Why hypertension is on the increase in Nigeria

…Healthy lifestyle, regular medical checkup important

Biodun Ogungbo, a consultant neuro-surgeon, Cedarcrest Hospital, Abuja, had a stroke while driving home from work. He never knew he had high blood pressure (or hypertension) until the stroke occurred. Luckily, it caused him a blinding headache which made him stop the car. He was seen slumped at the wheel and bystanders took him to the hospital. His blood pressure, it was discovered at the hospital, had hit the roof.

Ogunbgo is one of the few Nigerians said to have successfully passed through such an ordeal and lived to tell the story following recent reports which suggest that about one in every six to ten adults in Nigeria has hypertension; a very high percentage that calls for real awareness among the Nigerian people.

Hypertension is dubbed ‘the silent killer.’ Many Nigerians are not aware of this silent killer and for those who are aware; they often neglect to take it seriously as high blood pressure does not give one any warning sign.

As more Nigerians, due to current economic challenges, are predisposed to increased stress, unhealthy lifestyles (such as tobacco and excessive alcohol consumption), poor physical activity, medical experts have tasked Nigerians to take their health seriously by observing regular medical checkups even as they call on government to develop standards of care and cost effective case management for cardiovascular diseases (CVDs).

In a recent chat with BusinessDay, Anam Mbakwem, consultant nephrologist, Lagos University Teaching Hospital, (LUTH), Idi-Araba, Lagos, noted that though there is no country wide data on cardiovascular diseases in Nigeria, the prevalence of hypertension in the country is estimated at 20 percent.

While noting that cardiovascular diseases (which are a group of disorders of the heart and blood vessels) has been shown to form the bulk of admissions in the nation’s hospitals, Mbakwem revealed that the mean age of Nigerians that come down with hypertension are less than 50 years of age.

“The mean duration of admission is between 5 to 6 hours with approximately 34 percent cent) dying within 1hour of presentation and about 50 percent dying in less than four hours. However, the commonest cause of death is stroke.

Treatment for hypertension is the main reason for admission within the ages of 65 and above. Globally, approximately USD $59 billion was annually by 1999 (up from about $38 billion spent in 1991) in addressing hypertension. While cases of hypertension are expected to rise as population ages, an estimated 75 percent of amount spent on hypertension is related to hospitalisation cost,” Mbakwem concluded.

Echoing the sentiment of Mbakwem, Benedict Anisiuba, consultant physician and cardiologist, University of Nigeria Teaching Hospital (UNTH), Enugu, disclosed that more often than not, high blood pressure does not give one any warning signs since it does not cause headache, vomiting or any noticeable symptom.

While noting that sometimes one may even feel on top of the world and in the best of health, Anisiuba stated that blood pressure continually changes, depending on activity, temperature, diet, physical state, and medication use.

 

According to Anisiuba, “With hypertension, there may be no symptoms. Normally, blood pressure readings are usually written as fractions (for example, 120 over 80 or 120/80 mmHg). The top number is the systolic blood pressure, and the bottom number is the diastolic blood pressure. Normal blood pressure is when the blood pressure is lower than 120/80 mmHg. High blood pressure is when the blood pressure is 140/90 mmHg or above most of the time.

“Blood pressure can be affected by many things, such as how much water and salt you have in your body and the condition of your kidneys. One also has a higher risk of high blood pressure as an African, if one is overweight, has a family history of high blood pressure, has diabetes, smokes, is often stressed or anxious and drinks too much alcohol,” Anisiuba stated.

While it is a tragic fact that many patients with high blood pressure in Nigeria don’t have their blood pressures adequately controlled, hence many preventable strokes, heart attacks and cases of heart failure occur unnecessarily. However, scientific research shows that it is cheaper to prevent high blood pressure by lifestyle changes compared to drug treatment. In the same way, it is cheaper to treat hypertension than to treat complications such as stroke or heart attack.

While hypertension is a condition one lives with for life, some patients think that hypertension goes away and stays away once they have reached a normal level of blood pressure. This false impression and misconception has ended up being the downfall of many. Whereas one crucial problem is the lack of control of blood pressure for many patients, despite medications, unavailability of essential drugs, cost and sometimes fake medications, are huge problems that have further compounded the current situation, thus requiring concerted efforts from government to address this anomaly.

“There is the need for increased government investment through national programmes aimed at preventing and controlling cardiovascular diseases (CVDs). CVD risk factors can be reduced through community based programmes for integrated prevention of NCDs, development of standards of care and cost effective case management for CVD. Also, disease surveillance methods to access the pattern of hypertension should be developed. In this way, the prevalence of hypertension can then be documented effectively,” Solomon Kadiri, consultant nephrologist, University College Hospital (UCH) Ibadan concluded.