Moyo now takes medication daily and attends regular clinic reviews. Her blood pressure has improved, and she encourages neighbours to get tested before complications arise.
“I tell people not to wait until they collapse,” she said. “Ask the nurse to check your blood pressure. It only takes a few minutes.”
As Zimbabwe confronts a growing burden of non-communicable diseases, routine blood pressure screening should become as common as HIV testing. Zimbabwe transformed HIV testing from a specialised service into a routine part of healthcare. Public health specialists say applying the same approach to blood-pressure screening could help identify thousands of undiagnosed cases before they become strokes, heart attacks or kidney failure. Until then, many Zimbabweans may continue living with a potentially fatal condition they do not know they have.