Word Hypertension Day: Over 1 bn live with disease worldwide -Health minister

By AKOR SYLVESTER-Abuja

As Nigeria joined the rest of the world to celebrate the World Hypertension Day, the minister of health, Osagie Ehanire has said that over one billion people worldwide are living with hypertension.

The minister said the number represents more than 30% of the adult population, noting that only 52% are aware of their condition while about 35% are on treatment and less than 14% have their blood pressure controlled.

Ehanire who spoke at the press conference to mark the 2023 World Hypertension Day in Abuja yesterday, expressed concern that the burden of hypertension is disproportionately more in the low and middle-income countries in recent decades due to the increase in prevalence of risk factors such as tobacco use, physical inactivity, unhealthy diet and harmful alcohol consumption.

He said: “The significant burden is further accentuated by the high proportion of persons that are unaware of their condition, putting them at risk of avoidable medical complications and death.

“It is important to note that public awareness creation, education, routine screening at every opportunity, early detection and diagnosis, counselling, and prompt provision of standard treatment and care are essentials elements for hypertension prevention and control, otherwise hypertension can lead to fatal complications such as heart disease, heart failure, stroke, blindness, chronic kidney failure, dementia, etc.

“Several pockets of studies and surveys in Nigeria put the prevalence of hypertension in excess of 30%”, .

According to the 2019 WHO Non-Communicable Diseases Country Profiles, NCDs accounted for 29% of all deaths in Nigeria with cardiovascular disease, predominantly hypertension, responsible for 11% of all the NCD deaths, and premature mortality due to NCDs at 22%. Premature mortality due to NCDs is defined as the probability of dying between ages 30 and 70 years from any of the common NCDs”,.

Represented at the event by the Director of public health, Morenike Alex-Okoh, the minister said, in response to the high burden of hypertension in Nigeria, Government over the years, had instituted several strategic interventions at the Tertiary, Secondary and Primary Health Care levels with the target of screening at least 80% of the eligible population and placing 80% of people with hypertension on standard treatment and care; as well as ensuring that 80% of those on treatment have their blood pressure sustainably controlled so as to avert complication and contribute to achieving at least 25% relative reduction in unconditional probability of dying prematurely from cardiovascular diseases and other NCDs.

He said: “In addition to these, the healthy lifestyle interventions specified in the National NCDs Multi-Sectoral Action Plan importantly apply.

“Considering the duty and responsibility of PHCs in health promotion and prevention services, the FMOH in collaboration with NPHCDA, WHO Country Office, and Resolve To Save Lives (RTSL) launched the National Hypertension Control Initiative (NHCI) in August 2019 with the main objective being the strengthening of PHCs to provide hypertension services such as awareness creation, education, screening, early detection, quality treatment, care and support, including referral in line with standard national tools and guidelines to reduce morbidity and mortality due to hypertension in the country.

“In November 2020, under the NHCI initiative, services commenced in selected PHC facilities in both Kano and Ogun States. Currently a total of 104 PHCs in the two States have been activated and are providing hypertension control services. As at December 2022, over 1 million episodes of blood pressure (BP) checks had been conducted with over 43,000 hypertension new cases recorded; over 21,409 patients were placed on treatment for high BP; and over 1,000 patients referred. BP control rate which was less than 20% at the start of the Project has been improved to almost 30%.

“Beyond the 104 PHCs in Kano and Ogun States, additional 360 PHCs across 17 States plus FCT have been included to provide hypertension prevention, treatment and care services under the Healthy Heart Africa (HHA) Programme that was launched in August 2022, supported by AstraZeneca through Population Services International (PSI).

“The HHA supported States are Nasarawa, Kwara, Bauchi, Gombe, Adamawa, Jigawa, Kebbi, Sokoto, Ondo, Osun, Oyo, Anambra, Imo, Enugu, Akwa-libom, Delta, Rivers and the FCT. Through the HHA Programme, a total of 744,773 BP screenings have been conducted with 162,060 (22%) hypertension cases diagnosed as at April 18, 2023.

“To support the PHCs to function efficiently, the FMOH through the NCDs Division led Stakeholders to produce a National Task-Shifting and Task-Sharing Policy for the prevention and control! of NCDs at the PHC level. In addition, a National Guideline for the prevention and management of hypertension in Nigeria has been developed to guide provision of standardized care.

“The hypertension guideline has treatment protocols and algorithms for used at all levels of health care provision.

“I must mention and salute the health care providers at all our secondary and tertiary health facilities (public and private) who provide hypertension treatment services for majority of the populace and are also engaged in research studies*,.
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Continuing, the minister noted that in order to improve on hypertension prevalence data gap, the FMOH has concluded plans to conduct the National Steps Survey for NCDs (including hypertension).

According to him, upon completion of the survey, the ministry will have nationally representative data of the prevalence of hypertension and associated risk factors for proper planning and designing of interventions to curb the development of hypertension.

He reiterated that hypertension is preventable and can easily be detected and treated, stating that its control is paramount in reducing the burden of cardiovascular disease in the country.

For those on treatment, the minister advised them to avoid the temptation of stopping their medication and follow-up clinic visits without advice from their doctors or the health care worker attending to them.

He said the adoption of healthy lifestyle by individuals is an integral strategy that should be practiced by all.

The minister urged Nigerians to engage in physical activity for a minimum of 30 minutes daily, make use of the stairs instead of the elevator, try trekking instead of taking the bus for short distances.

According to him: “Physical activity relieves stress, keeps you fit, controls body weight, and lowers heart disease and stroke risk.

“Avoid tobacco use and exposure to second-hand smoke.

Avoid drinking alcohol, or if you must drink, make sure it is in moderation, and drink a lot of water.

“Eat a healthy diet containing a minimum of 5 servings of variety of fresh fruits and vegetables spread over each day. In addition, eat a variety of whole grains, lean meat, fish, peas, beans, and lentils.

“Avoid processed foods, limit salt intake to less than 5 grams (1 teaspoon) daily, reduce dietary cholesterol and avoid industrially produced trans-fats.

“Know your numbers by regularly checking your blood pressure, cholesterol, and glucose levels.

“Finally, with all that being said, it is important to remind us that winning the war against hypertension is a joint responsibility”, .

Also, the Edo State Governor, Mr. Godwin Obaseki, has urged residents in the state to take advantage of the state government’s healthcare initiatives such as the Edo Health Insurance Scheme, to manage the risks of hypertension.

The governor said this in commemoration of World Hypertension Stroke Day marked by the World Stroke Foundation.

He said, “In commemoration of World Hypertension Day, I encourage residents and stakeholders to take advantage of the Edo Health Insurance Scheme (Edo-HIS) which provides quality, affordable healthcare, and regular health checks to reduce the risk of the condition.”

According to him, “Ongoing reforms by the state government in the health sector are geared towards strengthening the delivery of quality and affordable healthcare for every resident. We have enhanced the capacity of personnel and are providing quality healthcare infrastructure to encourage more people to visit our health facilities and enroll for regular medical checkups.

“My administration will continue to strengthen primary healthcare to provide basic care that ensures access to quality healthcare in rural areas. As we make progress in ensuring we have 192 fully functional centers, we are working round the clock to provide the necessary infrastructure, technology, personnel, and resources to assure quality care,” he said.

On the theme of the 2023 World Hypertension Day, ‘Measure Your Blood Pressure Accurately, Control It, Live Longer,’ Obaseki urged stakeholders to support the government to strengthen advocacy campaigns on the importance of regular medical checkups to detect signs and early management of the disease.

He noted, “It is important for stakeholders to support governments across all levels to sustain enlightenment campaigns that encourage people to adopt healthy behaviours that limit the risk of hypertension by embracing healthy lifestyle choices, regular checks of blood pressure, eating healthy, and engaging in regular exercise.”

Obaseki tasked stakeholders in the private sector to take advantage of the state government policies and ensure their employees are enrolled in the state’s health insurance scheme to access qualitative and affordable healthcare packages.

According to the World Hypertension League, World Hypertension Day was created first in 2005 to communicate the importance of hypertension and its serious medical complications, and to provide information on prevention, detection, and treatment.