Minister of Health, Professor Isaac Adewole
Unfortunately, over 80 per cent of Nigerians living with the condition are not aware that they have it (since many do not go for routine blood pressure test), he said. As a result, many of them end up in the hospital with complications such as stroke, kidney failure, paralysis, coronary heart disease, cardiac arrest and untimely death. He warned that except government comes out with policy to address this situation, the nation will continue to lose its manpower. Unlike the infectious diseases that are easily noticed, raised blood pressure could be hidden for ages, without any symptoms, striking when it is too late. A particular case is that of a nurse at Lagos University Teaching Hospital (LUTH) who never knew she had high blood pressure until her colleague playfully put the BP cuff on her. To their amazement, her blood pressure was 180/130mmHg. She was admitted immediately but unfortunately died six months later. The nurse had daily access to BP monitor, but never bothered to check her reading.
“Like the nurse, many people with hypertension do not even realise they have it because majority do not have symptoms and this is why it is necessary to go for regular check-up”, said Norvatis Medical Consultant, Dr. Chinwe Adebiyi. According to her, normal BP reading is below 120/80, it is considered high when it is 140/90 and above, while 120/80 and 139/89, is pre-hypertensive. She recommends that those prone to the disease should eat healthy diets with less salt, exercise regularly, quit smoking (if they do), reduce alcohol and caffeine intake, and maintain a healthy weight. But beyond a change in lifestyle, a cardiologist and president, Nigeria Heart Foundation, NHF, Kingsley Akinroye, said there was an urgent need for Nigerian government to tackle the rising incidents of high blood pressure and its subsequent complications. Just like the massive awareness campaign done on HIV, Lassa Fever and Ebola, more public sensitization on need for regular check-up should be carried out, as well as increased funding for treatment of non-communicable diseases, he said.
Once diagnosed with this condition, the individuals have to live with it for the rest of their lives, but the cost of daily treatment cannot be afforded by most average Nigerians since they pay out of pocket. For example, the cost of a 30-day high blood pressure medication (Norvatis goes for N1800 x 2 monthly (about $18) in a country where millions live for less than a dollar a day. As a result, about 70 per cent of people diagnosed with High BP, default in their medication, Dr. Akinroye divulged. Although hypertension treatment is covered in the national health insurance scheme, most Nigerians are not enrolled in the scheme, as revealed by National Health Insurance Scheme (NHIS) Assistant General Manager, Dr. Christopher Okoh. This is compounded by unavailability of hypertensive treatment at the Primary Health Centres (PHC’s). Research carried out by National Mirror shows that patients with high blood pressure are usually referred to the secondary health facility, hence nearness and access to treatment is a problem. A health worker at Lagos Mainland PHC, Akinterinwa Temitope, who confirmed this, explained that the PHC’s (with exception of Lagos flagship PHC’s) only treats childhood diseases, uncomplicated maternal issues and public health issues such as family planning, HIV.
Experts are certain that an improved PHC will bring treatment nearer to the populace, help in managing the high incident and reduce strain on teaching hospitals. Professor Ngozi Ajuluchuku, a professor of medicine and a Cardiologist at the Lagos University Teaching Hospital (LUTH) revealed that incidents of cardiovascular diseases are now more frequent at the hospital than infectious diseases, with cases of high BP recorded on daily basis. This agrees with a recent World Health Organization (WHO) report, that hypertension is responsible for an estimated 45% of deaths due to heart disease and 51% of deaths due to stroke globally. Due to increased hypertension, more Nigerians are also dying from stroke, a professor of Neurology from University of Ibadan, Prof. Adesola Ogunniyi, said.
According to him, about 91,800 new cases of stroke are expectedly diagnosed each year, with 64,076 (69.8%) dying from it. Comparing the stroke mortality rate of various countries from World Health Organization figure, Prof. Ogunniyi said that Nigeria has one of the highest occurring deaths from stroke. From the data, the Don noted that while stroke patients in other developed countries are able to manage their disease for a long time, stroke patients in Nigeria often die quickly, within the same year due to inability to cope with the economic cost of stroke management. According to him, the average cost of care for stroke within first 36 weeks in government and private Hospitals are N95,100 ($600 ) and N767,900 ($4860) respectively. “Managing stroke constitutes a huge direct cost burden unaffordable by an average Nigerian stroke sufferer”, he explained. The implication is that lack of means for rehabilitative care may result in disability adjusted life years which further compounds burdens in terms of indirect cost on the sufferers’ and care givers’ productivity.
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