By: Tochi Onyeubi
Hypertension, commonly known as high blood pressure, has emerged as a significant public health concern in Nigeria.
The World Health Organization (WHO) has identified Nigeria as one of the countries with the highest global prevalence of Hypertension.An estimated 44.9% of Nigerians between the ages of 18 and 69 are affected, with many either unaware of their condition or not receiving adequate management.
In light of this growing issue, *Trumpeta* Correspondent Tochi Onyeubi, interviewed Nigerian-born American Physician, Dr. Kelechukwu Kennedy Okere, Founder of the Horizon International Medical Mission (HIMM). As a seasoned medical professional and the Traditional Prime Minister of Owerri West LGA in Imo State, Dr. Okere shared valuable insights on Hypertension, dispelled common myths, and provided practical advice for managing the condition.
Good to meet you.
Thank you!
Nigeria has one of the highest hypertension prevalence rates in Africa. What do you attribute this alarming trend to?
We have the highest population in Africa. So, most studies will likely rate Nigeria at the top of the list. We are also highly competitive, and the constant struggle to acquire wealth, economic pursuit, and family burden of care. All this and other predisposing factors compound stress levels and cause blood pressure to rise.
What can you say are the primary risk factors contributing to Hypertension, and how can they be mitigated?
Risk factors contributing to Hypertension include; Genetics- Familial or primary hypertension is mainly a genetic predisposition, meaning that it could be hereditary or run in the family. This type of Hypertension you cannot change it. Obesity is another factor that is more common in the Western world, but we are also noticing an increase in the Nigerian population.
How aware do you think the average Imo state person is, about Hypertension, its risks, and management strategies?
The average person in the Imo state is just like every other Nigerian. They are unaware of the disease and its health implications or complications, if it is not controlled. A lot of people walk around like a time bomb waiting to explode. They do not understand that Hypertension could cause stroke, heart attack, kidney failure, risk factors for other diseases and other health complications.
How will they know when they don’t understand the risk factors?
Management strategies include controlling diet, like eating a low-salt diet and exercising. Healthcare workers need to start education and awareness creation, especially in rural areas.
What are the noticeable symptoms of Hypertension?
Hypertension is known as the “silent killer” because 80 to 90% of cases present no symptoms. People often only realize they have high blood pressure after experiencing serious complications such as a stroke, heart attack, hypertensive retinopathy (damage to the eyes), or even death. Occasionally, symptoms like headaches are misattributed to conditions like malaria, or individuals may experience tingling sensations on their face—both of which can be linked to hypertension. These subtle signs often go unnoticed, highlighting the importance of regular blood pressure checks to catch the condition early.
There’s a common myth that Hypertension is solely a “rich person’s disease.”
How do you address this misconception? Again, is there an age limit for developing Hypertension?
Our belief system plays a significant role in keeping us in the dark, particularly the misconception that Hypertension is a disease only for the rich. This is quite ironic because, in reality, hypertension is actually more common among people of lower economic status. Poverty and the stress and anxiety of not having basic necessities like food can significantly increase stress levels, which in turn raises the risk of developing hypertension. While it’s true that wealthy individuals can have hypertension, it’s a mistake to associate the condition solely with the rich.
Hypertension can affect people at any age. In fact, the American Academy of Pediatrics recommends starting blood pressure checks as early as age three. Additionally, as we age, our blood vessels become less flexible, making it more difficult for the body to regulate blood pressure, which increases the likelihood of developing hypertension.
Some people believe that traditional medicines can cure hypertension.
What’s your stance on this claim? How do you respond to claims that certain foods, like garlic or ginger, can single-handedly lower blood pressure?
This belief is quite common, and while I can’t definitively say yes or no, it’s important to recognize that many of the medications we use today were originally derived from herbs. However, we must exercise caution when using herbal remedies, as they often lack standardized dosages, and their sources are not always clear. It’s essential to rely on treatments that have been rigorously tested and proven effective in a laboratory setting.
Interestingly, my grandfather, Okere, was a renowned herbalist. Throughout his career, while he discovered herbs that treated various skin ailments, he never found a cure for hypertension.
There have also been claims about the effectiveness of garlic and ginger as standalone treatments for high blood pressure. In my experience, I don’t believe this to be true. I’ve treated patients in the USA, the Caribbean, and Nigeria who, despite using these natural remedies, still returned to me with uncontrolled hypertension. To date, garlic and ginger have not been scientifically proven to cure Hypertension.
What are the most effective management solutions for hypertensive patients, considering accessibility and affordability?
The management and control of hypertension largely depend on the type of hypertension a patient has—either primary or secondary. In cases of secondary hypertension, where high blood pressure is caused by an underlying condition, the treatment focuses on addressing the root cause. For example, patients with pheochromocytoma (a tumor of the adrenal gland that releases hormones, leading to vessel constriction and hypertension) will see their blood pressure normalize once the tumor is removed. Similarly, if hypertension is caused by renal artery hyperplasia (narrowing of the artery supplying the kidney), procedures to dilate the vessel can effectively control blood pressure.
In cases where sleep apnea contributes to high blood pressure, using a CPAP machine to treat the sleep apnea can help manage the hypertension.
On the other hand, primary hypertension, which accounts for 70% to 80% of cases, tends to be familial and is not linked to another medical condition. This type of hypertension typically requires long-term medication for effective control.
How important is indication adherence in hypertension management, and are patients expected to live on medications all their lives?
Medications for hypertension come in various classes. Common, affordable options include diuretics like Hydrochlorothiazide and calcium channel blockers such as Amlodipine (Norvasc), which are particularly effective for controlling blood pressure in Black individuals and are widely accessible across the country. Adherence to these medications is crucial, as it significantly reduces the risk of complications like kidney failure.
Although side effects, such as erectile dysfunction, may occur, it’s important to remember that these medications are often essential. While a small number of individuals may manage their condition through diet and exercise alone, the majority will require lifelong medication depending on their specific type of hypertension. When weighing the risks versus the benefits, it becomes clear that the advantages of staying on medication outweigh the potential side effects.
Lastly, what policy changes or public health initiatives would you advocate for to combat hypertension in the state and how can individuals contribute to this effort?
To effectively combat hypertension, diabetes, and arthritis, we must prioritize improving our primary healthcare centers, particularly those in rural communities. Unfortunately, many of these facilities are poorly equipped, the infrastructure is deteriorating, and healthcare professionals are often absent. Addressing this issue should not fall solely on the government. Corporate organizations, associations, and especially Nigerians in the diaspora, must contribute, just as my organization, Horizon International Medical Mission (HIMM), has done for the past 24 years in Owerri West and Imo State.
However, these interventions are not sustainable. Free medications provided to patients often last no more than three months, after which many return to battling uncontrolled high blood pressure and diabetes. Sustainable solutions are essential to make long-term progress in managing these conditions.
Any Health Advise?
I strongly encourage everyone to see their doctor at least once a year for a physical examination, even if they feel perfectly healthy. I understand that many people may question the need to visit a doctor, especially when financial resources are limited, and they feel fine. However, my argument is simple: only those who are alive can eat. It’s essential to listen to our bodies and prioritize regular checkups, particularly for cholesterol, blood pressure, and blood sugar levels—these are fundamental to maintaining good health.
