As populations move to urban centres across East Africa, lifestyle habits that affect cardiovascular disease have changed, affecting non-communicable disease risk. In particular, the prevalence of hypertension, and associated awareness of this life-threatening condition, has not been studied in Mombasa, Kenya. This paper assesses the rates of prevalence, awareness, treatment and control of hypertension in Old Town, an urban district of the coastal city. We surveyed 469 subjects, gathered via a clustered sampling technique. Age-adjusted prevalence of hypertension was measured at 32.6% (± 2.2) for adults over 18 and was linearly related to age. Results indicate that hypertension awareness was associated with age and sex, as women were substantially more likely to be aware of and to control their hypertension. Only 23.2% (± 2.0) of subjects had knowledge of both the causes of and practical solutions to hypertension, and practical hypertension knowledge was associated with hypertension awareness and gender (women had higher rates of knowledge than men). These results indicate that hypertension is a real public health concern in Old Town, and that younger individuals, particularly males, are least likely to be aware of the dangers of hypertension. Public health measures should focus on this population.

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In January 2001, a team of researchers from the University of Ulster (Northern Ireland) conducted an innovative maritime archaeology project on the East African coast in partnership with the British Institute in Eastern Africa and the National Museums of Kenya. Its focus was Mombasa Island on the southern Kenyan coast, a historical settlement and port for nearly 2000 years (Berg 1968; Sassoon 1980; 1982). The East African seaboard, stretching from Somalia in the north to Madagascar and Mozambique in the south, was culturally dynamic throughout the historical period. This area, traditionally known as the Swahili coast, is culturally defined as a maritime zone extending 2000 km from north to south, but reaching a mere 15 hi inland. The origins of ‘Swahili’ cultural identity originated during the middle of the 1st millennium AD, following consolidation of earlier farming and metalusing Bantu-speaking communities along the coast and emergence of a distinctive ‘maritime’ orientation and set of cultural traditions (eg Allen 1993; Chami 1998; Helm 2000; Horton & Middelton 2000). Previous research produced evidence of exploitation of marine resources for food and an early engagement in longdistance exchange networks, linking parts ofthis coast with the Classical world by at least the BC/AD transition.