Hypertension: Nigeria’s silent epidemic- An urgent call for national action
Report by Aminat Dosunmu, a cardiovascular disease researcher
Hypertension, also commonly referred to as high blood pressure remains the most prevalent cardiovascular disease in Nigeria as of today, affecting millions of individuals and contributing to a significant portion of the nation’s non-communicable disease burden. Often described as a “silent killer”, hypertension frequently goes undetected until it has caused severe, irreversible complications like stroke, heart failure, kidney disease and sudden death. This condition has a rising prevalent rate ranging from 22% to 44% across regions in Nigeria and thereby impacting an estimate of 27-39 million adults. The public awareness of this illness stands at just 29%, and treatment between the range of 12-33%, hence revealing a serious public health crisis that demands immediate attention and action. Thus, this article explores the leading causes of hypertension in Nigeria, effective prevention strategies, and a national call to action for the government to implement sustainable management measures.
The Leading Causes of Hypertension
Recent estimates have shown that nearly one in three Nigerian adult lives with hypertension, yet less than half are aware of their condition, and only a small fraction have it adequately managed and controlled. Healthcare centers around the country consistently report stroke and hypertensive heart disease as the top causes of admission and mortality. Blood pressure that is consistently at or above 140/90 mmHg causes hypertension and this arises from range of genetic, lifestyle and environmental factors. Dietary factors like the consumption of processed foods, fast foods that are rich in salt and a shift from traditional diets to those that contain unhealthy fat, and sugars contribute to conditions like diabetes and obesity which is a key risk factor in hypertension due to impaired glucose tolerance. Moreover, lifestyle factors like reduced physical activity, excessive alcohol consumption and smoking further elevate blood pressure as well as stress from daily life and economic pressures. Ultimately, low health literacy, limited access to healthcare in rural areas and economic constraints hinder early detection, thus exacerbating this condition.
Prevention Strategies: What Works and What Must be Scaled
Preventing hypertension requires a dual approach which includes individual lifestyle modifications and population-wide interventions. Examples of individual lifestyle approaches includes adopting a healthy diet that contains a balanced intake of at least 400g of fruits and vegetables daily, limiting free sugars to less than 10% of energy intake and keeping fats under 30%, which is in line with World Health Organization (WHO) healthy diet recommendations and evidence from dietary interventions such as the Dietary Approaches to Stop Hypertension (DASH) study. Also, reducing salt intake to under 5g per day can lower blood pressure by 3-5 mmHg. Engaging in physical activity like brisk walking and aerobic exercises for at least 150 minutes could help reduce systolic blood pressure by 2-11 mmHg, depending on the type of exercise. Additionally, lifestyle changes that involve limiting alcohol consumption, quitting smoking and maintaining a healthy body mass index through portion control could help avoid obesity. Population-wide interventions include community-based screenings in accessible locations to boost early detection and promoting public awareness. Ensuring tailored prevention like regular monitoring and addressing comorbidities for high-risk groups such as individuals with HIV, diabetes or sickle-cell disease would be beneficial. Programs like the Hypertension Treatment in Nigeria (HTN) initiative have demonstrated success, achieving over 90% treatment and 50% control rates in participating centers by 2023, proving that scalable prevention is infact feasible.
A National Call to Action: Government Strategies for Management
Nigeria can no longer afford to treat hypertension as an individual health issue. It is a national development challenge that demands decisive and coordinated government leadership. Strengthening primary healthcare infrastructure through increased budgetary allocation for early detection, treatment, and the provision of essential equipment must be a national priority because effective hypertension control begins not only in tertiary hospitals, but in local clinics, primary health centers, and community settings where most Nigerians first seek care. In addition, the government should implement a National Blood Pressure Surveillance System, aligned with the WHO STEPwise approach, to systematically monitor detection, treatment, and control rates across the country on an annual basis.
Such a framework would enable data-driven decision-making and allow measurable progress toward improved hypertension outcomes by 2030. Furthermore, the provision of free or subsidized blood pressure screening, antihypertensive medications, and structured follow-up care should be expanded through a coordinated program such as a National Hypertension Control Initiative (NHCI). Finally, the government should consider investing in locally driven research to identify population-specific risk patterns and effective interventions, integrating these data into platforms such as District Health Information Healthcare-2 (DHIS-2) for real-time monitoring and responsive policy implementation.
