Speaking at a recent Ibadan College of Medicine Alumni Association (ICOMAA) Worldwide webinar titled “From Guidelines to Practice: Key Updates and Insights from the 2025 AHA/ACC Hypertension Guidelines,” Prof. Ogunniyi warned that high blood pressure remains the most prevalent and modifiable risk factor for cardiovascular disease worldwide.
More than 1.3 billion adults globally live with hypertension, she noted, including nearly half of all adults in Africa. In Nigeria, she said, about one in three adults has high blood pressure.
“Despite decades of data and effective therapies, hypertension control rates remain abysmally low across the globe, particularly among racial and ethnic minorities,” Prof. Ogunniyi said, highlighting the disproportionate burden carried by Black communities.
A Silent Driver of Deadly Diseases
Prof. Ogunniyi emphasized that hypertension fuels a wide range of cardiovascular and metabolic conditions, including coronary artery disease, heart failure, atrial fibrillation, stroke, dementia, chronic kidney disease, and premature death. She stressed that national data from Nigeria show widespread and largely uncontrolled hypertension, with little improvement over time.
New Guidelines, Renewed Urgency
Highlighting key recommendations from the 2025 AHA/ACC hypertension guidelines, Prof. Ogunniyi described blood pressure control as a major public health priority—especially in low- and middle-income countries (LMICs).
The guidelines recommend lowering blood pressure to below 130/80 mmHg for most adults, with an ideal systolic target of less than 120 mmHg when safely achievable. She cited strong evidence that reducing blood pressure significantly lowers the risk of heart disease, stroke, kidney disease, dementia, and all-cause mortality.
A Risk-Based Approach to Treatment
Prof. Ogunniyi urged clinicians to shift from isolated blood pressure readings to a risk-based treatment approach, where therapy intensity matches patient risk while avoiding unnecessary medication for low-risk individuals.
She also highlighted the role of lifestyle and psychosocial interventions, including:
- Maintaining a healthy body weight
- Regular physical activity
- Reduced sodium intake
- Increased dietary potassium
- Limiting alcohol consumption
- Stress management
She noted that potassium-based salt substitutes can be especially effective, particularly among Black individuals who are more likely to have salt-sensitive hypertension.
Accurate Monitoring and Modern Care Models
Prof. Ogunniyi stressed the importance of accurate blood pressure measurement, recommending routine use of validated home monitors. Home readings, she said, are often more reliable than clinic measurements and help identify white-coat hypertension. She warned against reliance on smartwatches and other non-validated devices due to accuracy concerns.
To improve control, she also endorsed telehealth, standardized treatment protocols, electronic health records, and multidisciplinary team-based care—especially in resource-limited settings.
“Low-Hanging Fruit” in Cardiovascular Care
Describing hypertension control as “low-hanging fruit” in the fight against cardiovascular disease, Prof. Ogunniyi said:
“We know what to do. The challenge now is its implementation. If we get blood pressure right, we save hearts, brains, kidneys, and lives.”
Local Challenges in Nigeria
In his remarks, the event chairman, Prof. Solomon Kadri, acknowledged that hypertension control remains particularly challenging in Nigeria due to cost, limited access to care, and low awareness.
“Getting people to 140/90 mmHg is already difficult. It is even more difficult in Nigeria than in developed countries,” he said, while expressing optimism that wider access to medication and improved knowledge would strengthen hypertension care nationwide.