A senior physician at Mengo Hospital, Dr. Ezra Nnunda Kibirango, has warned that thousands of Ugandans may be living with hypertensive heart disease without knowing it, putting them at risk of heart failure and sudden death.

Speaking on Next Radio, Dr. Kibirango said hypertension remains one of the most underdiagnosed and poorly managed non-communicable diseases in Uganda.

“About one in four people is either hypertensive or pre-hypertensive. However, only 26 percent of Ugandans know they are hypertensive. Of those, only 7 percent are on treatment, and from that group, just 36 percent have their blood pressure under control,” he said.

Dr. Kibirango explained that the heart functions like a pump, while blood vessels act as plumbing.

“When hypertension sets in, it’s like the plumbing system becoming clogged. The heart is forced to pump harder to push blood through narrowed vessels,” he said. Over time, the heart muscle enlarges in response to the increased workload — a dangerous change.

“It is not good for the heart to grow bigger. As it enlarges, it receives less oxygen and blood. Eventually, heart cells begin to die. Once it reaches that stage, there is no return,” he warned.

According to Dr. Kibirango, hypertensive heart disease is often silent in its early stages, meaning many people do not know they are sick until the condition becomes critical.

“In the beginning, people do not feel anything. Symptoms like chest pain usually appear when the disease has already progressed,” he said.

Warning signs may include:

• Palpitations
• Swelling of the body
• Fatigue
• Difficulty breathing, especially when lying flat
• Persistent cough

He urged anyone experiencing these symptoms to seek medical evaluation promptly.

Dr. Kibirango emphasized that everyone is at risk, regardless of body size. “You can be slim and hypertensive, or obese and not hypertensive. The key is lifestyle and early testing,” he noted.

He stressed the importance of:

• Regular exercise such as walking, jogging, football, tennis, and gardening
• Strength training and body-conditioning exercises
• Eating fruits and vegetables at least three times a day
• Consuming whole fruits instead of fruit juice
• Reducing fat intake, especially saturated fats like butter and margarine
• Removing cream from boiled milk

Dr. Kibirango warned that smoking and excessive alcohol use significantly increase the risk of hypertension.

“One shisha pot is equivalent to smoking 20–25 packets of cigarettes, while vaping is like smoking about 20 cigarettes,” he said.

He added that raw salt is one of the biggest contributors to hypertension in Africa, noting that high blood pressure is now increasing rapidly in rural areas — a shift from when it was considered a disease of the wealthy.

On alcohol consumption, he advised:

• Men should not exceed three units per day
• Women should not exceed one to two units per day
• One unit is about 300ml
• One tot of whisky for women and two for men per day is the upper limit

“My advice is to stop alcohol altogether. At worst, take only one glass of red wine per day,” he said.

Dr. Kibirango noted that physical inactivity in Uganda is increasing, with many people relying on boda bodas, cars, and elevators.

“As you get some money, you stop walking. Everything eaten after 8pm turns into fat,” he said.

He explained that sex only counts as exercise if it lasts more than 30 minutes at least five days a week. “Otherwise, walking, jogging, and active work remain the best forms of exercise,” he added.

Dr. Kibirango stressed that early diagnosis can prevent or even reverse hypertensive heart disease in some patients.

“Medication protects the heart. When caught early, this disease can be reversed in some people,” he said.

He advised Ugandans to:

• Check their blood pressure at least once every two years
• Go for annual check-ups if heart disease is detected

Screening tools include:

• Blood pressure monitoring
• Laboratory tests
• Electrocardiogram (ECG)
• Echocardiogram
• Stress ECG
• MRI and coronary angiograms in advanced cases

Call for Preventive Care

Dr. Kibirango encouraged Ugandans to invest in preventive healthcare, noting that Mengo Hospital has established a dedicated wellness section for non-communicable diseases to reduce waiting times.

“People don’t want to invest in themselves until it’s too late,” he said.

He concluded by urging Ugandans to eat right, exercise, use medication correctly, and get tested regularly, saying these simple steps can protect the heart and save lives.