Prevalence, Awareness, Treatment and Control of Hypertension in Nigeria: Data from a Nationwide Survey 2017

Abstract

Background: Previous studies that evaluated the prevalence, awareness and treatment of hypertension in Nigeria were either localized to some specific regions of the country or non-standardized thereby making evaluation of trend in hypertension care difficult.

Methods: We used the World Health Organization (WHO) STEPwise approach to chronic disease risk factor surveillance to evaluate in a nationally representative sample of 4192 adult Nigerians selected from a rural and an urban community in one state in each of the six geo-political zones of the country.

Results: The overall age-standardized prevalence of hypertension was 38.1% and this varied across the geo-political zones as follows: North-Central, 20.9%; North-East, 27.5%; North-West, 26.8%; South-East, 52.8%; South-South, 44.6%; and South-West, 42.1%. Prevalence rate did not differ significantly (p > 0.05) according to place of residence; 39.2% versus 37.5 %; urban vs rural. Prevalence of hypertension increased from 6.8% among subjects less than 30 years to 63.0% among those aged 70 years and above. Awareness was better (62.2% vs. 56.6%; P = 0.0272); treatment rate significantly higher (40.9 % vs. 30.8%; P < 0.0001) and control similar (14 vs. 10.8%) among urban compared to rural residents. Women were more aware of (63.3% vs. 52.8%; P < 0.0001); had similar (P > 0.05) treatment (36.7 vs. 34.3%) and control (33.9% vs. 35.5%) rates of hypertension compared to men.

Conclusion: Our results suggest a large burden of hypertension in Nigeria and a closing up of the rural-urban gap previously reported. This calls for a change in public health policies anchored on a primary health care system to address the emerging disease burden occasioned by hypertension.

Keywords: Africa; Awareness; Blood pressure; Control; Hypertension; Prevalence; Treatment.

Figure 1

Awareness (vertical lines), treatment (solid) and control (dots) of hypertension across the six geopolitical zones and the overall population. Awareness includes subjects previously diagnosed of hypertension. Treatment includes hypertensives patients on antihypertensive medication and control includes hypertensive patients receiving treatment whose systolic and diastolic BP are less than 140 and 90 mmHg respectively.

Figure 2

Hypertension Care Continuum Cascade. All hypertensive subjects whether diagnosed or undiagnosed is represented as 100%. Of these, 14.2% have never been screened for hypertension, 34.9% has been screened but not diagnosed, 36.2% have been diagnosed but not receiving treatment and 65.4% were treated but their blood pressure was still uncontrolled.