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Hypertension still killing many Nigerians despite govt policy to reduce the number

WHEN Tanko Gwapna, a 46-year-old civil servant, felt continuous dizziness that affected his work, he had to listen to his wife’s advice to visit the hospital. He was earlier treated for Malaria, but the dizziness persisted. Eventually, he had his blood pressure measured and was diagnosed with hypertension.

That was in 2002. Tanko is still managing hypertension, 17 years later.

Hypertension, also known as high or raised blood pressure, affects millions of Nigerians.

Blood pressure is created by the force of blood pushing against the walls of blood vessels (arteries) as it is pumped by the heart.

The higher the pressure the harder the heart has to pump. Blood pressure reading comprises of two values: systolic and diastolic pressure. Any number above 140 over 90 is considered high.

This reporter met Tanko, now 63 years, on Thursday, May 16,  when he came for another routine checkup at the Wuse District Hospital, Abuja. His blood pressure was checked at the Medical Outpatient Department clinic, and measured 179 over 90, a figure that shows a high in the systolic pressure.

His treatment over the years has included a modified diet and a daily intake of anti-hypertension drugs.

“Whenever I get my salary, the first thing I do is to set aside the money for my drugs,” Tanko said to relate the importance of the medications to him. “Every month I set aside between N50 to N80 thousand”

“It is better living with a financial burden than not buying the drug and I die,” he said.

Though he is an National Health Insurance Scheme, NHIS, beneficiary, Tanko said he gets the medications paying out-of-pocket.

Tanko in white on a queue with other patients at the waiting area of MOPD clinic at Wuse District Hospital, Abuja. Credit: ICIR.

The disease, for Tanko, also came with complications. He had suffered a knee problem earlier between February and March. “You know when a man, as aged as I am, start crying out of pain, you should know that the thing must be very grievous,” Tanko narrated to The ICIR the pain he went through. Though after receiving a series of treatments, he said the condition disappeared.

Studies have shown that hypertension increases the possibility of knee arthritis, a condition that leaves the patients with a throbbing pain on the knees’ joints.

Tanko, who has been advised to be at the clinic on a regular basis, complained of the crowd in the clinic, causing patients to wait for too long.

“On some clinical days, I discover that this place is like a market. There are days I leave the clinic as late as 5:30 pm after arriving very early,” he said, stressing the shortage of doctors compared to the number of patients.

“Even that situation alone is enough to cause hypertension for me”.

The akara seller who suffers hypertension

Just like Tanko, Adamu Lami, a petty trader who sells bean cakes, commonly known as akara in Gwarinpa area of Abuja, also suffers from hypertension.

Lami was diagnosed as hypertensive in 2004 after a visit to the hospital due to a complaint of sleepless nights and persistent headaches.

Since then, Lami has been visiting the hospital on a monthly basis, but sometimes once in three months. As she does not have a personal blood pressure monitoring machine, she checks when she comes to the hospital after making the usual payment of N500 for registration.

At the hospital, she went straight for her blood pressure check. The figure was written in a paper for her, 163 over 103. It was high, the matron in the MOPD clinic told her.

“The madam (matron) advise me now to stop frying akara,” Lami said. “But wetin I go do,” the mother of six children said, agonising about how ending the business would result in financial difficulty.

Adamu Lami at the Medical Outpatient Department of the Wuse District Hospital, Abuja. Credit: ICIR
Adamu Lami, on Thursday, at the Medical Outpatient Department of the Wuse District Hospital, Abuja. Credit: ICIR

 

Efosa Obamwonyi, a Senior Registrar at the Obafemi Awolowo University Teaching Hospital (OAUTHC) told The ICIR that a very high BP, like Lami’s, was as a result of non-compliance with the drug prescription.

Hypertension is a disease that affects about 1.13 billion people worldwide, according to WHO statistics in 2018. Africa has the highest percentage of cases of hypertension.

According to the data, about 23.9 per cent of Nigeria’s population aged 18 years and above are hypertensive. That means that more than 38 million people have hypertension in country, a ratio of almost one in every four Nigerian.

Need to fight hypertension

Oladipupo Fasan, a consultant cardiologist at the National Hospital, Abuja told The ICIR that hypertension is a disease that one should not neglect.

Hypertension could lead to other diseases like stroke, heart failure, heart attack, eyes problem, knee arthritis and kidney failure, he said.

. “Anybody who is hypertensive can have these complications if not well managed.”

According to him, 80 per cent of Nigerians who develop hypertension may not know the specific cause. “Most of our patients fall into essential hypertension. We (doctors) cannot categorically classify what lead to their hypertension.”

He outlined the risk factors leading to hypertension as high salt consumption, obesity, excessive alcohol consumption, tobacco consumption, sedentary lifestyle with lack of exercise and a family history of hypertension.

For hypertension, there is no specific symptom, “that is why it is a silent killer”, Fasan said. He advised people should always measure their blood pressure regularly.

Hypertension on the rise despite government policy to reduce the number

There is a projection of 25 per cent relative reduction in hypertension prevalence by 2025, according to the targets contained in the national plan.

The national strategic plan of action on prevention and control of non-communicable diseases, including hypertension, was adopted in September 2015 to be achieved by 2025.

In the plan, hypertension was speculated as the commonest heart disease in Nigeria and the following targets were set to achieve a reduction in the modifiable factors that can lead to hypertension.

  • Tobacco: 30 per cent relative reduction in the prevalence of current tobacco use
  • Alcohol: 10 per cent relative reduction in overall alcohol consumption (including hazardous and harmful drinking).
  • Physical inactivity: 10 per cent relative reduction in the prevalence of insufficient physical activity.
  • Dietary salt intake: 30 per cent relative reduction in mean adult (aged ≥18) population intake of salt, with the aim of achieving the recommended level of less than five gram per day.

Four years after, however, there has not been any report on the progress made in realising the strategic plan.

In fact, the level of tobacco consumption has increased over the years not only among adults but in minors too. A report noted that one in four Nigerians aged below 18 has access to tobacco.

According to a research published on Pan African Journal, developing and implementing a strategic plan for physical activity are the best strategies that can help Nigeria move towards a more physically active population and society,

But Nigeria is yet to develop a national plan on physical activity, and this is part of the reason hypertension is on the rise in the country, Fasan said.

“Cases of hypertension is on the increase because we are yet to deal with all the modifiable factors in this country. There are no recreational centres in our communities, hence few Nigerians exercise regularly. And to take a walk sometimes, vehicular movements swarming around would even dissuade you to undertake such exercise,” he said.

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