Hypertension: Why what you eat matters

By Jacinta Nwachukwu

For millions of Nigerians living with hypertension, managing the condition goes beyond taking prescribed medication.

What people eat, how active they are and other everyday lifestyle choices can influence their blood pressure and overall cardiovascular health.

Hypertension, commonly known as high blood pressure, is one of the major risk factors for heart disease, stroke and kidney disease.

The World Health Organisation (WHO) says about one in three adults in Nigeria has hypertension, highlighting the scale of the country’s growing non-communicable disease burden.

Globally, the burden is also substantial, with an estimated 1.4 billion adults aged 30 to 79 living with hypertension in 2024.

More importantly, hypertension often produces no obvious symptoms, meaning many people may not know they have it until complications develop.

According to WHO, the only reliable way to detect hypertension is to have blood pressure measured by a health professional or with an appropriate blood pressure device.

Against this background, health experts are urging Nigerians to pay greater attention to factors that can increase blood pressure, including excessive sodium intake, unhealthy diets, physical inactivity, obesity, excessive alcohol consumption and tobacco use.

Associate Prof. Florence Uchendu, a public health nutrition and epidemiology expert at the National Open University of Nigeria, Abuja, described hypertension as a major public health problem, especially in sub-Saharan Africa and Nigeria.

She identified excessive sodium intake as an important dietary risk factor for high blood pressure and advised Nigerians to reduce the amount of salt used in cooking and avoid routinely adding extra salt to meals.

“Every food has its natural taste. There are people who, with everything they cook, must dump salt there: yam, rice, corn, virtually everything.

“Eat your food the way it has been cooked. It is not advisable to add any more salt,” she said.

The advice is consistent with WHO recommendations, which call for adults to consume less than 2,000 milligrammes of sodium daily, equivalent to less than five grammes of salt or about one teaspoon.

In Nigeria, the Federal Ministry of Health and Social Welfare has also said excessive sodium consumption is a significant contributor to high blood pressure, stroke, heart failure and kidney disease.

The ministry recommends a maximum of five grammes of salt daily and says Nigeria is implementing a national sodium reduction strategy.

Uchendu, however, cautioned that reducing salt intake should not be interpreted as eliminating sodium completely because sodium is an essential nutrient required for normal body functions.

She also advised Nigerians to be cautious about processed and packaged foods, including biscuits, bread, noodles, soft drinks and other products that may contain substantial amounts of sodium or added sugar.

“Read food labels carefully and avoid ‘fry-fry’ street foods,” she advised.

Furthermore, she urged consumers to pay attention to information on sodium, added sugars and saturated fats when buying processed foods.

According to WHO, excessive sodium intake is a well-established cause of raised blood pressure and contributes to cardiovascular and kidney disease.

WHO estimates that excessive sodium consumption was associated with about 1.7 million deaths globally in 2023, underlining the importance of population-wide efforts to reduce intake.

Beyond salt, Uchendu identified frequent consumption of fried foods, obesity, sedentary lifestyles, excessive alcohol intake and diets high in unhealthy fats and refined sugars as other factors that could increase the risk of hypertension and related diseases.

She said vegetable oils generally did not contain cholesterol because cholesterol occurs naturally in animal-derived foods, but excessive consumption of cooking oil still increased overall dietary fat intake.

She therefore advised Nigerians to moderate their use of cooking oil, avoid repeatedly heating oil and reduce their consumption of heavily fried foods.

Rather than relying heavily on packaged seasonings and processed foods, she recommended greater use of fresh vegetables, fruits and locally available spices.

She also encouraged households to prepare meals at home, where the quantities of salt, sugar and oil could be better controlled.

Similarly, she advised people living with hypertension to consume fish and lean meats and choose lower-fat dairy products where appropriate.

However, Uchendu stressed the need for professional dietary counselling, especially for people already living with hypertension or other diet-related chronic conditions.

Meanwhile, Dr Omolade Falade, a public health physician at Bethel Specialist Hospital, Ibadan, urged Nigerians to challenge common health myths and adopt evidence-based approaches to preventing chronic diseases.

Falade said carbohydrates should not be eliminated completely from the diet, explaining that the type and quantity consumed were more important.

“Carbohydrates are a major source of energy and fibre. The challenge is the type of carbohydrates we eat.

“Unrefined or minimally refined carbohydrates obtained from oats, fruits, Ofada/Abakaliki rice, millet, guinea corn, yam, sweet potatoes, cassava and wheat are healthy. These should be taken in moderate amounts,” she said.

She advised Nigerians to limit refined carbohydrates, including some white-flour products, cakes, pastries and sugar-sweetened drinks.

In addition, Falade cautioned against assuming that being thin automatically meant being healthy.

She stressed the importance of routine medical checks regardless of body size, including measurement of blood pressure, weight and height, as well as appropriate screening for conditions such as diabetes.

She recommended a gradual reduction in the consumption of highly processed foods, excessive salt and unhealthy fats, alongside increased intake of fruits, vegetables and other nutritious foods.

Regular physical activity, she added, was also important in reducing the risk of cardiovascular disease.

Falade recommended brisk walking for about 30 minutes a day on five days a week, alongside other moderate physical activities suited to an individual’s health status.

WHO similarly recommends physical activity, healthier diets and weight management as important measures for preventing and controlling hypertension.

Moreover, Falade said prolonged or poorly managed stress could contribute to hypertension and other health problems, including poor sleep.

She recommended meditation or prayer, deep breathing, social interaction, regular exercise and professional support when necessary.

She also stressed the importance of adequate sleep, recommending that adults aim for at least seven hours each night.

While lifestyle changes can significantly improve cardiovascular health, the experts stressed that they should not be viewed as substitutes for prescribed treatment in people diagnosed with hypertension.

WHO advises people with hypertension to take medicines as prescribed and not to stop treatment without consulting a health profess

NAN