Trends, Care Cascade Gaps and Projected Burden of Hypertension in Rivers State, Nigeria (2015–2034)
Nduye Christie Tobin Briggs *
Department of Community Medicine, Rivers State University, Port Harcourt, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Hypertension is the leading modifiable risk factor for cardiovascular morbidity and mortality globally, with a rising burden in sub-Saharan Africa. This study assessed ten-year trends in hypertension prevalence, awareness, treatment, and control in Rivers State, Nigeria, and projected future burden to 2034.
Methods: A retrospective trend analysis was conducted using routinely collected health facility records, state surveillance reports, and population-based survey data from 2015 to 2024. Data from 156 health facilities across all 23 Local Government Areas were analysed, comprising 2,847,693 adult encounters. Hypertension was defined as blood pressure ≥140/90 mmHg or as current use of antihypertensive medication. Data analysis was conducted with SPSS version 27. Temporal trends were assessed using joinpoint regression, with projection modelling (2025-2034) using AutoRegressive Integrated Moving Average and population-based methods under three scenarios.
Results: Hypertension prevalence increased from 24.8% (95% CI: 24.1-25.5) in 2015 to 33.7% (95% CI: 32.9-34.5) in 2024 (Average Annual Per cent Change: 3.2%; p<0.001). Prevalence was higher among males (35.2% versus 30.1%), urban residents (35.8% versus 29.2%), and increased with age. Awareness improved modestly from 26.3% to 34.8% (p<0.001), treatment from 18.4% to 24.7% (p<0.001), and control among treated individuals from 12.1% to 14.3% (p=0.03). Only 3.5% of all hypertensives achieved blood pressure control in 2024. Projections indicate the number of adults with hypertension will increase by 47-55% to 2.78-2.94 million by 2034, with uncontrolled cases rising from 1.82 million to 2.68 million.
Conclusion: Hypertension burden in Rivers State is high, accelerating, and projected to increase substantially. Profound gaps in awareness, treatment, and control leave most hypertensives at risk for preventable complications. Urgent health system strengthening and population-level prevention strategies are needed.
Keywords: Hypertension, prevalence, awareness, treatment, control, disease projections, Rivers State, Nigeria