Strategies for Managing Prehypertension in Adults in Kisangani: Adaptations to Limited Resources and Strengthening Primary Care in the Democratic Republic of Congo

Abstract

Prehypertension (PHTN) is widely recognised as a public health problem due to its high prevalence and its role in increasing the risk of cardiovascular disease and established hypertension (HTN). PHTN represents a major public health challenge in Africa, with prevalence ranging from 2.5% to 34% in children and adolescents, and from 32.9% to 56.8% in adults.  This narrative review aims to explore strategies for managing PHTN, adapted to the context of Kisangani, by examining community-based approaches, models of shared responsibility, and organisational innovations that help strengthen primary care in a resource-constrained setting. The literature review was conducted in PubMed, Google Scholar and institutional archives, for the period 2020 to 2025. The narrative analysis was structured around four main areas. In a study conducted in Kisangani on 422 adult participants, the prevalence of PHTN was estimated at 33.8%. This prevalence is within the range observed in sub-Saharan Africa (30-56.8%), but remains worrying given the youth of the population studied (66.2% aged 18-29). The high prevalence of cardiovascular risk factors, particularly HTN and PHTN in Kisangani, provides strong justification for the implementation of early, community-based interventions. For the PHTN integrated control model in Kisangani to be successful, it should be based on strategic, multi-sectoral coordination. The WHO HEARTS framework, mHealth, task shifting, and community activities serve as the foundation for this strategy. It also discusses finance, staffing, and resource-related concerns and provides creative answers to guarantee successful cardiovascular disease prevention.