By Abujah Racheal
In Nyanya, a densely populated satellite town in the Federal Capital Territory (FCT), 51-year-old Mr Matthew Iwu sits in his small carpentry workshop, quietly counting his remaining tablets.
“I have five pills left; that means five days of safety.
“After that, I must choose between my medicine and feeding my family.”
For him, hypertension is no longer a diagnosis; it is a calculation of survival, of hunger, and of time.
He said two years ago, he ignored his headaches and dizziness believing it was exhaustion from long days under the sun.
Like many Nigerians, he did not see danger in what did not immediately stop him from working.
According to him, during a routine community screening, a nurse wrapped a cuff around his arm and recorded a reading of 180/110 mmHg.
“She told me I was living with a silent killer,” he said.
Experts said that hypertension rarely announces itself. But when it does, it often arrives as a stroke, kidney failure, or sudden collapse.
Iwu said it came as a mild stroke after months of rationing medication he could no longer afford.
A 2026 systematic review and meta-analysis of 32 studies involving 49,788 adults, titled: “Prevalence of Hypertension among Adults in Nigeria: A Systematic Review and Meta-analysis” has delivered the clearest national picture yet.
It found that 34.2 per cent of Nigerian adults live with hypertension, approximately one in three.
The study confirms that hypertension in Nigeria is no longer confined to cities, wealth, or lifestyle categories. It is a national condition distributed across geography, gender, and class.
Key findings show that rural prevalence stands at 34.4 per cent while urban prevalence is 34.0 per cent.
The study also found no significant difference between men and women.
In addition, there was no statistically significant variation in hypertension rates across the geopolitical regions
Researchers concluded that Nigeria now faces a population-wide hypertension burden, not a segmented one.
According to the Federal Ministry of Health and Social Welfare (2025 State of Health of the Nation Report), no fewer than 40 per cent of adults in Nigeria are living with hypertension, with an estimated 80 million people potentially affected nationwide.
However, only 29 per cent of those affected are aware of their condition, while just 12 per cent are receiving treatment.
Furthermore, only 2.8 per cent have their blood pressure under control.
Hypertension remains one of Nigeria’s leading causes of stroke, heart failure, and kidney disease.
The ministry reports modest gains in awareness due to expanded screening and outreach programmes—but control rates remain critically low.
For Iwu, treatment costs have become unbearable.
According to him, his monthly medication costs N25, 000, a sum that competes directly with food, rent, and school fees.
“When money runs out, I skip doses; that decision nearly killed me.
“After my stroke, my workshop shut down temporarily; my income disappeared.
“My elder daughter, a university student, took part-time tailoring jobs to keep the household afloat,” he said.
Chioma, Iwu’s daughter, told NAN that every phone call made her panic.
“We are always waiting for bad news,” she said.
Health experts identify a convergence of factors driving the rise in hypertension in Nigeria, including rapid urbanisation and changing dietary patterns.
High consumption of processed foods rich in salt, along with physical inactivity, also plays a significant role.
Alcohol and tobacco use further increase the risk, while rising stress linked to economic hardship adds to the burden.
In addition, cultural beliefs that associate larger body size with prosperity and weak primary healthcare coverage continue to worsen prevention and early detection efforts.
Felicia Anuma, Professor of Medicine/Endocrinology and Diabetology) Director, Centre for Diabetes Studies, University of Abuja, said that more than a quarter of adults were already affected, driven by lifestyle transition and limited prevention.
Mr Francis Okonkwo of the Patients Advocacy Working Group said that hypertension care remained largely out-of-pocket, unlike HIV or tuberculosis treatment programmes.
“Many patients are forced to choose between buying drugs and meeting basic family needs,” Okonkwo said.
Studies show hypertension is responsible for up to 80 per cent of stroke cases in Nigerian hospitals, making it one of the country’s most lethal but preventable conditions.
Pilot programmes supported by the Federal Ministry of Health and development partners are introducing routine screening at the primary healthcare level, alongside essential drug supply systems.
They are also implementing protocol-based treatment through the HEARTS package to standardise care and improve outcomes.
The 2025 national report further notes that expanded screening efforts, particularly among men aged 15 years to 59 years, have led to modest improvements in detection rates.
But experts warn that detection without sustained treatment access is not control.
Globally, hypertension affects about 1.28 billion adults, with the majority of cases occurring in low- and middle-income countries.
However, Nigeria’s burden is particularly severe because control rates remain below three per cent, while awareness is still under 30 per cent. Treatment adherence is further undermined by the high cost of care and persistent gaps in drug supply.
A 2026 meta-analysis also highlights the wider economic implications, noting that strengthening hypertension control systems could yield up to an 18-fold return on investment through reduced healthcare costs and improved productivity.
At a policy dialogue organised by the Legislative Advocacy Initiative for Sustainable Development (LISDEL) in Abuja, experts called for urgent reforms.
They recommended the introduction of free or subsidised hypertension treatment to reduce financial barriers to care.
They also called for stronger financing of primary healthcare systems and the establishment of consistent drug availability mechanisms to ensure continuous access to essential medicines.
In addition, they urged nationwide prevention campaigns, the implementation of workplace wellness policies, and stronger multisectoral action targeting diet, alcohol consumption, and tobacco use.
The stakeholders warned that hypertension was driving a silent epidemic of stroke, heart failure, and kidney disease across Nigeria.
The National Association of Seadogs (NAS) called for coordinated national action across government, civil society, and communities.
Dr Odoemene Chiazor, Secretary, Health Committee, NAS, urged a shift from reactive care to prevention, warning that Nigeria was facing a growing non-communicable disease emergency.
Hypertension in Nigeria is no longer hidden; it is widespread, measurable, and growing.
“The science is now clear: about one in three adults is affected; but behind the numbers is a harder truth,’’ an analyst said.
Iwu now measures his life in pills–five tablets, five days–not enough to guarantee stability, but enough to remind him of what is at stake.
Experts warn that managing hypertension in Nigeria often costs more than ignoring it.
For millions of Nigerians like Iwu, staying alive depends on a healthcare system that still fails to recognise chronic diseases as a public emergency, treating them instead as a personal struggle.
News Agency of Nigeria.
