Hypertension is the main risk factor for morbidity and mortality in the world. In Sub-Saharan Africa, hypertension, previously almost unknown, is now a major risk factor. A paper recently published showed that mean systolic blood pressure is higher in all regions of Africa compared with other parts of the world, and, most important and contrary to what is happening in the rest of the world, it is increasing in the last years. Another important issue that characterises hypertension in Africa is its extremely low level of awareness and consequently low level of control. As a consequence, there is a high incidence of stroke, characterized by an almost 10 year's younger age of incidence and a relatively high percentage of haemorrhagic strokes with a high intra hospital mortality. New and innovative ways of increasing the levels of hypertension awareness are needed as well as a regular provision of anti-hypertensive generic drugs of good quality to face this enormous burden of the African health.