OPINION: Tackling Hypertension In Nigeria’s Health System

In Nigeria, a dangerous health crisis is quietly gaining ground. Hypertension, or high blood pressure, is steadily becoming one of the country’s most pervasive threats.

Unlike infectious diseases that often announce themselves with fevers, coughs, or rashes, hypertension is typically symptomless — earning it the ominous nickname “the silent killer.”

Today, more than 30 per cent of Nigerian adults are estimated to be living with high blood pressure, and many have no idea. The World Health Organization reports that over 1.28 billion people worldwide suffer from hypertension, with about two-thirds residing in developing countries like Nigeria.

Despite its enormous toll, hypertension continues to lurk in the background of national health discussions, overshadowed by more immediate crises such as malaria, tuberculosis, and maternal mortality.

Lifestyle, Awareness, And Cultural Misconceptions

Several forces are driving this largely unrecognized epidemic. Nigeria’s rapid urbanization has transformed daily life. Traditional diets, once rich in leafy vegetables, legumes, and lean proteins, have been pushed aside by more convenient but less healthy options. Processed foods loaded with salt, sugar, and saturated fats have become staples, particularly in bustling cities. Meanwhile, economic growth and modern work patterns often mean long hours spent seated in offices, behind steering wheels, or glued to computer screens, leaving little room for physical activity.

A recent study found that more than 60 percent of urban Nigerian adults exceed the WHO’s recommended daily salt intake, sharply increasing their risk for developing hypertension. Rising obesity rates, particularly among women in urban areas, add another layer of concern. These shifts are reshaping health outcomes in profound ways.

But lifestyle factors only tell part of the story. Public awareness of hypertension remains stubbornly low. Many Nigerians still see high blood pressure as a disease that only affects the wealthy or the elderly. Some attribute sudden collapses or strokes to spiritual attacks or curses rather than to preventable medical causes. These deeply ingrained beliefs often lead people to delay or completely avoid seeking medical attention.

Surveys in Lagos show that fewer than half of adults can correctly link excessive salt consumption to hypertension, and even fewer understand that it is a lifelong condition requiring consistent management. These misconceptions have serious consequences. They mean that people often skip routine screenings, fail to adjust their diets, and abandon medication as soon as they feel better, setting the stage for sudden and devastating complications.

A Health System Stretched Thin

Nigeria’s health system has made significant strides in tackling infectious diseases and improving maternal health, but it has struggled to adapt to the rising tide of non-communicable diseases like hypertension. Routine blood pressure checks, which should be a standard part of adult healthcare, are far from common in many primary health facilities.

A nationwide survey revealed that fewer than 30 percent of local health centers regularly measure adults’ blood pressure, and even when the necessary equipment is available, it is often outdated or poorly maintained. Many healthcare workers lack adequate training on how to screen for or manage hypertension effectively.

Financial barriers only worsen the problem. With most Nigerians paying out of pocket for healthcare, the costs of frequent clinic visits and lifelong medication quickly become burdensome. Even when affordable generic drugs exist, unstable supply chains and unpredictable price fluctuations discourage patients from maintaining treatment. As a result, many start and stop their medications or turn to unproven traditional remedies, undermining long-term control of their condition.

The Economic And Social Fallout

The human cost of uncontrolled hypertension is immense. Cardiovascular diseases, largely driven by untreated high blood pressure, are now among the leading causes of death in Nigeria. WHO data estimates that over 364,000 Nigerians die each year from cardiovascular-related illnesses, a figure that will likely continue climbing if bold action is not taken.

Beyond individual tragedies, the broader economic and social impact is staggering. When working-age adults suffer strokes or heart attacks, families often lose their main source of income. Children may be forced to drop out of school to help at home, and entire households can slip into poverty under the weight of hospital bills and lost earnings. A 2022 report by the Nigerian Heart Foundation estimated that hypertension-related illnesses cost the country more than ₦500bn annually, factoring in direct healthcare expenses as well as lost productivity and wages. This quiet drain on the economy weakens communities and undercuts national development.

Slow progress and what still needs to change

Nigeria is not standing idle. The Federal Government’s National Multi-sectoral Action Plan on Non-Communicable Diseases (2019–2025) has identified hypertension control as a national priority, aiming to expand screening efforts, improve access to affordable medication, and launch stronger public education campaigns. In Lagos, targeted initiatives like the Healthy Heart Lagos campaign bring free blood pressure screenings to busy markets and motor parks, meeting people where they are rather than waiting for them to visit clinics.

Non-governmental organizations are also stepping up. Programs run by groups such as the Hypertension Control Initiative in Nigeria (HCIN) are working with local clinics to train healthcare workers, improve screening rates, and ensure a more stable supply of affordable medications. Meanwhile, technology is beginning to play a role, with mobile health apps and SMS reminders helping patients track their blood pressure and stay on their medication regimens.

Still, these efforts are far from comprehensive. Many initiatives depend heavily on external donor funding, which means their long-term sustainability is uncertain. Experts emphasize that a robust, coordinated national strategy is needed to integrate hypertension prevention and management into routine healthcare across the country. This includes making blood pressure checks a standard part of every clinic visit, expanding culturally sensitive public health campaigns that address common misconceptions, and investing in infrastructure to keep essential drugs available and affordable.

Just as importantly, Nigeria needs better data systems to identify who is at risk, who is receiving treatment, and where the biggest gaps remain. Without accurate information, it is difficult to target resources effectively or measure the true impact of intervention programs.

Conclusion: Breaking The Silence

Hypertension may not trigger the same public alarm as outbreaks of malaria or Lassa fever, nor does it produce the immediate heartbreak that comes with maternal deaths. But its slow, relentless march through Nigerian society is every bit as devastating. It empties homes of parents, drains family savings, and quietly chips away at the country’s workforce and economic future.

The encouraging reality is that this is a crisis that can be prevented. With stronger political commitment, smarter and more inclusive public health campaigns, reliable treatment systems, and communities that truly understand what is at stake, Nigeria can turn the tide against this silent epidemic. Because ultimately, the fight against hypertension is about far more than preventing a single disease — it is about keeping families intact, sustaining livelihoods, and ensuring a healthier, more prosperous future for all Nigerians.

– Saidi Suara is a public health analyst, interventionist and a manager within the Institute of Church Office Management (ICOM).

OPINION: Tackling Hypertension In Nigeria’s Health System is first published on The Whistler Newspaper