Blood Pressure — The Number That Determines Everything
Hypertension — high blood pressure — is the most common chronic medical condition in older Nigerians, affecting more than 60% of adults over the age of 60. It is the single most important risk factor for stroke in Nigeria, where stroke is a leading cause of death and disability in older adults. It drives heart failure, kidney failure, and blindness. And it does none of this with any warning — no headache, no dizziness, no symptom of any kind in the vast majority of cases. Nigerian families have normalised high blood pressure in their elderly relatives — ‘E don dey old, e go dey high’ — as though it is an expected part of ageing that requires no treatment. It is not. Uncontrolled hypertension at 65 or 75 is just as dangerous as at 45, and just as treatable.
Why Blood Pressure Rises With Age
As the body ages, the large arteries that carry blood away from the heart gradually lose their elasticity — they stiffen and become less able to expand and contract with each heartbeat. This stiffening raises the systolic blood pressure (the upper number). In older adults, hypertension often takes a specific pattern called isolated systolic hypertension, where the top number is elevated but the bottom number may be normal or even low. This pattern is particularly associated with stroke risk. The causes of age-related arterial stiffening include cumulative salt exposure over a lifetime, low physical activity, smoking, excess alcohol, and genetic factors — all of which interact differently in the Nigerian context.
The Challenge of Hypertension Management in Nigeria
Even when hypertension is diagnosed, managing it in Nigeria’s healthcare environment presents real challenges. The cost of antihypertensive medications, the inconsistency of drug availability in public facilities, the distances to clinic follow-up appointments, the tendency to stop medications when they run out or when the person feels well — all of these erode blood pressure control in older Nigerians. Family members play a critical role in supporting medication adherence and in recognising the warning signs of stroke and hypertensive emergency. A sudden severe headache, confusion, sudden weakness on one side of the body, or sudden difficulty speaking in someone with known hypertension is a medical emergency — they need to be at a hospital within minutes, not hours.
Warning Signs in an Older Person With Known Hypertension
- Sudden severe headache — unlike any headache they have had before
- Sudden confusion or difficulty speaking or understanding speech
- Sudden weakness or numbness in the face, arm, or leg — especially on one side
- Sudden vision loss or double vision
- Sudden difficulty walking or loss of balance
- These are the signs of stroke — call for help and get to hospital immediately
What Older Adults and Their Families Can Do
- Measure blood pressure regularly — every week at minimum for someone on treatment, more often if control is poor
- Take blood pressure medication consistently — every day, even when feeling perfectly well. Feeling well does not mean the blood pressure is controlled.
- Reduce salt dramatically — excess dietary salt is one of the strongest drivers of hypertension in Nigeria. Reduce added salt, reduce stock cubes, reduce canned and processed foods.
- Eat more fruits and vegetables, particularly those rich in potassium — pawpaw, banana, leafy greens, beans — which help moderate blood pressure
- Walk daily if the person is able — even 20 to 30 minutes of gentle walking has a blood pressure-lowering effect
- Reduce or eliminate alcohol
- Ensure blood pressure medication is always in stock — do not wait until the last tablet before going to refill
How Doc on Wheels Can Help
Blood pressure can be measured at home through Doc on Wheels — avoiding the difficult and sometimes painful journey to a clinic for an older or frail person. Our doctors can review readings, discuss whether management is adequate, and arrange relevant blood tests at home to monitor for kidney function and other complications of long-standing hypertension. For families managing an elderly relative’s blood pressure at home, we provide guidance and ongoing support.