WHO-ISH Guidelines for the management of hypertension: implementation in Africa--the Nigerian experience

A 1990-91 country-wide survey in Nigeria showed the prevalence of hypertension to be 11.2% in those aged 15 years and above. The management, however, has been shown to be inadequate. At the instance of the Nigerian Hypertension Society a Consensus Meeting of National Medical Societies and other interest groups produced in 1996 Guidelines for the Management of Hypertension in Nigeria. Medical societies and the pharmaceutical industry have tried to increase awareness of the condition and its control through lectures, seminars, sponsor of essay competitions among secondary school and university students as well as canvassing against cigarette advertising and smoking in public places. However, their efforts are thwarted by luring advertisements by multinational tobacco companies driven from developed countries by anti-tobacco lobbies and legislation. A questionnaire survey showed that no other African country had produced similar guidelines in the past five years. In Sub-Saharan Africa there appears to be negligible implementation of the WHO-ISH Guidelines.