More than half of adults in a three-month Lagos blood pressure screening had hypertension, and nearly two-thirds of those found to have it were unaware, cardiologists who ran the testing stations said.
The researchers set up testing points in hospitals, pharmacies, workplaces and public spaces across the city in 2023 and tested about 1,500 adults who passed by.
Of those tested, 52.5% had hypertension, defined as blood pressure of 140/90 mmHg or above. Among the hypertensive group, 65.3% did not know their blood pressure was high.
The care gap extended beyond awareness. Only 13.8% of those identified as hypertensive were taking medication for the condition, and just 8.3% had their blood pressure under control.
In a city of more than 20 million people, the authors note, that pattern implies millions may be living with a serious medical condition without knowing it or without receiving the care they need.
The findings were published as part of the researchers’ own account of the study. The World Health Organization estimates that about 36% of Nigerian adults have hypertension, a burden the authors describe as having climbed for years.
Cost and adherence
When the team interviewed participants, 57.3% said they had to pay the full cost of their medication themselves, and more than one in five said they took their tablets only when they felt they needed them.
Among those on treatment, 64.6% reported taking their medication regularly, while 22.4% took tablets only when they felt the need, despite clinical recommendations against that approach.
The authors also found that adherence and prevalence partly reflected education levels: people with no formal schooling were around two and a half times more likely to fall into a higher blood pressure category.
From awareness to action
Globally, fewer than one in five people with hypertension have their blood pressure controlled, according to the authors, who say their study illustrates some of the reasons why.
Treatment that already exists
The authors argue that most of what is needed is already available and inexpensive. The medicines and protocols exist in the World Health Organization’s HEARTS package, they write.
What has to change, in their view, is where care happens: nurses and primary healthcare workers can measure blood pressure, start treatment under protocol, refill prescriptions and identify patients who need referral, leaving tertiary centres to handle complications.
They also point to the cost of late care.
“If a patient reaches me in a hospital, the system has already failed them,” the authors write, adding that the cost of treating one heart attack could fund management of risk factors for many people long before they need a cardiologist.
Solutions
Nigeria was at the centre of 2026 World Heart Day activities, with the World Heart Federation partnering with the Nigerian Cardiac Society on a two-day conference in Abuja that included a secondary school debate and arts competition, a community walk, health screenings and CPR training.
The Nigerian Heart Foundation, CHDf Nigeria and regional chapters of the Nigerian Cardiac Society also ran grassroots events elsewhere in the country focused on awareness and community health services.
The authors say such efforts by the World Heart Federation’s members can only do so much, and that systemic action is needed.
What is missing in Lagos and across much of sub-Saharan Africa, they write, is two-fold: access to screening and access to treatment when hypertension is found.
They call for integrated health systems that reduce out-of-pocket costs, embed routine checks into primary care, and enable community health workers to screen, refer and follow up with patients, alongside making proven, off-patent blood pressure medications available at reasonable cost.
The authors note that reaching the WHO and World Heart Federation target of 50% hypertension control could prevent at least 75 million deaths globally before 2050.
Their own findings, they write, show that the first hurdle is improving awareness, since a condition that is not found cannot be treated.
Next steps
Source: The Conversation
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