An international global health consultant, Emmanuel Agogo, has called for stronger alignment between U.S. and Nigerian hypertension management guidelines.

Mr Agogo, who is also the Director of Pandemic Threats at the Foundation for Innovative New Diagnostics (FIND), made the call during an interview on Thursday in Abuja.

He said that the call became necessary as an estimated 30 per cent of Nigerian adults live with high blood pressure (BP).

He said that this was according to findings from a recent systematic review, adding that the findings were, however, pending further validation from the ongoing STEP survey.

He stated, “This prevalence underscores the urgency of prioritising prevention through population-wide awareness and early intervention.

“Non-pharmacological measures should remain the foundation of hypertension control. Lifestyle must be treated as medicine. Low-sodium diets, regular physical activity, weight control and stress management should precede drug therapy in many cases.”

He highlighted an analytical difference between U.S. and Nigerian guideline thresholds that carries practical implications for diagnosis and treatment.

“Under the American Heart Association guidance, blood pressure readings of 130/80 mmHg and above are considered elevated and often trigger earlier treatment and lifestyle interventions.

“By contrast, the 2023 Nigerian guidelines generally use 140/90 mmHg and above as the threshold for defining hypertension and initiating pharmacologic treatment in many adults.

”Lower thresholds, like 130/80, aim to prompt earlier detection and intervention, which can reduce long-term cardiovascular risk. However, we must balance these targets with local healthcare capacity and patient realities,” he added.

He emphasised that while lower thresholds might improve early detection, implementation must be grounded in Nigeria’s clinical context and resource considerations.

He also highlighted the ABCD pharmacologic treatment framework, noting that evidence supported its effectiveness, particularly among patients of Black African heritage, emphasising the need for personalised treatment decisions.

According to him, blood pressure targets must be ambitious but realistic.

“We must push for control, but clinical judgement is critical, especially in elderly patients, where aggressive targets must be balanced with safety and quality of life,” he said.

He, however, identified limited access to affordable anti-hypertensive medications as a major barrier to effective blood pressure control in Nigeria.

He described the 2023 Nigerian Hypertension Guidelines as a significant milestone in adapting global scientific evidence to Nigeria’s healthcare realities and population profile.

He urged policymakers, clinicians and stakeholders to strengthen implementation of the national guidelines, expand public awareness and improve access to essential medicines to reduce cardiovascular-related morbidity and mortality in the country.
(NAN)