The Burden Of Heart Diseases In Nigeria

The growing burden of cardiovascular diseases (CVDs) in Nigeria is becoming increasingly difficult to ignore, with hypertension, diabetes, unhealthy lifestyles and inadequate access to sustained medical care contributing to preventable deaths across the country.

The concern was brought into sharper focus during the commemoration of World Heart Day on September 29.

Organised annually by the World Heart Federation, this year’s theme, “Don’t Miss a Beat,” focuses attention on recognising the often hidden, overlooked or dismissed signs and symptoms of cardiovascular disease early enough to prevent serious complications.

In a statement to mark the occasion, the World Health Organisation (WHO) said about 22 million Nigerians aged 30 to 79 are living with hypertension, while only about 13 per cent have their blood pressure under control.

The number of Nigerians living with hypertension is projected to rise to 39.1 million by 2030, from 20.8 million in 2010.

Worryingly, hypertension is no longer a condition associated only with older people.

The prevalence among adults below the age of 30 has been put at 6.8 per cent, highlighting the need for greater awareness and early intervention among younger Nigerians.

Many people with high blood pressure remain unaware of their condition until it results in serious complications such as heart failure, kidney disease or stroke.

This is particularly troubling because hypertension is often preventable, detectable and manageable when people have access to regular screening, affordable medicines and appropriate follow-up care.

Cardiovascular diseases, including heart attacks and strokes, have emerged as a major public health challenge in Nigeria.

Experts identify raised blood pressure, elevated blood sugar, unhealthy body weight, poor diet, physical inactivity and other lifestyle factors among the major risks.

The WHO has emphasised that several of these risk factors can be measured and managed effectively through basic primary healthcare services.

Yet, limited access to screening, trained healthcare workers, essential medicines and specialised services continues to contribute to avoidable deaths.

The shortage of specialists is another major concern. Nigeria reportedly has only about 400 cardiologists serving a population estimated at more than 220 million people.

This reflects the wider gap in specialised healthcare capacity and infrastructure required to prevent and manage cardiovascular and kidney diseases.

While there has been greater awareness of physical exercise and healthy living in recent years, much more needs to be done to tackle sedentary lifestyles and other behaviours that increase the risk of non-communicable diseases.

This newspaper therefore supports the call by the Nigerian Cardiac Society (NCS) for federal and state governments to intensify efforts in cardiovascular health promotion, disease prevention and treatment.

According to the NCS, a nationwide survey put adult hypertension prevalence at 38.1 per cent, with only 12.4 per cent of those affected having their blood pressure controlled.

These figures are a stark reminder that diagnosis alone is not enough. Patients must be able to commence and sustain treatment.

Unfortunately, many Nigerians pay out of pocket for blood pressure checks, consultations and medicines.

When funds become scarce, treatment is often interrupted, increasing the risk of complications. Nigeria’s relatively low health insurance coverage, particularly among people in the informal sector, further compounds the problem.

Even among those enrolled in health insurance schemes, awareness of the hypertension services covered by their packages remains inadequate.

There is, however, evidence that better control is achievable.

The Hypertension Treatment in Nigeria programme, which applied the WHO HEARTS package across 60 primary healthcare facilities, demonstrates the potential of strengthening hypertension management at the primary healthcare level.

This newspaper believes that knowing one’s numbers is an important first step, but it cannot be the destination. A blood pressure check today means little if the patient cannot afford the medicines needed to control it tomorrow.

The Legislative Initiative for Sustainable Development (LISDEL) has rightly identified hypertension as not only a health issue but also a health-financing issue.

Consequently, policy priorities must translate into concrete and adequately funded programmes.

We urge the Federal Ministry of Health and Social Welfare to make hypertension screening, diagnosis, treatment and follow-up routine components of primary healthcare.

This requires functional blood pressure equipment, properly trained health workers and uninterrupted supplies of essential medicines.

The National Non-Communicable Diseases Strategic Plan and Multisectoral Action Plan must similarly be translated into funded annual operational programmes.

The National Health Insurance Authority (NHIA) and state health insurance agencies should ensure that hypertension consultations, essential diagnostics and medicines are adequately covered in benefit packages, while expanding enrolment among informal-sector workers and vulnerable populations.

Nigerians, on their part, must take personal responsibility by checking their blood pressure, blood sugar and cholesterol regularly. Healthy eating, reduced consumption of salt, sugar and saturated fats, increased intake of fruits and vegetables, regular physical activity, maintaining a healthy weight and avoiding tobacco and excessive alcohol are important preventive measures.

The rising burden of cardiovascular disease should not be allowed to become another silent crisis.

Nigeria has the knowledge and basic tools to detect and control many of its risk factors. What is required is sustained political commitment, adequate financing, stronger primary healthcare and a culture of prevention.

The heart may not always give a warning before serious damage occurs. Nigeria must therefore act before the next beat is missed.