About four months ago, my friend travelled home for the semester break only to meet what was going to change her life forever. Her agile father, who had driven her to the bus stop where she picked a bus to Ibadan earlier this year, was not there to receive her, hug and drive her home – as was his tradition. My friend knew something was amiss, but she could never have envisaged that she would find her father in a wheelchair, with a slurred speech and his face fallen to a side, unable to move his arm anymore. “Stroke” was what the doctors called it, but to her, the word sounded like “shattered hope”.
When I think of this friend of mine and her beloved father, I am upset by the countless families in Nigeria who share this sad story with her. Hypertension is fast becoming the major non-communicable disease bedeviling older adults in the country. Also known as high blood pressure, it is a silent killer because it never announces its presence until it suddenly strikes. The implication of hypertension, of course, is not immediate death. Since it is a long-term condition, it deteriorates over the years into a stroke, chronic kidney disease, vision loss, coronary artery disease, or heart failure, among others. A former Nigeria’s Minister of Health, Professor Isaac Adewole, has remarked that hypertension is the leading cause of cardiovascular diseases in the country, stating that an average of 1 out of every 5 Nigerians is hypertensive and at risk of premature death [1] . This places hypertension as a very serious health problem in my community, and as such, it needs to be urgently addressed.
For a proper understanding of hypertension, one should know what blood pressure means in the first place. Blood pressure is the force exerted by the blood against the walls of blood vessels, and the magnitude of this force depends on the cardiac output and the resistance of the blood vessels [2] . Thus, a person is said to be hypertensive when their blood pressure is higher than 140/90mmHg. In other words, hypertension means the systolic reading (the pressure as the heart pumps blood around the body) is over 140 mmHg and/or the diastolic reading (as the heart relaxes and refills with blood) is over 90 mmHg. According to American Heart Association, normal blood pressure should be 120/80 mmHg or less [3] .
Generally, an increasing prevalence of hypertension is blamed on lifestyle and dietary factors. These include physical inactivity, poorly managed stress, alcohol use, tobacco use, and
consumption of products particularly high in sodium, usually from processed and fatty foods. For Nigerians, as noted by the former Health Minister, “there is widespread low consumption of proteins, fruits and vegetables, and increasing patronage of fast food outlets by the population. There is also large promotion of sweetened products such as carbonated drinks, pastries, candies, and other refined sugars, while excessive intake of salt is promoted by food additives like monosodium glutamate, common delicacies such as suya, kilisi, isi-ewu, ngwo-ngwo, among others”. These diets predispose Nigerians to obesity and high blood pressure.
However, it should be noted that blood pressure also increases steadily with age. Other risk factors include a family history of the disease and the presence of other conditions such as endocrine disorders, kidney disease, use of birth control pills, etc. When other conditions, as stated above, lead to high blood pressure, it is referred to as secondary hypertension [4] .
My friend had always known her father to be a healthy man, or so she had thought until he suddenly came down with the stroke. In the same manner, many adults in Nigeria are ticking bombs waiting to explode. They have alarming blood pressures, but they hardly ever know because it is not in the habit of Nigerians to go for regular medical checkups. But how does a seemingly ordinary figure like blood pressure give information about deadly conditions such as a lurking kidney problem, stroke, and heart failure?
It all begins with damage to the arteries. A healthy artery is flexible, strong, and elastic. It has a smooth inner lining, which enables blood to flow freely, supplying vital organs and tissues with nutrients and oxygen. When one has high blood pressure, blood pushes too hard against the artery walls, and the force of this blood can damage the delicate inner lining of the artery walls. If this inner lining is damaged, fat and calcium can build up in the artery wall, forming a plaque. This plaque makes the artery stiff (atherosclerosis), thereby reducing its elasticity. It might also narrow the artery. This narrowing would reduce the amount of blood that is flowing through the artery [5] . Over time, the constant high pressure of blood moving through a weakened artery can cause a section of its wall to enlarge and form a bulge (aneurysm). An aneurysm can potentially rupture and cause life-threatening internal bleeding [6] .
Thus, high blood pressure forces the heart to work harder than necessary to pump blood to the rest of the body. Over time, the strain on the heart can cause the heart muscle to weaken and work less efficiently. This is the basis of heart attack and abnormal heartbeats. As for stroke, it occurs when a part of the brain no longer gets the oxygen and blood it needs so that it begins to die. This may be due to the rupture of a blood vessel or its blockage. Also, when a blood vessel to the kidney is damaged, it causes a kidney problem which makes it difficult for the kidney to perform its function of filtering fluid and waste from the blood. One thing peculiar to the aforementioned is that hypertension has been implicated in the occurrence of all of them, which emphasizes why we cannot afford to be lax about high blood pressure.
There is an urgent need for mass awareness on the causes and dangers of hypertension. The government and health institutions need to orient the populace using all available media. Necessary facilities to carry out tests and manage health crises that may arise from high blood pressure should also be provided. Nigerians should learn to go for regular medical checkups because “a stitch in time save nine”. Sedentary lifestyles should be discouraged, and proper stress management should be encouraged. An adult should have exercises of 30 minutes or more at least twice a week, and intake of salt and additives, especially those that contain monosodium glutamate, should be reduced. As much as possible, people should consume more fruits, vegetables, and whole grains. Nigerians should learn to watch their weights and mean it when they say so. Excessive alcoholism and tobacco-use have never particularly been great friends of the human body, and one is better off without them.
My friend’s father may never regain full control of his muscles, but if the right steps are taken, we may yet be able to salvage the many Nigerians who are walking about with alarming blood pressure, oblivious to the time bomb they carry. Hence, all hands must be on deck!
Author: Omoya Yinka Simult (omoyasimult@gmail.com)
REFERENCES
[1]. “Nigeria to lose $8bn to cardiovascular diseases by 2026 – Minister”. Sola Ogundipe. Vanguard newspaper of December 1, 2016.
[2]. Essential Physiology by David O. Oyebola. Vol. 1, pp. 66.
[3]. “Blood Pressure: Highs, Lows and What’s Normal”. Bahar Gholipour. Live Science.
[4]. “Hypertension: Causes, Symptoms and Treatment”. Markus MacGill. Retrieved from http://www.medicalnewstoday.com/articles/150109.php on December 6, 2016.
[5]. “How Blood Pressure Damages Arteries”. Retrieved from http://www.webmd.com/hypertension-high-blood-pressure/how-high-blood-pressure-damages-arteries on December 4, 2016.
[6]. “High Blood Pressure Dangers: Hypertension’s Effects on Your Body”. Retrieved from http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20045868 on December 5, 2016.
