Cost of living crisis worsening hypertension cases in Nigeria

Hyacinth Omenihu, 68-year-old father of three said the last couple of months have been very difficult for him and his family as they struggled to meet even the most basic needs amid prevailing economic hardship.

Omenihu, who is a retired civil servant, lamented that his pension can no longer take his family for a month, especially due to the persistent rise in the cost of goods and other essential services.

“It has been very difficult. I have not even finished paying my daughters’ school fees and my son is not feeling very fine. We barely feed a day, and things are very expensive in the market now. N10,000 cannot even do anything for anybody now,” he cried.

“I was so overwhelmed by the thoughts of how to take my family off this hardship that I almost had a heart attack the other day; I am down with hypertension as a result of worries. I will now have to take a loan because even my wife’s provision store is running on serious losses,” he said in a telephone interview with BusinessDay.

Like Omenihu, several other Nigerians have suffered high blood pressure triggered by stress or anxiety as a result of socio-economic conditions. BusinesDay findings show that hypertension cases have risen in the country.

It is common nowadays to see people on the road partially paralysed.

According to the World Health Organisation (WHO), hypertension, also known as high blood pressure, is a serious medical condition that significantly increases the risks of heart, brain, kidney and other diseases. It is a leading cause of death and mortality in Nigeria and across the world.

The WHO lists the risk factors of hypertension to include unhealthy diets such as excessive salt consumption, a diet high in saturated fat and trans fats, low intake of fruits and vegetables; physical inactivity, consumption of tobacco and alcohol, and being overweight or obese.

Other risk factors include a family history of hypertension, age over 65 years and co-existing diseases such as diabetes or kidney disease.

Health experts have also revealed that anxiety, thinking which is often fuelled by poor socio-economic conditions such as poverty, insecurity can result in high blood pressure.

Innocent Ujah, president of the Nigerian Medical Association (NMA) in his remarks to mark the 2022 World Hypertension Day, said poverty and anxiety fuel hypertension.

Adaobi Onyechi, a public health expert, told BusinessDay in an interview that thinking and anxiety are causal effects for blood pressure to rise temporarily and could result in complications if not properly managed.

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“A person’s life style particularly diet choices and age are major factors that fuel hypertension, but we cannot ignore the social and economic problems we have been grappling with over the years. Living has become a struggle. The most common commodity such as bread is even out of reach for the common man. Nigerians today leave in fear due to the prevailing insecurity.

When you embark on a journey, you are literally anxious throughout the journey. This can trigger a high blood pressure,” she said.

Nigeria’s socio-economic situation has plunged many Nigerians into poverty as prices of basic commodities continue to surge. The World Bank projects that as double-digit inflation persists, up to six million Nigerians will fall into poverty.

BusinessDay reports that Nigeria’s headline inflation maintained its upward trend as it rose 20.52 percent in August 2022 on a year on year basis. This is higher than 19.64 percent it reached in July. It is also the highest in 17 years.

The cost of basic commodities and services such as power, bread, and transportation has more than doubled. But, Kunle Elebute, Senior Partner and Chief Economist at KPMG Nigeria and Chairman KPMG Africa, recently disclosed that poverty and unemployment would worsen if Nigeria does not grow its economy by at least 7percent in the next five years; explaining that the current population growth rate is 2.61 percent and the economy needs to dwarf it to avoid dire consequences.

Currently, Nigeria is seeing rising cases of hypertension. A 2021-WHO data suggests that while hypertension has decreased in wealthy countries, it has increased in many low- or middle-income countries, including Nigeria.

Other studies suggest that hypertension is a leading risk factor for cardiovascular disease (CVD) in low- and middle-income countries, including Nigeria, which appears to be worst hit, with relatively higher number of cases and limited awareness, treatment, and control rates.

In the same vein, the Nigerian Medical Association (NMA) and Nigerian Heart Foundation (NHF) have warned that the prevalence of hypertension in the country is on the rise, and is being fuelled by the prevailing insecurity and poor socioeconomic condition.

A study report from the University of Edinburgh’s Usher Institute shows that nearly a third of Nigerians experience high blood pressure, and has grown by 540 percent since 1995. The study estimates that there were more than 28 million cases of hypertension in Nigeria in 2020, rising from four million in 1995.

In 2021, NHF puts the prevalence at 38.1 percent, with 76 .2 million Nigerians hypertensive; but recent data from the agency shows that the prevalence is now at about 40percent which is an estimated 80 million hypertensive Nigerians.

A global analysis of trends in hypertension prevalence, detection, treatment and control, led by Imperial College London and WHO, and published in The Lancet journal, revealed that the number of adults aged 30 to 79 years with hypertension increased from 650 million to 1.28billion in the last 30 years; and early half of these people did not know they had hypertension.

Unfortunately, despite being described as a silent killer by WHO, millions of sufferers are not even aware they have the condition, and those who do often have limited access to care. Apart from other severe complications such as heart failure, kidney damage, stroke, hypertension ultimately leads to death.

According to the latest WHO data published in 2020 hypertension Deaths in Nigeria reached 10,692 or 0.72percent of total deaths. The rate is 16.07 per 100,000 of population.

More so, a research team, led by the University of Edinburgh in partnership with the Federal Ministry of Health, the World Health Organisation, and researchers in Nigeria, say that hypertension poses significant public health and economic threat in African countries, comparable to malaria and other infectious diseases.

The WHO, while describing it as a silent killer, said An estimated 46percent of adults with hypertension are unaware that they have the condition. In Nigeria, experts revealed that only about 23 million of the 80 million afflicted are on treatment.

WHO says people with hypertension are unaware of the problem because it may have no warning signs or symptoms. When symptoms do occur, they can include early morning headaches, nosebleeds, irregular heart rhythms, vision changes, and buzzing in the ears. Severe hypertension can cause fatigue, nausea, vomiting, confusion, anxiety, chest pain, and muscle tremors.

Cynthia Preston, who runs a private health centre in Abuja said more than 50 percent of her patients are often not aware that they have a high blood pressure. “I always carry out a blood pressure check for all my patients and even visitors. Most of them don’t when know they have a high blood pressure, I even end up putting some on medication,” she said.

“So, this is a very serious situation that Nigerians and government must take seriously. We must imbibe the culture if checking out blood pressure regularly, it doesn’t cost anything, and the benefits far outweighs whatever it will take you to get your blood pressure checked,” Preston said.

WHO recommends reducing salt intake (to less than 5g daily), reducing and managing stress, being physically active on a regular basis, avoiding use of tobacco, Reducing alcohol consumption, among others.