Hypertension, often dubbed the "silent killer," is quietly but profoundly impacting the lives of millions of Nigerians, contributing to a worrying rise in sudden deaths across the country.

With more than 41 million Nigerians affected, the challenge of managing high blood pressure has worsened amid skyrocketing drug prices and deepening economic hardship. For many patients, the fear of dying in their sleep is a constant burden, driven not just by the condition itself but by the overwhelming cost of treatment.

Although hypertension affects roughly 38–40% of the adult population, only 60% know their status, 30% receive treatment, and just 10–15% have their blood pressure under control, according to recent studies.

Vanguard’s investigation reveals that hypertension is no longer a silent threat—it’s a loud, unrelenting emergency. Hospitals are overwhelmed, families are grieving, and patients are forced to choose between medication and daily sustenance.

Experts—including pharmacists, cardiologists, and physicians—warn that millions of Nigerians are unable to afford consistent care. As more patients skip treatment due to high costs, the number of sudden, often unexplained deaths is expected to rise.

Voices From the Frontline

David Ogbo, 46, was diagnosed during a routine check-up. Since then, he has spent around ₦15,000 monthly on medication—a heavy strain on his finances. “Some days I feel fine, but the fear never leaves,” he said.

For Nwankwo Chijioke, 54, the struggle is even tougher. He spends about ₦25,000 monthly. “I once skipped my medication for two weeks because I couldn’t afford it. I ended up in the hospital,” he recounted.

Both men expressed concerns over the affordability of drugs and called on the government to provide subsidies, routine checks, and public awareness campaigns to address the crisis.

The Cost of Staying Alive

Pharm. Amakeze Azubike, CEO of Health Peak Pharmaceutical, explained that the price of hypertensive drugs has surged over the last three years. For example, Novasc, a premium brand, now sells for over ₦8,000 per pack—up from ₦2,000. Patients often need three packs monthly, totaling nearly ₦24,000–₦28,000.

Even generic brands, once seen as affordable alternatives, have become expensive. Amlodipine generics now cost between ₦1,000 and ₦1,500 monthly. Local manufacturers still depend on imported ingredients, making them vulnerable to exchange rate fluctuations and importation costs.

“Self-medication is rampant,” Azubike warned, “but hypertension treatment is not one-size-fits-all. A patient needs proper diagnosis and medical supervision.”

Despite government tariff waivers, he noted that drug prices have yet to reflect the benefits due to continued reliance on imports.

Skipping Medication, Risking Lives

Chinedu, a 52-year-old tailor, now buys his blood pressure medicine every two months instead of monthly. “I have to choose between feeding my family and buying drugs,” he said.

Pharm. Olumide Akintayo, former President of the Pharmaceutical Society of Nigeria (PSN), warned that untreated hypertension is leading to unprecedented rates of strokes, cardiac arrests, and heart failures. He added that even young people are dying suddenly due to unmonitored high blood pressure.

Akintayo advocated for increased access to affordable generics and stronger government policy to ensure medication availability and safety. He also urged President Bola Tinubu to restructure the health sector and include more input from pharmaceutical professionals.

The Statistics Speak

Prof. Akin Osibogun, Executive Director of NCD Alliance Nigeria, reported a sharp rise in hypertension cases—from under 10% in 1990 to nearly 40% today. He described the condition as a major cause of sudden death and organ failure, often going undetected until it’s too late.

According to him, controlling drug prices requires reducing import dependence and fixing exchange rate volatility. He welcomed recent pledges from lawmakers to address the issue but emphasized the need for proper execution.

The Price of Medicines

Branded hypertension drugs can cost up to ₦200,000 monthly, while generic therapy can start at ₦5,000. “It’s a matter of affordability,” Akintayo said.

He urged for a sustainable drug prescription policy backed by legislative support, while calling for the implementation of the National Drug Distribution Guidelines (NDDG) to regulate pricing and improve access.

Cardiologists Weigh In

Prof. Augustine Odili, President of the Nigerian Cardiac Society, confirmed that many sudden deaths are linked to heart issues rooted in untreated hypertension. He cited a recent study showing that 38% of adult Nigerians have high blood pressure, with the South East recording the highest prevalence.

He stressed the importance of regular check-ups, especially for adults over 40, and called for improved public awareness and lifestyle changes—such as better diet, exercise, and reduced alcohol consumption.

The Nigerian Cardiac Society has launched the “Know Your Numbers” initiative, encouraging free blood pressure checks in public spaces and offering CPR training to improve emergency response.

Ignorance and Stigma Still Loom

Pharm. Jonah Okotie criticized the fear surrounding life-long medication and emphasized that proper treatment saves lives. He advocated health insurance schemes as a sustainable solution to financial barriers.

“Healthcare must be accessible, not free,” he argued, urging Nigerians to support inclusive health insurance programs.

Manufacturing and Infrastructure Gaps

Patrick Ajah, MD of May & Baker PLC, linked the high drug costs to Nigeria’s dependence on imports, volatile forex rates, and operational hurdles like unreliable power supply and labor shortages.

“Pharmaceuticals require round-the-clock power for production. We now spend three times more on energy than we did two years ago,” he noted.

Ajah also lamented the brain drain affecting the pharmaceutical industry and emphasized the need for local production to cut costs and improve availability.

NAFDAC’s Push for Local Manufacturing

NAFDAC’s Deputy Director of Public Relations, Mrs. Christiana Obiazikwor, confirmed that the agency is actively working to reduce drug importation through initiatives like the 5+5 directive, which limits the registration of imported drugs to five years if they can be produced locally.

She also noted that Nigeria's WHO Maturity Level 3 status has boosted confidence in local drug regulation and enabled international collaboration. NAFDAC is now focusing on strengthening local manufacturers through inspections, technical assistance, and stakeholder engagement.

“Locally made drugs eliminate shipping and tariff costs, helping to bring down prices,” she said, affirming NAFDAC’s commitment to ensuring affordable medication for all Nigerians.

Federal Government Action Plan

Dr. Malau Toma of the Federal Ministry of Health and Social Welfare confirmed the ministry’s implementation of a national strategy to fight hypertension, including public awareness campaigns, primary health center upgrades, and expanded health insurance.

He highlighted the ongoing training of healthcare workers and plans to subsidize or provide free hypertensive drugs for vulnerable patients under the Basic Healthcare Provision Fund.

Toma concluded with a call for collective responsibility: “Hypertension is manageable with early detection, medical care, and healthy living. Nigerians must take their health seriously and use the available resources.”