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Hypertension is the leading cause of morbidity and mortality globally. Africa has the highest prevalence which is rising. There has been insufficient focus on prehypertension yet it accounts for a significant proportion of blood pressure (BP) associated morbidity. Not only are they at risk of BP associated morbidity, since the increased risk begins from 115/75 mmHg but are also at high risk of developing hypertension. Hypertension control programs therefore need to address this population. We used data from the Health Heart Africa (HHA) program to estimate the prevalence of prehypertension in the community.HHA is a community hypertension control program aimed at raising public awareness; improving management in primary care and availing affordable drugs. The activities included public screening for hypertension in health facilities and non-traditional settings e.g. workplaces, markets and places of worship. BP was measured using standard techniques by trained staff using digital sphygmomanometers. Data was anonymized and transferred to a central data base. Prehypertension was defined as BP of 120–139/80–89 mmHg.So far 4.62 million subjects have been screened. Prevalence of hypertension was 20.98%. Prevalence of prehypertension was 47.3% (males 50.6%, females 45.5%). The prevalence increased with age, peaking at 50–69 years (49.9%) with subsequent decline. The decline coincides with an increase in hypertension most likely reflecting transition to hypertension.We found a high burden of prehypertension with consequent high population cardiovascular risk. Population wide-interventions to lower BP will reduce the prevalence. Targeted primary preventive measures to reduce transition to hypertension and cardiovascular risk are necessary.