The challenge of hypertension control in Nigeria
On 17 May, 2015, Nigeria joined the rest of the world to mark the World Hypertension Day (WHD). Stakeholders throughout the country used the opportunity to call attention to hypertension, described by experts as a “silent killer”.
The WHD was inaugurated in May 2005 by the World Hypertension League (WHL), an umbrella organisation of 85 national hypertension societies and leagues, in partnership with the International Society of Hypertension (ISH) and other organisations, to promote public awareness on hypertension and to encourage citizens of all countries to prevent and control the disease, which has become a modern epidemic.
This initiative of the WHL was premised on available global statistics, indicating that more than 50 per cent of the hypertensive population worldwide were unaware of their condition, and that only a few populations had an awareness rate of more than 75 per cent. Research also showed that awareness level in some populations was as ridiculously low as less than 10 per cent. Thus the WHD was birthed with the goal of enlightening the global populace on the danger of hypertension and how it can be prevented.
It is worrisome that while some developed nations in Europe and Americas have achieved significant levels of awareness and, consequently, reduction in the prevalence of the disease since the inauguration of WHD, the reverse is the case across Africa where the occurrence of elevated blood pressure was recently ranked highest, at 46 per cent for both sexes combined.
The Nigerian situation closely reflects what obtains in other African countries. A community-based study of rural and semi-urban population in Enugu, conducted in 2013, put the prevalence of high blood pressure in the country at 32.8 per cent (representing over 55 million citizens). More recently, precisely in May 2015, Managing Director of Neimeth International Pharmaceutical Plc, Pharm. Emmanuel Ekunno, said available screening records indicated that one out of three adults in Nigeria suffer from hypertension. Ekunno made the observation at the inauguration of the National Secretariat of Cardiovascular Support Club (CSC) – a club of individuals supporting the fight against hypertension in Nigeria.
Hypertension (or high blood pressure) is described as a”silent killer” due to its ability to set in and wear down an individual’s organs, unknown to the victim. While some people might be fortunate to notice signs of discomfort when high blood pressure has set in, others may not be so fortunate, which accounts for the rampant cases of heart attacks and sudden death. The situation is more worrisome in that, while hypertension had hitherto been associated with older people, especially above 60 years of age, it has in recent years become a common ailment among people below 40.
Heavy salt consumption has been identified as a major risk factor of hypertension. So also is obesity, as it creates additional burden for the heart. Lifestyle dispositions like smoking and alcohol consumption are other factors that predispose the individual to elevated BP. Stress is equally a major factor, since it causes the release of certain hormones into the blood which trigger the heart to beat faster and constricting blood vessels to get more blood to the core of the body instead of the extremities.
It is our view that for the scourge of hypertension to be curtailed in Nigeria, there is urgent need for all stakeholders – individuals, health care professionals, advocacy groups and government at all levels – to take proactive steps in implementing strategies that can help reduce the prevalence of the disease. Awareness campaigns must be taken beyond the commemoration of WHD. Public health facilities must be improved and funding for health care initiatives must be increased by the government, donor agencies, and development partners.
Since “the security and welfare of the people shall be the primary purpose of government”, as enshrined in chapter 2 of the 1999 Constitution of the Federal Republic of Nigeria, the government in particular must be at the forefront of the fight against hypertension, employing proven methods and channels to reach out to the heterogeneous populace.
It is also imperative for Nigerians themselves to make their health a priority, by cultivating the culture of regular medical check-up, which would help those diagnosed of hypertension to begin to manage the ailment early. Advocacy on regular routine check of blood pressure must be carried out regularly in the country, especially at the grassroots.
We also urge health care practitioners to counsel all patients that come in contact with, during consultations, on their BP level. Our health care givers must desist from waiting until a patient’s BP is alarmingly high before offering clinical counseling. It is in the interest of all that health professionals constantly educate Nigerians on hypertension and not wait to do it only during the commemoration of WHD or when intervention has become practically impossible.
Once more, we urge Nigerians to assume greater responsibility for their health and not solely rely on health care providers. Every citizen must seek, on regular basis, to know their health status, while consciously avoiding habits, lifestyles and diets that make them susceptible to high blood pressure.