Cardiovascular disease prevention in the slums of Kenya

We can no longer ignore the increasing presence of the cardiovascular risk factors in the African continent. This thesis shows that among the urban poor of Nairobi the rates of cardiovascular risk factors like hypertension, diabetes and obesity are substantial, whereas awareness and control of these risk factors remain very low. Therefore there is a strong urgency to develop and implement interventions to increase awareness, treatment and control of cardiovascular risk factors. The development of such interventions for prevention of CVD can be supported by approaches from both public health and private sector. It is important to realize that the implementation of these new interventions in slum settings can be confronted with serious challenges related with the high levels of poverty in these disadvantaged settings. However we have demonstrated that a community based intervention with affordable costs can significantly increase awareness and access to treatment of hypertension, leading to a reduction of BP both in the population level as well as among people at high risk. This would hopefully encourage other researchers and policymakers to develop, implement and evaluate cost-effective interventions for prevention of CVD among the urban poor in Africa and beyond.