Worried by the high prevalence of hypertension in the Nigerian society, attributed to unhealthy lifestyles and shortage of medicines to manage the condition, medical experts have called for the inclusion of hypertension management in the Basic Health Care Provision Fund (BHCPF). They also canvassed the adoption of routine screening for hypertension and identification of risk factors at the Primary Healthcare (PHC) level; as well as involvement of people living with cardiovascular diseases in decision-making process on access to hypertensive care, screening and treatment.
The practitioners who spoke at a roundtable meeting organised by the World Heart Federation (WHF) in collaboration with Nigerian Heart Foundation (NHF) harped on the importance of increased access to medications and medical devices at PHC and community levels for hypertensive patients, arguing that patients’ inability to access medicines, especially non-affordability of monitoring devices by retirees has led to the untimely deaths of many.
In easing the bottleneck around hypertensive medication accessibility to the vulnerable at the grassroots level, the stakeholders urged governments at all levels to increase funding for the prevention and management of high blood pressure, while stressing the need for food manufacturers and individuals to reduce salt consumption, which is an identified risk factor in the development of the condition.
Speaking at the meeting, World Heart Federation Hypertension Programme Manager, Elisa Codato, highlighted the importance of communicating with the people in their local dialects, as that will enhance the assimilation of the awareness campaign messages on lesser salt consumption and more physical exercise, which are proven means of preventing cardiovascular diseases. She further corroborated the call for medicines availability, as she tasked officials at the helms of affairs at the Federal Ministry of Health, to place this on priority list in order to improve the health of the nation.
“Focus on availability of medicines is my first suggestion to Nigerian policymakers, while they are also to ensure that medicines are available to people at affordable rates, which will not adversely affect their already stressed finances. Of course, inclusion of people living with non-communicable diseases and cardiovascular diseases into relevant policymaking committees is crucial, for accurate and timely decisions to be made in impacting their health positively.
“And then I think there's a lot of work to do on salt consumption. While there is a food policy in the country, it is need for concerted advocacy on lesser salt consumption and the need for people to embrace healthy eating habits, which should be the preference for the population compared to unhealthy food options that are available. I think this is common trend in most African countries, where healthy foods are more expensive than unhealthy ones. So I think the government should do a lot of work to resolve this challenge”, Codato said.
The World Heart Federation representative further raised the concern on the observed absence of nicotine replacement services in the country, adding that though there is no high prevalence of smoking in Nigeria, but since smoking is a major risk factor for developing high blood pressure, it is expected that nicotine replacement therapy are available in the country, to assist people smoking quit easily.
“So I think another recommendation for the government is to focus on how to strengthen availability of such services to help the population stop smoking. And once again, awareness campaigns can also support these policies”, she remarked.
In his contribution, Director, Hypertension, NHF, Prof. B.J.C. Onwubere, listed the various risk factors that predispose people to hypertension, as he suggested mitigating measures against them. He mentioned genetics, sedentary lifestyle, unhealthy eating habits, and obesity, as red flags to guard against.
While people with genetic risk factor have little or no control over the development of the condition according to him, he said it has been found that more males than females are hypertensive, but post-menopausal women are likely to be the in same group as men.
“Other risk factors are obesity due to inactivity; as a lot of people today just sit down to press their phones instead of taking a walk. Eating abnormal foods is another factor, as it has been discovered that when people consume a lot of cholesterol, it can block the blood vessels that supply the heart and the brain. Foods that make you gain much weight should also be avoided. It is advisable to eat more vegetables and fruits, but people with diabetics should regulate their fruits intake”, he advised.
Addressing the gathering on the resolution of the symposium, Executive Director, NHF, Dr Kingsley K. Akinroye, among other things mentioned the need for the provision of adequate and appropriate equipment, human and financial resources at the PHC centres; ensuring a two-way referral system between the PHC and secondary/tertiary healthcare facilities; as well as complete implementation of TSTS policy
Other recommendations presented at the various plenary sessions at the meeting according to him were: streamlining of guidelines for the management of hypertension; wide-spread advocacy for front of package labelling; standardised use of simple treatment protocols at the PHC and SHC levels; adoption of a simplified model of treatment for hypertension; training and re-training of healthcare workers at PHC level and increase access to medication and medical devices at PHC and community levels; strengthening of advocacy and support for hypertension at national, sub-national and community levels ; improved hypertension data documentation on the national database and domestication of WHO-hearts strategies
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