The grim reality in Nigeria is that many people are still slumping and dying without warning, their lives abruptly cut short by a silent killer they may not even know they have.

“Hypertension” is highlighted as the most common risk factor from sudden deaths, cardiologists attributes it to a combination of lifestyle factors, economic stress, and lack of regular medical check-ups.

Over a dozen Nigerians have recently surrendered to sudden deaths. Among them are prominent figures like Senator Patrick Ifeanyi Ubah; famous singer, Onyeka Onwenu; Resident Electoral Commissioner for Ogun State, Olaniyi Ijalaye, and former Deputy Speaker of the Anambra State House of Assembly, Harford Oseke. The list is long.

While death is an inevitable part of life, the sudden and medically- related nature of these deaths raises pressing questions about the prevalence of undiagnosed and poorly managed hypertension in the country.

“Hypertension has become an epidemic in our society,” said Adeola Ajibare, a cardiologist at Lagos State University Teaching Hospital and a senior lecturer at the University of Lagos College of Medicine.

“It’s critical that people regularly check their blood pressure, as many individuals remain unaware of their condition until it’s too late. Hypertension is often asymptomatic, and by the time symptoms like headaches, palpitations, or swollen legs appear, complications have already set in,” he warned.

According to data from the Nigerian Hypertension Society, hypertension affects approximately 38 to 42 percent of the adult population in Nigeria. This overwhelming rate is described as very high, signalling a widespread public health emergency.

The World Health Organization (WHO) defines hypertension as a condition where an individual’s blood pressure consistently measures 140/90 mmHg or higher. If left untreated, this condition can lead to severe complications, including heart failure, stroke, and, most critically, sudden cardiac death.

While slumping without warning and dying has become a silent epidemic in the country, with people falling under the weight of their troubles, the harsh economic reality of Nigeria is taking a toll on people’s mental and physical health as inflation has driven up the cost of living.

A 34-year-old man recently suffered a fatal stroke without any warning, leaving his family in shock. Another case involves a woman in her 40s and an elderly man in his 60s who experienced severe dizziness and rapid heartbeats upon standing, a sign of underlying cardiovascular issues possibly triggered by stress.

Even young people are not immune, as evidenced by the case of a 19-year-old student who, despite being in good health, was rushed to the ICU after an unexpected heart failure.

Similarly, a 48-year-old man, typically active and in good physical condition, experienced a sudden heart attack. While another family member was diagnosed with a painful heart-related swelling.

Medical experts have pointed out that many sudden cardiac deaths are associated with pre-existing heart conditions that may not have been diagnosed.

“Sudden cardiac deaths are unexpected and rapid occurrences, often happening within an hour of decompensation in individuals who are perceived as otherwise healthy,” explained Ajibare.

“Most of the time, when we hear about sudden cardiac deaths, it is something that is not expected, something that is sudden, and of course, it’s irreversible. Usually, these occur within one hour of decompensation,” he said.

Ajibare further explained that hypertension remains the most common risk factor for sudden cardiac deaths.

“Over half of these unexpected deaths are linked to high blood pressure, which often leads to organ damage, heart failure, strokes, and even cardiac arrest.”

The cardiologist noted that these sudden deaths typically occur in individuals who appear otherwise healthy.

“It’s something that is not expected, something that is sudden, rapid in onset, and irreversible. The person may seem healthy, but they suddenly decompensate and, despite efforts to save them, pass away within an hour,” Ajibare said.

“The current economic situation is exacerbating stress levels, which is a significant driver of high blood pressure.” Ajibare mentioned, as stress in any form—whether financial, marital, or emotional—can increase blood pressure.

“Any form of stress increases the catecholamines in the body, and this drives the blood pressure to go up. So, it is a response to stress,” he added.

The rising cost of antihypertensive medications has also put an immense financial strain on patients, many of whom are already struggling with the high cost of living.

“The cost of managing hypertension is becoming increasingly prohibitive,” noted Ojo Sikiru, a medical practitioner based in Lagos.

“Many patients are now forced to choose between purchasing their medication and meeting other basic needs like food and shelter.”

“Inflation has affected every aspect of healthcare delivery, from the cost of medical equipment to the price of drugs. Unfortunately, these costs are often passed on to the patients,” he said. This situation is particularly terrible for those living in rural areas, where access to affordable healthcare is already limited.

For many patients, the inability to afford their medication means that they are unable to maintain consistent treatment, which is crucial in managing hypertension. “Skipping doses or going without medication altogether can lead to uncontrolled blood pressure, increasing the risk of heart attacks, strokes, and other life-threatening complications,” Sikiru warned.

The high cost of antihypertensive drugs has also led to a rise in the use of alternative therapies, some of which are not medically approved. “We’ve seen an increase in patients turning to herbal remedies or other unregulated treatments because they simply cannot afford the prescribed medications,” Sikiru observed.

While some of these alternatives may offer temporary relief, they often lack the efficacy and safety of approved pharmaceutical drugs, putting patients at greater risk.

Meanwhile, recent studies reveal that hypertension is becoming increasingly common in younger populations, the role of lifestyle factors in the rising cases.

“People are getting older, living more stressful lifestyles, resorting to cigarette smoking, alcohol, and substance abuse. Obesity is also on the rise, and these are all risk factors for hypertension,” Ajibare said.

The cardiologist further emphasised the alarming prevalence of hypertension in Nigeria, with recent surveys indicating that around 40% of Nigerians are hypertensive, a significant increase from previous years which was primarily a concern for those over 40.

Ajibare stressed the importance of both medical check-ups and lifestyle changes to combat hypertension. “Exercise, reducing salt intake, and avoiding smoking and excessive alcohol consumption are crucial. Weight loss can also significantly lower blood pressure. For those diagnosed with hypertension, consistent medication use is essential to prevent complications.”

He also advised that adequate knowledge and practice of cardiopulmonary resuscitation by bystanders and eyewitnesses may help stem progression of sudden cardiac collapse (reversible) into sudden cardiac death (irreversible).

Patrick Ene, a medical expert, has urged Nigerians to take life easy, adding that worries and anxieties do no help matters.

“Many Nigerians are today worried about many things. The challenging economy is pushing many to the brink. Now that schools are preparing to resume, many parents are already bothered about school fees and other needs of their children. This is expected, but people must go soft on thinking and ruminating over the problems. Worry and anxiety will only aggravate the situation. We must devise some means to deal with what we cannot change,” Ene said.

He also warned about excessive stress, urging Nigerians to always know their limits in everything they do these days.

According to him, “Nigerians must be careful not to push themselves too hard. They must know their threshold. I watched the video of the performance by our late sister, Onyeka Onwelu, I cried. Here was a woman, bubbling with energy, the next few minutes thereafter, she became a corpse. I saw when she danced to the table of the dignitaries at the event, full of life and energy. Did she push herself beyond the limits? I cannot say. We must be careful how we push ourselves; we are living in a different era, quite different from 50 years back. The rate at which people are slumping and dying is alarming; it is a sign that something is wrong.” (BusinessDay)

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