Hypertension, often called the “silent killer,” is becoming an increasingly urgent public health issue in Nigeria and beyond. Through personal stories, global insights, and modern tools, we explore what it really means to live with high blood pressure—and how to prevent it.
“It felt like my heart was about to explode.”
When Kayode* slumped at a dinner party last December, no one imagined it was hypertension. He wasn’t overweight, didn’t smoke, and was often the one reminding people to “cut down on the salt.” But in the weeks that followed, after a brief hospitalisation and a series of tests, his doctor confirmed it: dangerously high blood pressure.
“People kept telling me, ‘You don’t look like someone who has BP,’” he recalls with a dry laugh. “But what does that even look like?”
What surprised Kayode even more was that he was not alone. Several of his friends—mostly in their early 30s—confessed to having been on medication for years. Most had never spoken about it publicly. Some had only found out during routine checkups, or worse, after a health scare. “It made me realise how many people are silently dealing with this,” he says. “It’s not just older people anymore.”
And he’s right. Hypertension is no longer an “old person’s disease.” According to the World Health Organisation (WHO), 1.28 billion adults aged 30–79 have hypertension, with two-thirds of them living in low- and middle-income countries. Alarmingly, 46% of people with hypertension don’t even know they have it, and only one in five have it under control.
In Nigeria, the situation is dire. Estimates from the Nigerian Heart Foundation (NHF) put the number of hypertensive adults at 76.2 million—a staggering figure that highlights the scale of the crisis.
Among those aged 30 to 50, the rate is rapidly climbing. This is largely driven by urban stress, sedentary lifestyles, poor diets, and untreated medical conditions.
Silent symptoms, loud consequences
One of the deadliest things about hypertension is that it often offers no warning. No pain, no clear symptoms. In many cases, the first sign is a stroke or heart attack. Hence, it is often referred to as a “silent killer.”
According to WHO, cardiovascular diseases are the leading cause of death globally. In 2019 alone, 17.9 million people died from these conditions, 85% of which were caused by heart attacks and strokes. And high blood pressure is a leading risk factor.
The contributing causes are many and often intertwined: excessive dietary salt and saturated fat intake, obesity, lack of physical activity, alcohol abuse, smoking and tobacco use, chronic stress, and a family history of hypertension.
As Dr Ahmad Ibrahim, a chemical engineering professor, put it: “It was in the early 1990s when it became clear that trans fat was the real culprit behind the rise in cardiovascular diseases around the world.” This led to global calls for the elimination of trans fats, with WHO setting a target for total removal by 2023.
Genetics plays a significant role, especially for Africans, who are statistically more predisposed to developing high blood pressure earlier and with more severe consequences.
“Hypertension is what I would like to call a silent destroyer of organs,” says Dr Olusina Ajidahun, an internal medicine doctor at Federal Medical Centre Abeokuta. “It can damage the brain, eyes, kidneys, and heart without any clear warning signs.”
Hypertension doesn’t operate in isolation. It increases the risk of heart disease, kidney failure, stroke, and even vision loss. In women, it also complicates pregnancies, potentially leading to preeclampsia—a condition that endangers both mother and baby—and maternal mortality. According to the National Library of Medicine, preeclampsia encompasses 2% to 8% of pregnancy-related complications, more than 50,000 maternal deaths, and over 500,000 fetal deaths worldwide.
The Nigerian Heart Foundation has noted the strong link between dietary habits and heart health, prompting a push to reduce salt and trans fat levels in food. NHF has also pushed for the recertification of cooking oils as heart-friendly and announced a zero-tolerance policy for trans fats in food products.
Why younger Nigerians are at risk
Today, hypertension is affecting a younger population at alarming rates. Factors like fast food culture, financial anxiety, constant stress, poor sleep hygiene, and long hours in traffic-heavy urban centres have created a perfect storm of cardiovascular risk.
In cities like Lagos, where daily life can feel like a high-stakes obstacle course, managing blood pressure becomes even more challenging. Here, it’s not uncommon to find people in their 20s and 30s presenting with symptoms linked to elevated blood pressure—migraines, chest pain, fatigue—only to discover their readings are dangerously high.
Cultural misconceptions often add another layer of risk.
“One common myth and misconception about high blood pressure is that some people believe it only affects those over forty, or that if it doesn’t run in their family, they don’t need to check,” says Oluwayemi Banjoko, Chief Nursing Officer at the University of Lagos Medical Centre. “But blood pressure does not have a specific age it affects.”
Pregnant women are another at-risk group often overlooked. Hypertensive disorders during pregnancy, especially preeclampsia, are the leading causes of maternal and neonatal mortality in Nigeria. Unfortunately, routine antenatal checks are still inaccessible for many.
Taking action against hypertension
Nigeria’s public health institutions are waking up to the crisis, albeit slowly. The Federal Ministry of Health, in partnership with WHO, recently launched the HEARTS technical package in several primary health centres to improve screening, treatment, and data reporting.
Organisations like the Nigerian Hypertension Society and Hypertension Africa continue to push public education through community screenings and digital campaigns, especially around World Hypertension Day on May 17.
Despite these efforts, challenges persist. “Many Nigerians live without knowing they have high blood pressure just because they never go for a check,” says Dr Donald Aniekwe, Medical Officer at the University of Nigeria Teaching Hospital (UNTH). “They believe that if you are fine, you don’t need to see a doctor.”
The cost of healthcare is also a concern. “There are people who have been managed by chemists for several years without proper monitoring. There are organs that need to be assessed to ensure the person doesn’t go into some sort of failure as a result of their high blood pressure,” Dr Aniekwe says.
To address this, NHF has been working with NAFDAC and other partners to enforce food labelling regulations that help consumers identify heart-friendly products. There is now a renewed push for national dietary guidelines that align with international standards, as experts agree that what we consume has a direct impact on our heart health.
Tools, tech, and taking control
Living with hypertension today doesn’t have to mean living daily in fear or isolation. With the right tools, education, and support, people can take charge of their blood pressure and improve their quality of life.
Dr Aniekwe recommends patients get a digital monitor and check their blood pressure twice a day: “I tell them to do it once in the morning before breakfast, and again in the evening. Sit down, be calm, rest for five minutes, and take the reading. Log the results into a book or app. That consistency helps us catch changes early.”
Dr Ajidahun adds, “Every Nigerian should own a blood pressure machine. It’s not an article of ostentation. With just ₦15,000, you can track your numbers regularly instead of waiting for symptoms.”
For prevention, nutrition apps like MyFitnessPal assist in tracking salt intake, while smartwatches and fitness bands like Fitbit and Apple Watch monitor sleep, heart rate, and activity levels. Guided meditation apps like Calm and Headspace support stress management, which plays a huge role in blood pressure regulation.
Banjoko adds, “Preparing your own meal gives you control of what you ingest. Use natural products like ginger, garlic, and onions instead of heavily seasoned or processed meals.”
The goal isn’t perfection, says Kayode, who now wears a smartwatch that reminds him to check his pulse every morning. “I still have amala once a week. I still stress about work. But now, I know where my pressure stands. That awareness alone has changed how I live.”
Ultimately, hypertension need not dictate the terms of your life. Controlling blood pressure starts with knowing your numbers. From there, take the steps—big or small—to protect your heart. With early detection, community support and the right mix of devices and disciplines, you can release the pressure slowly and safely, protecting your heart and your future.
*Name changed for privacy.
