At 24, Diane Ihirwe Muhirwa never imagined high blood pressure would become part of her life. Juggling lectures, assignments and work left her little time to cook or exercise, and fast food became her daily routine. Within seven months, her weight climbed from 70 kilograms to 98. She felt constantly tired and heavy, gave away clothes that no longer fit, and found even short walks exhausting. A brief attempt at the gym fizzled when results didn't come quickly. ALSO READ: How to control hypertension through lifestyle changes Then a routine medical check-up changed everything. I was shocked to learn that my blood pressure was high, she recalls. I had always believed hypertension was a condition that affected older people, not someone in their twenties. Her story is becoming common. Once considered a disease of middle and older age, hypertension is increasingly showing up in young adults — driven, health experts say, by changing lifestyles, poor diets, stress, inactivity and a lack of routine checks. Many don't know they have it until the condition is already advanced. A silent condition Hypertension is often called the silent killer because it can develop without symptoms while quietly damaging the heart, blood vessels, kidneys and other organs. It's now part of Rwanda's growing burden of non-communicable diseases (NCDs), which account for 47.7% of deaths nationwide, according to UNICEF. Excess weight — a major risk factor — affects 18.6% of adults. The Ministry of Health's latest STEPS survey found that about 16.2% of Rwandans live with high blood pressure, many undiagnosed. The Rwanda Biomedical Centre (RBC) estimates over a million people may have hypertension, yet only around 80,000 are enrolled in specialized clinics — a significant treatment gap. The government recently launched the Healthy Heart Africa programme to expand screening and improve early diagnosis. ALSO READ: Community health workers to start screening high blood pressure Dr. Concorde Ishimwe, a medical doctor with over a decade in emergency and public health, points to rapid urbanization: more sedentary lifestyles, less physical activity, and more processed food high in salt, sugar and unhealthy fats. Rising obesity, alcohol and tobacco use, chronic stress, poor sleep and family history compound the trend — and skipped check-ups mean it often goes undetected until complications set in. I thought I was just tired Twenty-three-year-old Yves Ange Mugwaneza didn't connect his dizziness and mental fog — worse on hot days or after long walks — to blood pressure. Active through school, he became sedentary at university as coursework crowded out sports, and socializing over drinks replaced exercise. I would sweat sporadically, and eventually I told my mother how I felt, he says. A hospital visit revealed significant weight gain over three years, linked to elevated blood pressure. He started medication alongside lifestyle changes — more exercise, better diet — and his blood pressure is now normal. His experience underscores a key message from doctors: hypertension, caught early, is manageable. Lifestyle is outpacing health habits Hardi Sebanani, a fitness trainer at Fitness Point Rwanda, sees the same pattern: junk food like pizza, burgers and fries has become trendy, while some young people avoid even walking short distances for fear of being seen doing it. Busy parents, especially during school holidays, often leave kids reliant on fast food. The result, he says, is a generation that's not physically fit — some can barely exercise a few minutes before feeling breathless or faint. Staying active doesn't require a gym membership, he notes — Kigali's public exercise spaces and the monthly Car Free Day are free options. Combined with a balanced diet, regular activity significantly cuts the risk of hypertension and other NCDs. ALSO READ: Why many children in Rwanda live with undiagnosed H. pylori infections Why early nutrition matters Samson Desie, UNICEF Rwanda's Nutrition Programme Manager and Early Childhood Development Coordinator, calls nutrition one of the most powerful tools for preventing hypertension — habits formed in childhood and adolescence often shape health for life. Traditional Rwandan diets, built on whole grains, legumes, fruits and vegetables, are giving way to processed foods, sugary drinks and fast food high in salt and sugar — a shift Desie links to rising obesity and hypertension among younger generations. Today, busy lifestyles and changing food environments mean many young people are relying more on convenience foods that increase their risk, he says. More than just food Stress is a growing part of the picture — academic pressure, demanding careers, financial strain and an always-connected digital life leave little room for rest. Poor sleep compounds it: late nights studying, working or scrolling reduce sleep quality, while prolonged stress keeps the body in a state of heightened alertness that strains the cardiovascular system. Young people may feel completely healthy despite having dangerously high blood pressure, Dr. Ishimwe says. Left untreated, he warns, it raises the risk of stroke, heart attack, heart failure, kidney disease, vision loss and premature death. ALSO READ: Why HIV infections among young people remain alarmingly high Prevention starts with everyday choices The good news: hypertension is largely preventable. Dr. Ishimwe recommends a diet rich in fruits, vegetables, whole grains and lean protein, with less salt, processed food, sugary drinks and unhealthy fat — plus at least 150 minutes of moderate exercise a week, a healthy weight, no smoking, limited alcohol, stress management and adequate sleep. Above all: know your numbers. Regular screening catches hypertension before complications arise. It is not difficult to diagnose hypertension, and it can be treated with low-cost medicines and lifestyle changes, RBC's Dr. François Uwinkindi said at the Healthy Heart Africa launch, urging routine screening. Desie adds that prevention isn't just individual — families, schools, employers and communities all have a role in making healthy food accessible and active lifestyles the norm from an early age. ALSO READ: Urban lifestyles fuel rising childhood obesity in Rwanda Simple habits, like more home-cooked meals, choosing fruit over processed snacks, and cutting sugary drinks and salt, can meaningfully lower risk later in life. Protecting young people from hypertension is not only about preventing disease today, but also about safeguarding Rwanda's future health and productivity, he says. Knowing your numbers For Ihirwe, the diagnosis was a turning point — she now watches what she eats and knows conditions like this don't always come with warning signs. It changed a belief she'd long held: high blood pressure isn't just a disease of parents and grandparents. Across Rwanda and beyond, more young adults are learning that today's choices — diet, movement, sleep, stress — shape heart health for decades. The message from health experts is simple: this doesn't have to be part of the story. ALSO READ: The future belongs to the youth, but only when healthy enough Knowing your blood pressure, making healthier choices and seeking care early can stop a silent condition before it becomes a life-changing one.
