ABSTRACT:

Background: Sub-Saharan Africa has the highest age-adjusted prevalence of hypertension of any region in the world. Herbal and alternative medicine use is also common in this region. Little is known about the utilization of herbal and alternative medicines specifically for hypertension (HTN) among African adults, particularly among inpatients.

Objective: The aim of these studies was to determine the pattern and correlates of herbal and alternative medicine use in hypertensive patients in Africa. We also investigated whether herbal or alternative medicine use was associated with antihypertensive medication non-adherence.

Methods: We conducted 2 studies. The first was a prospective, cross-sectional study of 213 consecutive Tanzanian adults admitted to a Tanzanian zonal hospital with hypertension-related conditions. Factors associated with herbal and alternative medicine use and treatment adherence were examined using ordered logistic regression. The second was a systematic review of the literature to determine what is currently known and not known about herbal medicine use in the last month. Neither utilization of herbs nor other alternative therapies were significantly associated with recent medication non-adherence. Many patients reported using foods as herbal medication. In the literature from sub-Saharan Africa, the prevalence of THM use was 25-65% (average 38.6%). THM was the most common type of complementary and alternative medicines used by patients (86.7%-96.6%). Among THM users, 47.5% concomitantantly used both allopathic medicine and THMs. Increased age (p<0.001), male sex (RR 2.58), belief in a supernatural cause of hypertension (RR 2.11), and family history of hypertension (OR 1.78) were positively associated with THM use while belief that hypertension is
preventable was negatively associated with a THM use (OR 0.57).

Conclusion: Herbal and alternative medicine use is common among Tanzanian men and women admitted with hypertension-related conditions and is associated with lower socio-economic status. Many adults reported stopping allopathic medicines to take herbs in the past. These studies highlight the need for healthcare workers in Africa to discuss herbal and alternative medicine use with all adults with hypertension and to do so in a way that promotes open dialogue about proper and improper utilization patterns