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•My hubby slumped, died sending me into early widowhood, says widow
•Long-term anxiety, emotional stress increase risk for sudden death –Cardiologist
•‘Sexual intercourse lowers blood pressure, but not a treatment’
•‘Govt should improve economic conditions, increase access to affordable healthcare’
The growing incidence of high blood pressure in Nigeria currently is significantly linked to the country’s economic challenges. These challenges include poverty, unemployment, food insecurity, and limited access to quality healthcare. They lead to increased stress levels and poor lifestyle choices that contribute to the development of hypertension, according to this report by Isioma Madike
Prologue
Nigeria, according to the Journal of Cardiology and Cardiovascular Medicine, Nigerian Journal of Medicine, has a high rate of hypertension compared to many other countries, with studies showing that a significant portion of the adult population suffers from it.
The Journal points to economic hardship, which it said, leads to increased stress levels due to factors like financial worries, job insecurity, and inadequate nutrition, which can significantly contribute to hypertension development.
Poor access to healthcare facilities, particularly in rural areas, it further said, hinders early detection and management of hypertension.
“Even when diagnosed, many people struggle to afford necessary medication for hypertension due to the cost of treatment.
“Uncontrolled hypertension can lead to serious complications like stroke, heart attack, and kidney failure,” it stated.
According to the World Health Organisation (WHO), hypertension is the commonest form of cardiovascular disorder, occurring in 86.4 per cent of patients with cardiovascular disorders and in 38 per cent of the adult population.
Nigeria is one of many developing countries where the health services have tremendously focused on treating infectious diseases, such as malaria and tuberculosis.
In recent years, however, noncommunicable conditions have become an increasing nightmare, according to health experts.
One of the most prevalent, doctors said, is hypertension, which they added has of recent become a global concern responsible for an estimated 45 per cent of deaths due to heart disease and 51 per cent of deaths due to stroke. Hypertension is called a “silent killer” because most people are unaware of the problem since it may have no warning signs or symptoms. For this reason, it is essential, doctors said, that blood pressure is measured regularly.
Silent killer
Last Sunday, a shocking video of a lifeless body, clad in traditional attire, was seen on the street of Lagos. The onlookers said his Identification card showed he was working with the anti-corruption agency, the Economic and Financial Crimes Commission (EFCC), before his demise.
The man, who was later identified only as Sylvanus, was said to have been transferred to Makurdi, the Benue State capital from Lagos, recently. He was also said to be on leave from work.
Sylvanus, according to sources, left his family for Surulere that fateful morning but never got to his destination.
The EFCC later confirmed Sylvanus’ sudden death through its spokesperson, Dele Oyewale, in a text message he released to the media when he simply said: “The death is being investigated.”
Although the circumstances surrounding Sylvanus’ death are still unclear, medics, who spoke with Saturday Telegraph said such deaths are common with people who are hypertensive.
“That is why it’s often referred to as a ‘silent killer’ because it usually does not give notice and there is hardly any symptom to suggest its onset,” said one doctor, who prefers not to be quoted.
However, Sylvanus’ case is not an isolated one. Gabriel Okuose returned from a business trip out of Lagos where he had spent two weeks to the warm embrace of his loving family. He swiftly settled down for a sumptuous meal from his wife, Joy, since he was famished.
Okuose lived with his young family in the Ikorodu area of Lagos State. He was not the type that eats on the way when travelling.
Just the first cut of the Eba, Okuose slowly lost balance and slumped. The joyous mood of his family quickly transmuted into confusion and then mourning.
He was just 39 years old at the time of his death.
“We were all confused because he didn’t show any sign of ill health when he returned. In fact, he was in his jolly mood hugging everyone and seemed to be happy to have met us all in good health.
“How could we have known that was the last for the family?
“He just slumped and died instantly, sending me into early widowhood, and making our two children fatherless.
“Till date we couldn’t find an explanation to that tragic end,” recalled Joy with tears rolling down her youthful cheeks.
Like Okuose, Olayemi returned from a journey, received a warm welcome from his immediate family and shortly after settled down to take his favourite food. Unfortunately, that was his last.
Immediately he started eating, Olayemi, who had struggled to obtain his PhD after 20 years of study, slowly went down.
His wife, not suspecting anything serious, kept asking him to stop the joke and finish his dish.
His children, a girl of about 20 years of age, who just graduated from the University of Lagos with first class honours and her younger brother in
JSS2, were also seated in their modest sitting room, watching what later became their nightmare.
After some tap at the back, his wife, sensing it was no joke, raised the alarm for help. But, it was late; the man was gone.
A postmortem carried out before his burial, however, revealed hypertension as the cause of the sudden death, which threw his Sango Ota neighbourhood into mourning.
“We never had any inkling about that,” the wife said, adding, “He was healthy when he left home three weeks before the sad incident. He didn’t have any history of high blood pressure. But, the medics said he may have harboured it untreated without knowing.”
Adiniyi Wahab was in a church service somewhere in Egbeda, Lagos, when he suddenly slumped and died.
Though he was rushed to a nearby private hospital that was needless, as the doctor on duty simply pronounced him “dead on arrival”.
Pathetic as the above incidents are, Adegoke’s, was heart rending.
He was having a discussion with some of his close friends at the popular Tarmac in the Ogba area of Lagos State, when, after a while, he started behaving funny.
While he was still speaking, he suddenly held his forehead, indication of a headache. As his friends were still trying to figure out what could be wrong with him, his speech became faint and he felt weak on one side of his body.
The 34-year-old Okada rider had no idea what was happening to him, but feared the worst.
His friends, sensing danger, hurriedly rushed him to a nearby clinic, where a nurse checked his blood pressure. The facial look of the nurse afterwards wasn’t encouraging though she did not immediately reveal her readings to any of the anxious friends.
She simply ushered him into the consulting room where a doctor was waiting to see him.
Unfortunately, he slumped on the seat while the physician was still trying to figure out the best way to handle his case.
Medics speak
A cardiologist at the Nigerian Institute of Medical Research (NIMR), has attributed the rising cases of diabetes and hypertension in the country to stress occasioned by economic hardship.
The physician, who craved anonymity, told this reporter that many patients encountered at NIMR were diagnosed with hypertension and diabetes.
The unfortunate aspect of it, he said, is that they are not even aware of having such problems.
She said: “Some of the patients diagnosed with diabetes and hypertension are not aware of these problems.
“People should always go for regular check-ups to know their health status.
“The increase in diabetes and hypertension could conveniently be linked to stress caused by economic hardship in the country at the moment.”
Another Consultant Cardiologist, Gerald Edeh, had earlier identified stress as a major cause of high blood pressure and sudden death among Nigerian adults also.
Edeh, who works with the Lagos University Teaching Hospital (LUTH), stated this in an interview with the News Agency of Nigeria (NAN).
He was quoted to have said that high blood pressure is a major risk factor for cardiovascular diseases, particularly stroke and heart attack, which, according to the report, are very common leading causes of death in the Nigerian society at present.
He had said: “Research suggests that long-term anxiety or emotional stress can increase the risk for sudden cardiac death.
“For a person living with chronic stress, the result can be chest pain, irregular heartbeats, shortness of breath, and an increased risk of heart attack and stroke.”
Edeh also noted that the hardship in the country was becoming unbearable, particularly among the masses, which predisposes them to high blood pressure as well as suicidal thoughts.He then urged the Federal Government to intensify efforts to stabilise the economy and provide the citizens with the basic necessities of life.
“This will go a long way to ease the burden on the citizens and equally reduce stress in the country. Obviously, there’s too much stress in the country, which is already taking a toll on the lives of the citizens.
“In view of the high cost of living, people toil day and night to make a living.
“They go to bed late, and as early as 3:00 a.m. to 4:00 a.m., they have jumped out of bed in order to meet up with the days’ activities.
“For residents in cities like Lagos, they leave home very early in order not to be trapped in traffic gridlock,” he said.
The cardiologist further explained that prolonged stress reduces the body’s immune system, saying that too much and accumulated stress affects both mental and physical health.He lamented that many people had suddenly slumped and died due to accumulated stress.
“My advice is that people should pay attention to their health; prioritise sleep and rest, because they are fundamental to good health.”
Dr Abayomi Waheed, Medical Director, Crest Hospital, Isuti, Igando, Lagos, explained that stress is a factor that triggers the blood pressures to go up.
Stress, he said, does not cause hypertension but for someone that is hypertensive, it is a factor that triggers the blood pressure to go beyond the border line.“For families that have hypertension in their bloodline, and may not have been taking care of it, facing the present economic hardship, not having enough sleep, always thinking about his/her problems is a stress that will trigger the blood pressure to go up,” he added.
While a family physician, Dr Rotimi Adesanya, in his contribution said that stress and not thinking causes high blood pressure.
He also said that sleep and rest lower primary hypertension and not all types of hypertension and advises patients to check their blood pressures at home thrice weekly and not thrice a day.
He also said that the newer anti-hypertensive drugs protect the heart and kidneys.
He added: “Sexual intercourse lowers blood pressure but it is not a treatment for high blood pressure while Omega H3, garlic, green tea and other supplements have been found to lower blood pressure but cannot replace treatment.
“For dietary approaches, patients should equally restrict salt intakes, take more vegetables, fruits, and nonfat dairy products, and restrict calories if overweight.”
Even so, Adesanya advocates for government policies to improve economic conditions, increase access to affordable healthcare, and promote health education programmes.
He would also want to see improvement in the availability of healthcare facilities, especially in rural areas, and ensuring adequate medication supplies.
Moreover, Adesanya backs community awareness about hypertension, healthy lifestyle practices, and early detection through outreach programmes.Another doctor, Oyewole Kushimo, has said that about one in three Nigerians is hypertensive.
In addition, the majority of those who are hypertensive, he added, are not even aware of their condition. He also said that among those, who are hypertensive and on treatment, most are not well controlled.
“If you have millions of Nigerians, who are not aware of their raised blood pressure or not well controlled with their medications, complications of hypertension, which include heart and kidney problems will definitely be high.
“Most cases of hypertension do not have a specific underlying cause (we call this type primary or essential hypertension) and also do not have a cure. It can be properly managed with medications and lifestyle changes.
However, once blood pressure is adequately controlled and detected early, complications can be prevented.
“We are gradually seeing higher cases of hypertension among young people. Reasons are not definitely clear but it could be related with lifestyle and dietary changes in our population as we increasingly adopt western cultural habits.
“Also people, who have a family history of hypertension, especially in both parents, are more likely to develop hypertension at a younger age,” He said.
Another consultant Epidemiologist and Public Health Physician from LUTH, Professor Adebayo Onajole, said that hypertension is another word for high blood pressure.
What it simply means to a layman, according to him, is that the pressure in the pipes, which is called arteries, is high.
“It’s like a pipe carrying water to your room; if the pressure is high, it can get busted or broken at any point. This is when you have hemorrhaged most, especially in the brain, and it can cause stroke.
“Sometimes, the impact of this pressure is that the health organs, which it spins through, will also keep on causing fragile damages, and that is why it tends to damage the organs like the kidney, the heart, and so many other organs, including the brain.
“The risk factors are multiple in nature. Some of it is due to lifestyle – how we live our lives; some are due to how we are able to cope with the pressure of the environment around us.
“For example, we are currently having a high number of cases of environmental pressure due to poverty, and that could give you a lot of stress as you worry about what you eat, how you eat and others.
“There are a lot of issues of insecurity in the country and this puts pressure on you. And your ability to cope with this pressure will determine whether your blood pressure is elevated or not.
“Basically, treatment for secondary hypertension is to correct the structural defects that have led to it while for primary hypertension is to change their life and also improve on our coping mechanisms. How do we cope with the stress that we face on a daily basis?” he asked.
Former President of the Guild of Medical Directors (GMD), Prof. Olufemi Babalola, also said that the greatest cause of heart and kidney disease is hypertension.
Blood pressure, according to him, is related to body temperature regulation and also correlated to latitude from the equator. The further from the Equator the less the frequency and severity of hypertension, he added.
He said: “Almost half of adults above 40 years are hypertensive in Africa. In Africa and in black America, hypertension is increasing because we have risk factors for hypertension such as excess salt in diet, lack of exercise, overweight/obesity and diabetes.”
Another Public Health physician, Dr Doyin Odubanjo, said the natural progression is that hypertension causes damage to the organs of the body like the heart and kidney.
To him, the best way to manage it is to ensure that the hypertension is first detected early and controlled well by regular drug intake and monitoring by a physician.
THIS STORY FIRST APPEARED IN NEW TELEGRAPH
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