World Heart Day: Beyond Awareness, Can Nigerians Afford the Heart Care They Need?

As Nigeria joins the world to mark World Heart Day, the growing burden of cardiovascular disease is bringing another question into focus: what happens when people need heart care but cannot afford or reach it?

Every year, World Heart Day creates an opportunity to talk about one of the world’s biggest health challenges.

This year, that conversation is particularly important for Nigeria.

Cardiovascular disease is not only a problem of old age, and it is not only something that happens in other countries. High blood pressure, diabetes, obesity, physical inactivity and other risk factors are increasingly shaping the health of Nigerians.

The World Heart Federation estimates that Nigeria recorded 235,862 deaths from cardiovascular disease in 2024. The federation also puts the country’s age-standardized cardiovascular mortality rate at 264 deaths per 100,000 people.

Behind those numbers are people managing medication, attending hospital appointments, paying for tests and, in some cases, trying to raise millions of naira for specialized treatment.

That is where the heart-health conversation becomes bigger than awareness.

It becomes a question of access.

A health problem that can remain invisible

One of the challenges with cardiovascular disease is that some of its most important risk factors can develop without obvious symptoms.

Hypertension is a clear example.

WHO’s Nigeria hypertension profile estimates that high systolic blood pressure was responsible for 62 per cent of cardiovascular disease deaths in 2019. It also recorded cardiovascular disease as a significant cause of mortality in the country.

The World Heart Federation’s country profile puts age-standardized hypertension prevalence among Nigerian adults at 33 per cent based on 2019 data.

A person can therefore be living with elevated blood pressure for years without feeling seriously ill.

That makes routine screening important.

A blood pressure check may appear simple, but it can be the first indication that someone needs treatment or lifestyle changes before the condition develops into something more serious.

And this is where prevention becomes closely connected to healthcare access.

Knowing that you have hypertension only helps if you can also access the medication, follow-up and professional care needed to manage it.

The cost can rise quickly when specialized care is needed

Basic prevention and early management are one side of the equation.

Advanced cardiac care is another.

Health experts speaking on Nigeria’s heart-health challenges this World Heart Day have highlighted the high cost of diagnosis and treatment, limited specialist capacity and gaps in cardiac infrastructure.

The figures are significant.

Nigeria has roughly 400 cardiologists serving a population of more than 220 million people, according to the Nigerian Cardiac Society figures cited by health experts. Specialist catheterisation services are also available in only about 10 centers nationwide, with facilities concentrated largely in urban areas.

For patients who need advanced interventions, the financial burden can become enormous.

Experts cited costs of roughly ₦2 million to ₦5 million for cardiac catheterisation, depending on the procedure, while stent insertion can run into the ₦12 million to ₦15 million range. Open-heart surgery can cost considerably more depending on the facility and complexity of the procedure.

These are not costs that most households can easily absorb.

And cardiac treatment rarely involves only one bill.

There may be consultations, blood tests, imaging, medication, hospitalization, procedures and follow-up appointments.

For families paying out of pocket, the total cost can become much larger than the initial diagnosis suggests.

When healthcare becomes a financial decision

This is one of the less visible consequences of Nigeria’s cardiovascular disease burden.

A person may know that they need treatment but still have to ask another question:

Can we afford it?

That question can influence how quickly someone seeks care, whether they complete treatment or whether they continue taking prescribed medication.

It can also affect the entire household.

Savings may be depleted.

Family members may borrow money.

A business owner may stop working.

A relative may have to leave work to provide care.

Children’s school fees and other household expenses can suddenly compete with medical bills.

This is why cardiovascular disease is not simply a medical issue.

It can become an economic shock for a family.

Where you live can also determine what care is available

Nigeria’s cardiac infrastructure is not evenly distributed.

With specialized catheterisation services concentrated in a small number of centers, patients living outside major urban areas may have to travel significant distances for advanced cardiac care.

That creates another layer of cost.

There is transportation.

There may be accommodation.

There is time away from work.

There may be the cost of moving a patient who is already seriously ill.

And if the condition requires urgent treatment, distance becomes more than an inconvenience.

It can become a medical risk.

Healthcare access therefore cannot simply be measured by counting hospitals.

The more useful question is whether the right level of care is available close enough, quickly enough and affordably enough for the people who need it.

The specialist shortage matters

A healthcare system can have demand for specialized treatment without having enough specialists to meet that demand.

Cardiology requires highly trained professionals, and advanced cardiac care often depends on teams rather than a single doctor.

Cardiologists, interventional cardiologists, cardiac surgeons, nurses, radiographers, laboratory professionals and other specialists all form part of the wider care pathway.

Health experts have also raised concerns about Nigeria’s limited number of interventional cardiologists and shortages of functional equipment needed for complex cardiac procedures.

This makes the country’s health-worker challenge part of the cardiovascular conversation.

Training more specialists matters.

But retaining them matters too.

And ensuring that trained professionals have functioning equipment and facilities in which to work matters just as much.

Emergency care cannot be an afterthought

Some heart conditions allow time for diagnosis and long-term management.

Others do not.

A heart attack, for example, can require rapid access to specialized treatment.

Health experts have therefore called for stronger emergency medical services and ambulance networks that can move patients quickly to facilities capable of providing appropriate cardiac care.

This is an important part of the infrastructure conversation.

A hospital can have a specialist and the right equipment, but if a patient cannot reach that facility quickly during an emergency, the existence of that equipment may not be enough.

The entire chain has to work.

Recognition of symptoms.

Emergency response.

Transportation.

Hospital admission.

Diagnosis.

Specialist intervention.

Post-treatment care.

A weakness at any point can affect the outcome.

Prevention still offers one of the biggest opportunities

The difficult reality is that Nigeria cannot build its way out of cardiovascular disease using specialist hospitals alone.

Prevention has to remain central.

Regular blood pressure checks can identify hypertension.

Blood sugar testing can help identify diabetes.

Cholesterol checks can reveal another cardiovascular risk factor.

Healthy diets, physical activity, avoiding tobacco and managing weight can also reduce some risk factors.

The World Heart Federation’s Nigeria profile shows that the country already has an operational national action plan for cardiovascular disease.

The challenge is turning policy into routine action that reaches people where they live.

A person should not have to wait until they experience severe chest pain before discovering that they have been living with uncontrolled hypertension.

This is where primary healthcare becomes important.

The first heart-health intervention may not be a heart hospital

Nigeria’s cardiovascular response does not always have to begin with expensive procedures.

It can begin with a functioning primary healthcare center.

A blood pressure machine.

A trained health worker.

Affordable essential medicines.

Routine screening.

A reliable referral system.

Follow-up for patients with hypertension or diabetes.

These interventions may not attract as much attention as a new cardiac center or major medical equipment.

But they can help identify risk earlier.

WHO’s hypertension data shows why this matters: high blood pressure is a major contributor to cardiovascular mortality, yet prevention and control depend heavily on detection and long-term management.

The earlier a cardiovascular risk is identified, the more options there may be to manage it before it becomes an emergency.

Health insurance could change the conversation

The financial side of cardiac care also raises questions about health insurance.

If a patient is paying for every consultation, test, medicine and procedure directly, a serious illness can quickly become financially overwhelming.

Health insurance can spread some of that risk.

But coverage has to be meaningful.

It is not enough for a person to technically have an insurance card if essential investigations, medicines or procedures remain outside the coverage they can actually use.

For cardiovascular care, where some procedures can cost millions of naira, the difference between having meaningful financial protection and having none can be enormous.

Health experts have therefore continued to call for stronger insurance coverage and broader progress towards universal health coverage.

Heart health is also a productivity issue

There is another reason this conversation matters to businesses and communities.

A healthy workforce is part of a productive economy.

When workers develop serious cardiovascular conditions, they may need extended periods away from work.

Small businesses can be particularly vulnerable when the owner or a key employee becomes ill.

Families can lose income while simultaneously taking on medical expenses.

The economic impact can therefore extend beyond the hospital.

This is one reason employers also have a role to play.

Workplace health program-mes can encourage regular blood pressure checks, physical activity, healthier food choices, stress management and early medical attention.

For companies, this is not only about employee wellbeing.

Early detection and prevention can also help reduce the economic disruption associated with serious illness.

What would better cardiac care look like?

There is no single solution to Nigeria’s heart-health challenge.

It requires several parts of the system to work together.

Primary healthcare facilities need to be able to identify cardiovascular risks.

People need access to affordable medicines and follow-up care.

Referral pathways need to function.

More specialized services need to become available outside a small number of urban centers.

Emergency response needs to improve.

Health workers need training, equipment and supportive working conditions.

And patients need financial protection when they require advanced care.

The country also needs better data.

The World Heart Federation’s Nigeria profile notes that the country has a national cardiovascular disease action plan, but it also identifies gaps in areas such as evidence-based national guidelines for managing cardiovascular disease through primary care.

Better data and stronger primary-care systems can help policymakers understand where the burden is greatest and where resources are most needed.

World Heart Day should be about what happens after today

World Heart Day is useful because it puts cardiovascular health in the public conversation.

But awareness should be the beginning, not the end.

After the campaign messages disappear from social media, Nigerians will still wake up with hypertension.

Patients will still need medication.

Doctors will still need equipment.

Families will still face hospital bills.

And someone experiencing a cardiac emergency will still need to reach appropriate care quickly.

That is why the bigger question for Nigeria is not simply whether people know that heart disease is dangerous.

It is whether the healthcare system can help them prevent it, detect it early and treat it when necessary.

The country already has health professionals, institutions, policies and program-mes working on cardiovascular disease.

The challenge is connecting those pieces into a system that ordinary Nigerians can actually use.

Because a heart-health campaign can tell people to check their blood pressure.

A healthcare system must then make sure there is somewhere affordable to go when the result is too high.

And on World Heart Day, that may be the conversation worth having.

Heart health is not only about keeping people alive. It is about making sure the care needed to do so is within reach.

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