Source: The Conversation – Africa (2)
Hypertension – persistent high blood pressure – is one of the biggest contributors to strokes, heart failure and cardiac arrests. It claims more than 10 million lives every year worldwide. But it’s a largely treatable condition, manageable with relatively cheap medication and simple lifestyle changes.
That’s why detecting it early is so worthwhile.
In Nigeria, the burden of hypertension has been climbing for years. According to the World Health Organization, the prevalence of hypertension among Nigerian adults is about 36%.
The scale of the challenge became clearer when our team of cardiologists set up blood pressure testing stations in Lagos for three months in 2023. We set them up in hospitals, pharmacies, workplaces and public spaces across the city and tested as many as 1,500 adults who were passing us. The results were concerning.
Our findings show that 52.5% of those who tested had hypertension, and of those with hypertension, 65.3% had no idea their blood pressure was high. The care gap ran even deeper. Only 13.8% of the people we identified as hypertensive were taking medication for their condition, and just 8.3% had their blood pressure under control. Hypertension is blood pressure at 140/90 mmHg or above.
In a city of more than 20 million people, this meant that millions could be walking around unaware that they are living with a serious medical condition or not getting the care they need for it.
If Nigeria could reach the modest target of just 50% hypertension control, called for by the WHO and World Heart Federation, at least 75 million deaths globally might be prevented before 2050.
However, as our findings show, the first hurdle is to improve people’s awareness of their condition. Screening is central to this. If we can’t find the condition, we can’t treat it, especially in the early stages when a change of habits can still make a real difference.
Our findings underscore the need for sustained mass screening, improved access to affordable anti-hypertensive therapy, and stronger health systems to ensure that patients are not lost between diagnosis, treatment and successfully controlling their condition.
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From awareness to action
Worldwide, fewer than one in five people with hypertension have their blood pressure controlled. Our study shows some of the reasons for this.
When we interviewed participants in Lagos, 57.3% reported that they had to pay the full cost of their medication themselves, and more than one in five said that they only took their tablets when they felt they needed them.
When medication becomes a financial consideration, and when a month of pills competes with school fees or transport, it’s little surprise that adherence rates drop.
To an extent this is also a question of understanding and awareness. Of those on treatment, 64.6% said they took their medication regularly, while 22.4% took their tablets only when they felt they needed them, despite this being against clinical recommendations.
Adherence and prevalence partially reflects education levels. People with no formal schooling were around two and a half times more likely to fall into a higher blood pressure category.
Solutions
Most of what is needed already exists, and none of it is expensive. The medicines and the protocols already exist, set out in the World Health Organization’s HEARTS package. What has to change is where the care happens.
Nurses and primary healthcare workers can measure blood pressure, start treatment under protocol, refill prescriptions and spot the red flags that mean a patient should be referred, leaving the tertiary centres to handle the complications. Adding hypertension to a system that already exists costs far less than building a new one.
Awareness and prevention are key to improving Nigeria’s heart health. If a patient reaches me in a hospital, the system has already failed them. For what it costs to treat one heart attack, we could manage the risk factors of a great many people long before they ever need a cardiologist.
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Next steps
Nigeria was at the centre of the 2026 World Heart Day activities. The World Heart Federation partnered with the Nigerian Cardiac Society on a two-day conference in Abuja, including a secondary school debate and arts competition, a community walk, health screenings and CPR training (cardiopulmonary resuscitation).
The Nigerian Heart Foundation, CHDf Nigeria, and regional chapters of the Nigerian Cardiac Society are also running grassroots events elsewhere in the country, with a focus on improving awareness and providing community health services.
The World Heart Federation’s members around the world can only do so much, however. Systemic action is needed to tackle what is a global issue.
What is missing in Lagos, and across much of sub-Saharan Africa, is two-fold: access to screening, and access to treatment if hypertension is found. This is where systemic change is needed. Nigeria needs integrated health systems which reduce out-of-pocket costs, embed routine checks into primary care, and enable community health workers to screen, refer and follow up with patients.
There are proven and off-patent medications to control blood pressure. These should be made available at a reasonable cost.
Amam Mbawkem receives research grant from Pfizer and Astra Zeneca.
Original source: https://analysis1.mil-osi.com/2026/10/18/blood-pressure-rising-over-50-of-nigerians-we-tested-had-hypertension-and-over-65-didnt-know-it/