Blood pressure monitor

There is no doubt hypertension afflicts several Nigerians, irrespective of age and economic status. Martins Ifijeh writes on the way forward in addressing what has been generally termed the ‘silent killer’

Mrs. Adewale found out the consequences of high blood pressure the hard way because it most often doesn’t ring a bell about its presence. She lost her husband, who, until his death was full of life. Her husband talked about how he was going to invite all his children home for the Christmas and New Year. She was happy the year end would bring everyone to the dining table.

But on the 13th of December last year, while they were getting set for Sunday service, life served her lemons. She lost the man she had spent 47 years with. He was hale and hearty at night, but was gone in the morning. No thanks to the silent killer, a creepy disease that does not tell its victim to get prepared. He died of high blood pressure, according to the doctor who tried in vain to bring him back to life.

“He slumped that morning while we were preparing for church service. I and our driver hurriedly took him to a private clinic around Ilupeju neighborhood. As the doctor was trying to run a diagnosis on him, he discovered his blood pressure was extremely high, which he said, obviously had been like that for sometime before the unfortunate incident.” adding that, “in less than an hour in the hospital, my husband died. Just like a dream, I lost the best part of me to the cold hands of death,” Mrs. Adewale explained tearfully.

Blood pressure readings contain a systolic value and a diastolic value, which physiologically averages 120 over 80 respectively. Anything above 140 for systole and 110 for diastole is referred to as high blood pressure, and is considered dangerous. Mr. Adewale’s blood pressure was 183/115mmHg. His luck couldn’t push him further, he was already a walking corpse, a parlance often used by doctors to describe someone with an extremely high blood pressure. He was 74 years old before he died.

The fact that Mr. Adewale looked healthy even up to the Sunday morning he died is not surprising. As it’s the usual characteristic of high blood pressure, commonly known as hypertension, it does not present symptoms, which makes it about the deadliest disease known to man, forcing health experts to advocate for consistent and continuos check of blood pressure, since it does not present symptoms that would aid its host to get treatment and regulate the blood pressure.

Prior to his death, Mr. Adewale was just one among the 30 million estimated Nigerians suffering from hypertension, and he fell among the over 70 per cent of sufferers in the country who are not aware they are hypertensive.

This perhaps explain why sudden deaths have been a common occurrence in the country since the last decade when non communicable diseases like high blood pressure have been gaining grounds due to fast changing lifestyle of the citizens.

Until recently, hypertension was mainly associated with more affluent regions of the world, but the condition is increasingly emerging in low and middle-income countries, especially in Africa where health resources are scarce and stretched by a high burden of infectious diseases such as HIV, malaria and tuberculosis, and where awareness and treatment levels on the scourge control are still very low.

Currently, the worldwide burden of hypertension is greatest in low and medium income countries where it affects about one in every five of the adult population and this is projected to increase if current indices are considered. By 2025, almost three out of every four people with hypertension will be living in LMICs, especially in Africa where this number has been projected to increase as globalisation and economic advancement usher in urbanisation, and LMIC’s crave to mimic advanced countries in everything they do.

Among African countries currently having a surge of high blood pressure prevalence rate, Nigeria is most hit by the scourge, as about 20 per cent of its population, or about 40 per cent of its adult population, are hypertensive, according to available statistics, which therefore suggests that the country is sitting on a keg of powder waiting to explode if nothing is done to quell the rising prevalence of the menace in the country.

It is in addressing this concern and preventing the millions of Nigerians like Mr. Adewale, from dying, that experts are raising alarm over the continuous high prevalence rate of the disease in the country. They are especially calling on Nigerians to be wary of lifestyle that predisposes one to hypertension, while also calling on them to cultivate the habit of continuously checking their blood pressure.

According to a public health physician and the Medical Director, Livingstone Medical Centre, Benin, Dr. Kenneth Efosa, the prevalence of hypertension in the country might be higher than the figures currently being used. He said the current figure was unreliable because most Nigerians who were hypertensive do not bother to go for check up to know their blood pressure status, and hence there was no room for documenting a lot of people who may be suffering from it.

“Every Nigerian above 18 years old should be encouraged to check their blood pressure at least once every six months because the disease may not give any sign. So if you know before hand that your blood pressure is unstable, it would be easier to tackle it,” the MD stressed.

He, however noted that high blood pressure was no longer a problem of adults alone, adding that, children have now been discovered to suffer from it. “So my advice on routine check is that every family should own a sphygmomanometer or a computerised blood pressure machine, so that at their convenience, they can check the blood pressure of every member of their family,” he added.

Also lending her voice to the cause, the Medical Advisor, Novartis Pharm Services, Dr. Chinwe Adebiyi, in an interview with THISDAY, said the only way out of the high incidence rate of the disease currently threatening adult Nigerians, was for everyone to tailor their lifestyle towards minimising risk factors for hypertension.

According to her, habits to be stopped includes, lack of exercise, not getting enough sleep, reduction of caffeine intake, reduction in salt intake, reduction in alcohol consumption, among others.

“Exercise for 30 to 60 minutes five days a week will usually lower a person’s blood pressure by 4 to 9 mmHg. It is important you check with your doctor before embarking on any physical activity programme. Exercise needs to be tailored to the needs and health of patients,” she explained.

She noted that reduction in alcohol intake was a double edged sword against the scourge. “Alcohol in very small amounts may lower blood pressure, but if it is taken too much, or even in regular moderate amount, it may increase blood pressure.”

Adebiyi believes if Nigerians cut short on fast foods, processed, as well as canned foods, and patronise vegetables and fruits, it would help a long way in reducing the prevalence rate of the scourge in the country.

She also advocated for weight loss as a way out. “If you are overweight, the nearer you get to your ideal weight, the more likely your blood pressure is going to fall,” adding, she said, “ even for those already on hypertension drugs, the treatment is more likely to be effective if the body weight is on a physiologic state,” she explained.

Adebiyi also stated that not getting enough sleep can also increase someone’s risk of developing high blood pressure, noting that, people with sleep duration above or below the recommended seven to eight hours a day might face an increased risk of hypertension.

A recent study conducted by the University of Edinburgh, United Kingdom, also revealed that apart from the changing lifestyle of Nigerians and their habits of poor medical check-ups, another factor hampering the campaign against the scourge was the lack of patient data, as this has affected specific interventions, which should be tailored into tackling the scourge.

The study believed the country’s stakeholders may not be aware of the great threat the scourge poses to the country because of lack of data to vividly describe the menace. The study showed that hypertension is the single most important cause of morbidity and mortality globally and this highlights the urgent need of action to address the problem.