By Yunisa Adam Pra
Hypertension, a major risk factor for heart disease, stroke, and other cardiovascular cases, is a common and serious medical condition that continues to ravage many in Sub-Saharan Africa. With some studies suggesting that more than 76.2 million Nigerians are affected by hypertension and many more likely to develop the disease, including its attendant complications of paralysis, kidney damage, heart attack, and sudden demise, it is fast becoming a major public health burden.
But a team of medical researchers has been working hard to reverse the trend as much as possible through the Hypertension Treatment in Nigeria Programme, a collaborative academic research work between the University of Abuja; Washington University in Saint Louis, USA; and Northwestern University, Chicago, USA, which commenced in 2019 and will end in 2024. Other collaborators in this study are Federal Ministry of Health of Nigeria; Resolve to Save Lives; World Health Organization, Nigeria; Federal Capital Territory Primary Healthcare Board; and Public Health Department of Federal Capital Development Authority.
The study, which is ongoing in 60 primary healthcare centers in all the six area councils of the Federal Capital Territory (FCT) of Nigeria and has enrolled over 20,000 patients with hypertension, is to contextualise and evaluate implementation and effectiveness of a system for hypertension care and treatment centered on patient and non-physician healthcare workers.
As part of the researchers’ efforts to deepen their work, Dike Ojji, an associate professor of Preventive Cardiology, University of Abuja and Co-Principal Investigator Hypertension Treatment in Nigeria programme, University of Abuja, Nigeria; with his Co-Principal Investigator in the study, Mark Huffman, MD, MPH, Washington University in St. Louis, St. Louis, convoked the Hypertension Treatment in Nigeria policymakers Meeting in Abuja on Monday 22nd May 2023.
Ojji said, “ We set up this major stakeholders’ meeting so that we can all understand the study’s aims, approaches, findings, and implications; understand the study’s progress and share contextual factors that could influence its implementation and integration into the broader Nigerian health system; understand next steps in scaling up the study to the six geopolitical regions of the country, and Understand how the study can collaborate and harmonise with other similar studies in the country, especially the Nigeria Hypertension Control Initiative and Healthy Hearts Africa.”
On the same day, the scholars convoked related meeting on behalf of the Nigerian Sodium Study Team which comprise Medical Scientists from University of Abuja; University of Abuja Teaching Hospital; Washington University in Saint Louis, Missouri; Northwestern University, Chicago; Nutrition Coordinating Centre, University of Minnesota; and the George Institute for Global Health, University of New South Wales, Australia; in collaboration with Federal Ministry of Health (FMOH) of Nigeria; National Agency for Food Drug Administration and Control (NAFDAC); Resolve to Save Lives (RTSL) and Global Health Advocacy Incubator (GHAI).
Research has established a correlation between increased consumption of sodium with hypertension and increased risk of cardiovascular diseases. And the Nigeria Sodium Study which is currently ongoing in the Federal Capital Territory of Nigeria, and two other states of Ogun and Kano, has an overall objective of establishing mandatory sodium limits in Nigeria food so as to reduce hypertension.
According to Ojji, “After first rounds of in-depth interviews and focus group discussions already conducted among key stakeholders, and data on retail survey already collected in over 14,000 packaged and unpackaged foods in retail stores, we believe the team is well positioned to initiate meetings with policymakers and key stakeholders on how such data can be translated into policies and eventually implemented.
“We are sure that this would help to improve public health consequences and significantly bring down the risk of cardiovascular disease along with its associated morbidity and mortality in the country.”
Ojji’s partner, Huffman, said communicating key developments in the study was essential to its overall success. “We have no time to waste,” added Ojji, “Overall, the translation of research on hypertension into policy is critical for improving public health outcomes and reducing the burden of cardiovascular disease. By implementing evidence-based recommendations and policies, governments and public health organizations can help prevent and manage hypertension and its associated complications, ultimately saving lives and reducing healthcare costs.”
With several robust contributions from the stakeholders at the meetings, the team is set to embark upon its next of line of action, including to analyse and report primary effectiveness and implementation outcomes; collect and publish end-of-study qualitative data to explore and explain variability across age, sex, and urban and rural groups; plan for sustainment, integration of diabetes management, (FCT); and scale-up across 6 geo-political zones in Nigeria.
