By Sola Ogundipe & CHIOMA OBINNA
NIGERIA is one of the many developing countries where health services are focused more on infectious diseases, such as malaria, HIV and polio. However, in recent years, Non-Communicable Diseases, NCDs, such as hypertension, cancer, diabetes and stroke are becoming an increasing problem.
Hypertension, in particular, as one of the most prevalent NCDs worldwide, is responsible for an estimated 45 percent of deaths due to heart disease and 51percent of deaths due to stroke.
The prevalence of hypertension varies around the world with the lowest prevalence in rural India (3.4 percent in men and 6.8 percent in women) and the highest prevalence in Poland (68.9 percent in men and 72.5 percent in women).
Global prevalence of hypertension has been increasing. In 2000, 972 million people were hypertensive with a prevalence rate of 26.4 per cent. These are projected to increase to 1.54 billion affected individuals and a prevalence rate of 29.2 per cent in 2025.
According to WHO, Africa has the highest prevalence of hypertension estimated at 46 percent of adults aged 25 and above.
In Nigeria, the picture is particularly worrisome. A recent community based study of rural and semi urban population in Enugu, Nigeria put the prevalence of hypertension in Nigeria at 32.8 per cent while a Meta analytical study published recently estimated the country wide prevalence to be between 12.4 percent and 34.8 percent. The disturbing reality of this statistics is that between a staggering 20,088,000 and 56,376,000 Nigerian citizens are hypertensive.
From this revelation of the unacceptably overwhelming prevalence of hypertension within the Nigerian populace, it is expected that there should be a prompt and effective response to the menace.
Unfortunately, in Nigeria, the problems caused by hypertension are worsened by the fact that most Nigerians are either not aware of the neccessity for regular blood pressure checks, or are unable to afford the checks.
As Nigeria joined the rest of the world to mark this year’s World Health Day, on 7 April, the need to promote more awareness of the causes and consequences of high blood pressure, as well as how it can be prevented, and to encourage national and local authorities to do more about this growing problem, became more prominent than ever. From hindsight, efforts at the three tiers of government have made little or no impact on the management of the condition which has been described the most common cardiovascular condition in the country.
Worse still, the problem of defining a strategy for its control and prevention confronts the society at present.
In 2012, Nigerians, infected and affected by hypertension, applauded when the National Biotechnology Agency Development Agency, NABDA, announced plans to set up a centre for the study of the genetic and environmental determinants of blood pressure and associated cardiovascular phenotypes specificially amongst Nigerians.
According to the then, NABDA Director General, this was part of efforts to fight and stem the tide of hypertension. Nigerians are anxiously waiting to benefit from the project.
Also, in preparation for the United Nations summit on Non- Communicable Diseases which held in New York, in September 2011, the Federal government had inaugurated a Technical Working Group to come up with patriotic, articulate and cost effective framework for the country.
Minister of Health, Professor Onyebuchi Chukwu who was also Chairman of the Committee, had listed hypertension as one of the NCDs to be tackled by the committe. Well, the high level UN summit has come and gone, and the committee is yet to make siginificant recommendations about tackling the menance of NCDs.
With the current situation, observers are questioning the true position of Nigeri’s policy on hypertension – whether diagnosis, treatment or prevention. It is no secret that many local hospitals even at the tertiary level are lacking in capacity to deal appropriately with diagnosis and treatment of hypertension.
Instances abound of suspected or confirmed hypertensive patients who are unable to access essential care and treatment. For instance, lack of functionally equipped ambulance services has in no small measure put millions of Nigerians in potential danger as emergency rescue and early resuscitation for patients with severe complications of hypertension is a Herculean task.
But for the efforts of some independent groups, individuals and corporate bodies, the response to the management of hypertension would have been even less acknowleged.
However, to tackle the challenges posed by hypertension and its complications, stakeholders are calling for improved awareness on the causes and consequences. National President, Pharmaceutical Society of Nigeria, Pharm. Olumide Akintayo said: “Greater awareness, healthy behaviours, improved detection, and enabling environments. He argued that the right systems and services should be in place to promote universal health coverage.
President, Nigeria Medical Association, NMA, Dr Osahon Enabulele, says government should, through policy formulation on NCDs and enhanced funding, raise the bar in preventive and promotive health care activities and critical care in various hospitals.
“There should be a deliberate effort at promoting healthy lifestyles in the populace. This should come in the form of modifying designs of residential estates to create walk ways, bicycle tracks and neighbourhood centres with recreation facilities. Government must do more to increase Universal Health Coverage for Nigerians.”
As hypertension management depends mainly on accurate measurement of blood pressure, efforts should be made to sanitise the medical/blood pressure equipment supplies and marketing sector.
Reports show there are more fake blood pressure meters in the market than the genuine. Readings from these malfunctioning equipment have misled not a few with dire consequences. Also, local drug and medical equipment manufacturing should be encouraged to help reduce cost of anti-hypertensive drugs.