• 70% of Nigerian adults live with one form of heart disease, says Foundation
• Cardiac Society: Four in every ten adults hypertensive
• ‘Only 400 cardiologists serve more than 220m Nigerians’
• 17.9m people die of cardiovascular diseases globally each year
• Heart attacks, strokes account for 85% of deaths, says WHO
• NCS president calls for stronger infrastructure, affordable heart care
• Rising heart burden demands bold policy shift, says Akinroye
• Fasan: Robust primary care key to reversing cardiovascular crisis
Nigeria is facing a worsening cardiovascular crisis, with heart disease now a leading cause of death driven by hypertension, poor lifestyle choices, and weak healthcare systems.
As the country joins the global community to mark World Heart Day 2025, experts warn that without urgent policy action, investment in prevention, and stronger cardiac care, the country risks a major public health catastrophe.
They further cautioned that the situation is compounded by the high cost of treatment and a severe shortage of not only cardiologists but also the full range of medical specialists involved in the management, treatment, and control of cardiovascular diseases.
According to the Nigerian Cardiac Society (NCS), the country has only 400 cardiologists serving a population of more than 220 million people.
Cardiovascular disease (CVD) refers to a group of conditions that affect the heart or blood vessels (veins and arteries).
The World Health Organisation (WHO) describes CVD as the leading cause of death globally, accounting for an estimated 17.9 million deaths each year. Of these, 85 per cent result from heart attacks and strokes.
Tragically, more than three-quarters of all CVD deaths occur in low- and middle-income countries. WHO also noted that out of the 18 million premature deaths (under the age of 70) caused by non-communicable diseases in 2021, at least 38 per cent were due to cardiovascular diseases.
Similarly, the World Heart Federation (WHF) reports that heart disease and stroke are the leading causes of death worldwide, killing over 20.5 million people yearly. Developing countries account for about 80 per cent of these fatalities and up to 80 per cent of premature CVD deaths.
World Heart Day is observed yearly on September 29 to raise awareness about cardiovascular diseases and how they can be prevented and managed.
This year’s theme, “Don’t Miss a Beat,” serves as a global call to action, urging individuals to prioritise heart health and make daily lifestyle choices, such as staying active and managing stress, that protect the heart and reduce the risk of cardiovascular disease.
Heart: The body’s relentless pump
The heart is a muscular organ that pumps blood throughout the body via the circulatory system, which is composed of the heart, blood, and blood vessels. Although it is only the size of a fist, it is the hardest-working muscle in the body. The heart beats about 100,000 times a day and pumps up to 7,500 litres of blood daily. With every heartbeat, blood carries oxygen and nutrients to every part of the body.
Experts note that the burden of CVD in Nigeria is both high and rising, characterised by widespread hypertension as a major risk factor. Significant gaps in awareness and treatment contribute to increasing cases of stroke, ischaemic heart disease, heart failure, cardiomyopathies, and rheumatic heart disease.
They emphasised that most deaths caused by CVD are triggered by risk factors such as high blood pressure, high cholesterol, obesity, and diabetes, all of which can, to a large extent, be prevented or managed through healthy diets, regular physical activity, and avoiding tobacco use.
NCS president calls for stronger infrastructure, affordable heart care
In an interview with The Guardian, President of the Nigerian Cardiac Society (NCS), Prof Anthony Odili, said the burden of cardiovascular disease in the country is increasing at an alarming rate. He urged the government to support cardiac care by providing the necessary infrastructure in health facilities and including cardiovascular care in the national health insurance scheme to make expensive procedures more affordable for patients.
Odili stated that the cost of treatment for cardiovascular diseases is not just high but astronomical, and he appealed to well-meaning individuals to support efforts to reduce treatment costs.
He said, “The burden is high and is rising every day. Each time we look into the data and epidemiology, all we see is a rising trend and one keeps thinking that we will get to the plateau, but it appears we are not yet to the plateau point. In addition to the general increase in prevalence of hypertension and heart failure, we are also having a lot of sudden deaths in our country.”
“We are really worried about this trend and have been trying to call the attention of the government and all stakeholders. That is why this year’s conference theme of our society is mitigating the high burden of cardiovascular diseases with a lot of other sub-themes, including curbing the scourge of sudden death in Nigeria.”
Odili stated that hypertension is a significant driver of many cardiovascular diseases, adding that about four in every ten adult Nigerians are hypertensive.
He highlighted other risk factors such as reduced physical activity, diabetes, obesity, and increased levels of stress.
“Nowadays, children are made to wake up by 5:00 a.m. to get ready for school because the school bus will come by 6:00 a.m., and these are children who are still infants. They leave for school by 6:00 a.m. and then stay in school all day. When they come back, the time they are supposed to use to play, the children are still exposed to all manner of homework. So, there is a lot of physical inactivity. And when they are exposed to this stress for a very long time, a lot of hormones are released, including what we call cortisol and adrenaline. These things push up the blood pressure.”
“However, there are also some people who may not be hypertensive but have diabetes. Diabetes also is a risk factor for cardiovascular diseases.”
Odili lamented that despite the high prevalence of the diseases and the increasing number of health workers receiving training, Nigeria is witnessing a decline in the number of specialists, especially due to the ‘Japa’ syndrome.
“The fact is that more people are receiving training but for some, as soon as they receive training in any specialised area, the next second is that they leave the country. Even some young people, when they are sent abroad for training, with the intention that they finish their training and come back to Nigeria, what we are beginning to see is that some may do the training and stay back. So, it is really a very critical situation that we all have found ourselves in. We have only 400 cardiologists in the country.”
Odili implored all Nigerians to learn how to perform cardiopulmonary resuscitation (CPR) so they can assist people who suffer cardiac arrest, especially in situations where no medical personnel are available.
Rising heart burden demands bold policy shift, Akinroye warns
Also speaking with The Guardian, Executive Director of the Nigerian Heart Foundation, Dr Kingsley Akinroye, said the burden of heart disease is increasing in Nigeria, as it is in most developing countries, particularly in sub-Saharan Africa.
He noted that at least one in four adults in Nigeria aged 18 and above suffers from one form of heart disease or another, adding that the figure varies across different regions of the country.
Akinroye explained that about 20 million adults, representing roughly 70 million of Nigeria’s total population, live with one form of heart disease or another.
He said, “The number is increasing every day, especially we have younger people now collapsing in their offices, people below the age of 40, which we weren’t used to seeing before. People collapsing at their desks, people having heart attacks, and all these ones are increasing every day.”
He observed that the risk factors driving heart diseases include unhealthy diet, high salt intake, trans fat in the diet, low intake of fibre, physical inactivity, and air pollution, adding that tobacco smoking also aggravates the tendency to develop heart disease.
Akinroye noted that the number of professionals working in the field of cardiovascular diseases in Nigeria is insufficient.
He said, “They are not sufficient in any country. They are highly paid and most of them, when we train them in developing countries, are the ones that migrate to any country in the world. They migrate a lot because they are highly paid anywhere they are. We do not have enough hands to handle cardiovascular issues. Don’t forget that at the same time, they are very expensive to train. Yet when you train them, they migrate easily.”
Akinroye highlighted the need for the government to invest more to attract specialists back home.
“We have a lot of universities now, they have departments of cardiology, they have departments of preventive cardiology, surgery in so many private hospitals but we don’t have enough hands to manage these hospitals. We need to evolve our own out-of-box policy to attract them back home, give them incentives, build a village for specialists, equip those villages, give them special schools for their children, and then give them special remuneration.”
He emphasised the need to promote prevention and introduce cardiovascular health services in primary healthcare centres.
The cardiologist urged the government to also “let the heart live” by encouraging pharmaceutical companies, granting them around 60 per cent rebate to import heart-related drugs, and imposing higher taxes on sugar, salt, and tobacco products, with the revenue reinvested into cardiovascular care, prevention, and research in the country.
Akinroye stated that to mark the 2025 World Heart Day, the Nigerian Heart Foundation would promote community screening in pharmacies, schools, and communities, and also raise public awareness of the disease by decorating the Lagos Terminal Bridge and landmarks such as the 1004 building in red from September 29.
Fasan: Strengthen primary care to stem Nigeria’s heart crisis
For his part, Head of the Cardiology Unit at the National Hospital, Abuja, Dr Oladipupo Fasan, told The Guardian that cardiovascular diseases have become a menace and a major public health problem in Nigeria and across the world.
He stated that cardiovascular diseases alone account for 30 per cent of all deaths globally, adding that all available data show that the rate of increase is set to worsen in sub-Saharan Africa.
Fasan noted that about 29 per cent of all deaths in Nigeria are attributed to cardiovascular diseases, adding that every day, people present with strokes, hypertension, and heart failure.
He said, “In fact, in our clinics at the National Hospital, eight out of every 10 patients we see have hypertension. Every day, if we admit 10 patients, maybe four or five will be strokes, two or three will be heart failure, maybe another one or two will be kidney disease.”
Fasan stressed the need to strengthen the primary healthcare system and integrate the treatment of simple conditions, such as uncomplicated hypertension, diabetes, and other basic cardiovascular issues, into primary healthcare services. He called for the training of community health workers at the local level on how to recognise hypertension and diabetes, administer first-line medication, detect complications, and ensure proper referral.
He noted that it is more cost-effective to prevent cardiovascular diseases, stressing that even when full treatment modalities are available, a patient who suffers a stroke may survive but remain incapacitated, a situation that affects productivity and impacts the country’s economy.
Fasan appealed to the government to introduce preventive measures to reduce cardiovascular disease, such as tobacco control, promotion of healthy diets, alcohol regulation, increased physical activity, and reduction of air pollution.
On how to curb the rising cases of cardiovascular diseases in the country, Fasan advised Nigerians to eat a healthy diet, avoid excessive calorie intake, cut down on fatty foods, stop smoking, limit alcohol consumption, reduce salt intake, and exercise regularly.
“Nigerians should know that their heart is their life. There is no spare heart anywhere and they must protect it. We have to do everything to reduce the rate at which people are suddenly falling down and dying, and most of these deaths are due to preventable things.”
“People should eat right, be active, avoid tobacco, and stop excess alcohol. They should check their BP regularly, check their sugar regularly, check their cholesterol regularly, and at least do a medical check-up once a year. If there is something, then the doctor can give more frequent appointments and control. If they are placed on medication, they should take their medications and stop listening to all sorts of crap on social media, TikTok, this and that. If you don’t follow the right thing and you do something that has no scientific evidence, when the repercussions come, you have yourself to blame,” he added.
