Prevalence, awareness, treatment, and control of hypertension in Nigeria in 1995 and 2020: A systematic analysis of current evidence

Abstract

Improved understanding of the current burden of hypertension, including awareness, treatment, and control, is needed to guide relevant preventative measures in Nigeria.A systematic search of studies on the epidemiology of hypertension in Nigeria, published on or after January 1990, was conducted. The authors employed randomeffects meta-analysis on extracted crude hypertension prevalence, and awareness, treatment, and control rates. Using a meta-regression model, overall hypertension cases in Nigeria in 1995 and 2020 were estimated. Fifty-three studies (n = 78 949) met our selection criteria. Estimated crude prevalence of pre-hypertension (120-139/80-89 mmHg) in Nigeria was 30.9% (95% confidence interval [CI]: 22.0%-39.7%), and the crude prevalence of hypertension (≥140/90 mmHg) was 30.6% (95% CI: 27.3%-34.0%). When adjusted for age, study period, and sample, absolute cases of hypertension increased by 540% among individuals aged ≥20 years from approximately 4.3 million individuals in 1995 (age-adjusted prevalence 8.6%, 95% CI: 6.5-10.7) to 27.5 million individuals with hypertension in 2020 (age-adjusted prevalence 32.5%, 95% CI: 29.8-35.3). The age-adjusted prevalence was only significantly higher among men in 1995, with the gap between both sexes considerably narrowed in 2020.Only 29.0% of cases (95% CI: 19.7-38.3) were aware of their hypertension, 12.0% (95% CI: 2.7-21.2) were on treatment, and 2.8% (95% CI: 0.1-5.7) had at-goal blood pressure in 2020. Our study suggests that hypertension prevalence has substantially increased in Nigeria over the last two decades. Although more persons are aware of their hypertension status, clinical treatment and control rates, however, remain low. These estimates are relevant for clinical care, population, and policy response in Nigeria and across Africa.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Prevalence of Prehypertension in Nigeria: a Systemic Review and Meta-analysis

“…This study's pooled estimate of prehypertension prevalence in Nigeria, 34% (95% CI: 30-40%), is close to but more precise than a recent meta-analysis in the country, which reported a prevalence of 30.9% (95% CI: 22.0-39.7%) (6). The difference in precision between the two meta-analyses can be explained by the difference in the number of studies and individuals included in each; our analysis includes a larger number of studies and individuals, which explains our estimate's higher precision.…”

“…The difference in precision between the two meta-analyses can be explained by the difference in the number of studies and individuals included in each; our analysis includes a larger number of studies and individuals, which explains our estimate's higher precision. It's worth noting that prehypertension and hypertension have nearly identical prevalence rates (6). This indicates that twothirds of adult Nigerians have high blood pressure and are at a high risk of acquiring end-stage cardiovascular events such as stroke, coronary heart disease, and chronic kidney disease.…”

“…The modified tool used in critical assessment of the included studies is shown in Table 1. According to a recent meta-analysis of studies completed in Nigeria, the minimal sample size for ranking a study as a 'yes' was 323, calculated using the Epitools online calculator (10) and assuming a 30-percent estimated prevalence (6). The quantitative analysis includes only studies that were assessed to have good methodological quality.…”

“…However, the analysis only included studies from four of the country's six geopolitical zones. In addition, no sex-specific prevalence of prehypertension was reported (6). This study aimed to determine the sexspecific prevalence of prehypertension across the 6 geo-political zones as well as in urban and rural settlements of Nigeria.…”

The contribution of family physicians to primary health care: Experiences from southwest Nigeria

“…Studies have shown that about a third of hypertensives are unaware of their status. 5 , 6 Hence, every adult participant at the medical outreach programmes is screened for hypertension and diabetes mellitus. Also, every adult patient has a BP measurement at each clinic visit, irrespective of the clinical presentation.…”