Hypertension surges among young Nigerians, defying age beliefs

As the nurse strapped the cuff around her arm, Faith Bako sat still, feeling the pressure build up slowly. After a few seconds, the blood pressure monitor blinked and showed 180 over 110.

At first, the numbers meant little to her; it was the nurse’s pause, not the beeping machine, that told her something was wrong.

After weeks of feeling light-headed, the 31-year-old had visited the hospital for a check-up. Living in Masaka, a town in Nasarawa State, Ms Bako spends nearly three hours daily commuting to and from her office in Abuja, Nigeria’s capital city, often on rickety public vehicles on bad roads.

She experienced headaches almost daily and blamed her persistent headaches on stress and exhaustion.
But as the nurse quietly called for the doctor, Ms Bako realised it might be more serious. A few minutes later, after another check, the doctor confirmed what she never expected to hear.

Her blood pressure was dangerously high- she had hypertension.

This happened a year ago, when Ms Bako was just 30. “I never thought I’d be diagnosed with hypertension at such a young age, but that’s the reality. I’ve been managing it since then,” she said.

Ms Bako’s experience is becoming increasingly common among young Nigerians, many of whom are being diagnosed with hypertension in their 20s and 30s, a condition once thought to affect only the elderly.

For 34-year-old Emeka, a photographer based in Abuja, the discovery came by accident. He had gone for a pre-employment medical test at his new company when the nurse paused during his check-up.

“She asked if I was under any stress,” he recalled with a laugh. “I told her, of course, everyone in this country is stressed. Then she said my blood pressure reading was too high.”

The nurse tried a second device to confirm, but the result was nearly identical. “That was when they advised me to see a doctor,” Mr Emeka said.

Medical experts say the shift in the age range of those affected by hypertension signals an alarming public health trend, one worsened by Nigeria’s changing lifestyles, economic stress, and limited awareness about preventive care.

Hypertension, a silent killer

Hypertension, commonly called high blood pressure, is one of the world’s leading causes of heart disease, stroke, and kidney failure. It is dubbed a “silent killer” because it often presents no symptoms until serious complications set in.

When symptoms do appear, they can include headaches, dizziness, shortness of breath, and chest pain, among others. These were similar symptoms Ms Bako experienced before she visited the hospital.

According to the World Health Organisation (WHO), hypertension occurs when the pressure in a person’s blood vessels remains consistently high, typically 140/90 mmHg or above.

Elizabeth Emmanuel, a consultant cardiologist at the National Hospital, Abuja, explained that an individual is considered hypertensive when sustained readings exceed 140/90 mmHg.

“The individual will be checked at least three times before a diagnosis can be made,” she said.

Mrs Emmanuel noted that there are two main types of hypertension: primary and secondary hypertension.

“Primary or essential hypertension tends to run in families. You can’t always pinpoint the exact genetic factor causing it, but it’s the most common type, affecting up to 90 per cent of patients,” she said.

“Secondary hypertension is less common and is usually due to an identifiable medical condition such as kidney disease or hormonal disorders.”

She explained that various studies have shown a steady rise in hypertension cases across both rural and urban areas, especially among young adults below 40.

Rising numbers, lifestyle risks

The global health body also estimates that two-thirds of hypertensive adults live in low- and middle-income countries, where preventive screening and treatment remain limited.

“Every hour, over 1000 lives are lost to strokes and heart attacks from high blood pressure, and most of these deaths are preventable,” said Tedros Ghebreyesus, WHO Director-General.

However, doctors report increasing cases of hypertension in younger adults, signalling a shift in the pattern.

Mr Isezuo, also the President of the Nigerian Hypertension Society (NHS), said hypertension is no longer a disease of the elderly or middle-aged.

“Before now, we said hypertension is mainly a disease of the middle-aged and the elderly, which is still the case because they have the highest burden. But, because of increased screening, we are beginning to see many more young persons with hypertension,” he said.

Mr Isezuo explained that risk factors associated with hypertension include a high-salt diet, obesity, sedentary lifestyle, excessive alcohol consumption, chronic stress, smoking, and genetic predisposition.

Diet, sodium, and stress

It also links high sodium intake to about 1.89 million deaths annually.

The Programme Lead for cardiovascular health at the Corporate Accountability and Public Participation Africa (CAPPA), Bukola Olukemi-Odele, noted that while sodium is essential in small amounts (200–500 milligrams per day), it is now being consumed in excessive quantities across Nigeria.

Mrs Olukemi-Odele said the average Nigerian consumes between 2.8 and 10 grams of salt per day, more than double the WHO’s recommended limit of five grams, which is just about one level teaspoon of salt.
In Nigeria, salt-rich foods — from suya to packaged noodles and processed snacks remain common, while low fruit and vegetable intake worsens the situation.

John Tehinse, a food scientist at the Nigeria Health and Environmental Development, highlighted the dangers of high salt intake, noting that it is driving an increase in diet-related NCDs, particularly hypertension.

Mr Tehinse said evidence from Nigeria shows more than 70 per cent of sodium intake comes from industrially processed, pre-packaged, and ready-to-eat foods such as bread, instant noodles, bouillon cubes, sauces, processed meats, and snacks.

Beyond diet, experts said stress also plays a critical role in early hypertension.

“Chronic stress triggers the release of hormones that raise blood pressure,” explains Mr Isezuo, the consultant cardiologist. “When you add poor sleep, irregular eating, and daily emotional strain, you create perfect conditions for hypertension.”

Ms Bako admitted she replaced dinner with coffee or sugary drinks on busy nights. “I was just trying to keep up,” she said.

Young, diagnosed and unprepared

This reporter witnessed another example of this growing trend a few months ago at the Kubwa General Hospital, Abuja. A woman in her late 20s had come in for a routine medical check-up, but was immediately placed on admission after her blood pressure reading shot above 200 mmHg.

The doctor on duty, who requested anonymity, described her condition as ‘dangerously high’, adding that she was fortunate to have been in a health facility at the time.

“Some people have died with even lower blood pressure,” he said.

The woman, later identified as Lilian, told this reporter she had been experiencing constant headaches for weeks but never imagined it could be linked to high blood pressure.

Her symptoms are also like those of Ms Bako, who said she often relied on paracetamol to ease the persistent headaches she experienced before her eventual diagnosis.

For 33-year-old Adekunle, an architect in the Ikeja area of Lagos State, the diagnosis came as a shock, given that he was feeling very well at the time.

“I felt fine,” he said. “I don’t smoke; I only drink occasionally. So, when the nurse said my reading was 170/100, that was confusing.”

He was advised to start medication and make lifestyle changes, but sticking to the routine has not been easy. “My friends joke that I’m too young for BP meds, so I skip my drugs sometimes,” he said with a shrug.

This attitude, experts say, reflects a broader lack of awareness about the seriousness of hypertension and the importance of consistent treatment.

“Many young patients stop their medication once they feel better,” said Mrs Emmanuel, the cardiologist.

“But hypertension doesn’t go away; it must be managed for life. Irregular treatment can lead to stroke or heart failure even in one’s 30s.”

For 24-year-old Hassana Isah from Tudun Wada in Kaduna South LGA of Kaduna State, being diagnosed with high blood pressure was the last thing she ever expected. “I was quite shocked when the doctor explained the situation to me two months ago. I don’t even know how it started,” she said.

Shafa’atu Muhammad, a Primary Health Care Provider at Amina Namadi Sambo Comprehensive PHC, Kinkinau in Kaduna State, said cases of HBP among young people are becoming increasingly common, even in pregnant women.

“We have also observed that HBP can start during childbirth. That’s why we counsel pregnant women during antenatal sessions on how to manage and reduce the risk,” She explained.

She added, “I recently treated an 18-year-old girl with very high blood pressure. If we had not taken quick action, we might have lost her.”

The cost of staying alive

Managing hypertension can be financially demanding, especially for young Nigerians already under economic pressure, Mr Isezuo, the cardiologist, said.

He said many hypertensive adults struggle to maintain consistent treatment because of the cost of medicines and transportation to hospitals for follow-ups, among others.

“This has always been a problem because of the level of poverty in the country. Now, aside from poverty, we are undergoing a difficult time with inflation, which has now affected the cost of drugs,” he said.

“One thing is that the cost increases as the complication increases, so it’s cheaper to manage hypertension without complications than hypertension with complications. So, know that the cost of treating hypertension, if there is no complication, will increase by twice if heart failure occurs, by three times if stroke occurs, by nine times if there is kidney disease, and by almost 30 times if the patient has to be on dialysis as a result of kidney disease.”

Speaking on the cost of medications, Mrs Emmanuel said the average price of hypertension drugs is between N3,500 and N4,500 per month, or more.

She said this depends on whether the patient is on one or multiple drugs, the brand, and whether they have insurance coverage.

She added that treatment involves periodic check-ups, laboratory tests, and transportation costs. “It’s not just the drugs; you have to do routine tests to monitor side effects and other health conditions.”

Mr Isezuo said the NHS is doing its best to draw the government’s attention to areas that need improvement to support persons living with hypertension in the country.

He said the NHS has encouraged the government to promote and provide a conducive environment for local manufacturing of medicines for hypertension, as most of the available medicines are imported.
“As the value of the dollar changes, the value of the medicines also changes,” he said.

Low awareness, low diagnosis

According to the 2023-24 Nigeria Demographic and Health Survey, only about half of women and one-third of men aged 15 to 49 have checked their blood pressure.

Among them, just eight per cent of women and five per cent of men report ever being told by a health worker that they have hypertension, figures that point to low levels of screening and awareness.

Similarly, while about 30 to 40 per cent of Nigerian adults have high blood pressure, fewer than one in five are aware of their condition.

Oladipupo Fasan, head of cardiology at the National Hospital, Abuja, said the statistics explain why many cases remain undiagnosed and untreated, leaving people vulnerable to heart attacks, stroke, and sudden death.\

Mr Fasan said hypertension is the leading risk factor for heart disease and stroke, and unfortunately, many Nigerians don’t even know they have it.

He further explained that undiagnosed hypertension persists because of some systemic and social barriers.

“Hypertension has a long latency period and no obvious symptoms, so people often do not take it seriously until complications set in,” Mr Fasan, also the secretary-general of the NHS, said.

According to the cardiologist, ignorance and misconceptions remain a significant challenge, with many “resorting to unverified remedies and herbal mixtures widely promoted on social media.

“Among those who know their status, up to half do not control their blood pressure because of poor medication adherence or misinformation,” he noted adding that health workers must actively counteract false narratives online.

According to Mr Isezuo, people under 35 should have their blood pressure checked at least three times a year.

“Once it’s elevated, lifestyle changes and early management can prevent severe complications later.”

He noted that another challenge is the stigma attached to illness among young people, noting that many view hypertension as a “sign of weakness” or an “old person’s disease.

He said this discourages disclosure, treatment adherence, and support-seeking behaviour.

Reversing the trend

Public health advocates say reversing this trend requires a combination of awareness campaigns, accessible screening, and supportive policies.

They suggest that both government and private organisations can integrate blood pressure checks into youth programmes, workplaces, and university health services, while community pharmacies can serve as screening points.

“We need to normalise BP checks like we do malaria tests,” Mr Isezuo said. “Screening should be as routine as checking your temperature. The earlier we catch it, the more lives we save.”

Experts agree that awareness, early detection, and minor lifestyle adjustments can make a lasting difference in reducing hypertension among young adults.

For Ms Bako, those changes have become a quiet act of self-preservation. She now checks her blood pressure regularly, keeps a monitor at home, and takes long walks, mostly on weekends and her days off.

“I still have bad days,” she admits, “but I’m learning to rest and eat better.”