She woke up before dawn, as she always did. Tied her wrapper. Loaded her goods. Set out for the market. She never made it home.
This is not the story of one woman. It is the story of hundreds, perhaps thousands, of Nigerian women dying quietly, anonymously, without any public outcry or government inquiry. They slump on the way to market, collapse behind their trading stalls, and are rushed to hospitals they can barely afford, where they are pronounced dead of stroke or heart failure. Their families grieve and move on. The market resumes the next day.
Nobody calls it what it is: a public health emergency hiding in plain sight.
Among traders in the Kuje area of Nigeria’s Federal Capital Territory, there is a story making the rounds. In the space of just four consecutive Kango market days, that four day cycle that defines commerce across the FCT’s communities, a market woman reportedly slumped and either died on the way to hospital or arrived there already beyond saving. One woman. Four market days.
Unconfirmed reports say a reporter was unable to independently verify every detail of the Kuje account. But journalists who have worked this beat long enough know this: when communities are whispering something this specific and this consistent, the underlying truth is rarely as far from the surface as we think.
What is beyond dispute, because the numbers confirm it, is that Nigeria has a hypertension catastrophe unfolding at market stalls, in motor parks, in rural compounds, and along dusty footpaths from Kuje to Kano, from Onitsha to Ogoja. People are dying, and they never even knew they were sick.
The statistics are not polite numbers buried in academic journals. They are a national emergency that deserves front-page treatment every single week.
According to the Nigeria Demographic and Health Survey 2023–2024, approximately 30 to 40 percent of Nigerian adults are living with high blood pressure. A March 2026 report confirmed that while awareness has marginally improved, prevalence remains alarmingly high. That translates, at the most conservative estimate, to tens of millions of men and women walking around with a potential stroke fermenting inside them, undetected, untreated, and ticking.
Research confirms that while awareness has reached about 60 percent in some urban populations, treatment rates sit at a meagre 34 percent and, critically, only about 12 percent of hypertensive Nigerians have their blood pressure under meaningful control.
Of every 100 Nigerians with high blood pressure, only 12 have it controlled.
Hypertension is the single most common cardiovascular disease in Nigeria, and research published in leading medical journals confirms it is the country’s leading cause of sudden, unexpected death. It is responsible for 45 percent of deaths from heart disease and 51 percent of deaths from stroke worldwide. Africa has the highest hypertension prevalence of any WHO region, 46 percent of adults aged 25 and above, and Nigeria sits squarely at the centre of that crisis.
The risk of dying from hypertension-related complications in low- and middle-income countries is roughly double that in wealthy nations. About 25 percent of those deaths in countries like ours occur in people younger than 60 years compared to just 7 percent in high-income countries. Our market women are dying young, and we are calling it fate.
If you want to find the human face of Nigeria’s hypertension crisis, go to your local market.
The typical Nigerian market woman, the mama who wakes at 4 a.m., loads her goods, travels by commercial motorcycle through bad roads, stands or sits for ten hours under a scorching sun or cramped under a leaking tarpaulin, haggles over prices, manages credit she has extended to dozens of customers, worries about school fees, sends money home to the village, and eats whatever she can afford whenever she can afford it, is a walking catalogue of hypertension risk factors.
Medical experts have consistently identified stress and anxiety, poverty, excessive salt intake, physical overexertion, poor diet, obesity, and lack of access to healthcare as the primary drivers of hypertension. A cardiologist quoted in a 2024 investigation put it bluntly: hypertension “has become an epidemic in our society,” with around 40 percent of Nigerians now hypertensive, a significant increase, and no longer a disease confined to those over 40.
The former president of the Nigerian Medical Association stated plainly that “poverty and anxiety fuel hypertension.” That statement is almost a clinical description of a market woman’s daily existence.
High blood pressure is also now confirmed to affect more women than men in many developing countries. A study on the awareness, practices, and prevalence of hypertension among rural Nigerian women found that although excessive salt intake was the most recognised risk factor among women surveyed, the overall level of knowledge about the condition and its complications remained dangerously limited. And these women rarely see a doctor, not because they do not care about their health, but because preventive healthcare is simply not accessible or affordable for the majority of them.
Hypertension has earned its grim nickname, the Silent Killer, honestly. More than 50 percent of individuals with hypertension have no idea they have it. The disease typically produces no symptoms in its early and middle stages. A woman can have blood pressure high enough to rupture a blood vessel in her brain and feel nothing more than occasional headaches she attributes to stress, or a slight dizziness she chalks up to hunger or the heat.
By the time the body announces its distress loudly, with a stroke, with sudden collapse, with a massive heart attack, the cardiovascular system has already been sustaining damage for years. Researchers studying hypertensive Nigerians in rural communities concluded that “the fact that most people with hypertension are unaware of their blood pressure status may be responsible for sudden deaths reported orally in the study area.”
The 2024 study from the European Heart Journal on hypertension trends in Nigeria confirmed that hypertension is “the commonest cause of sudden unexpected death in the country.” Yet sudden deaths in markets, motor parks, and rural compounds rarely make headlines. They are recorded, if they are recorded at all, as cardiac events, strokes, or simply “died suddenly.” The thread connecting them, undiagnosed, uncontrolled hypertension, is invisible in death certificates and absent from public discourse.
A cross-sectional study of Primary Healthcare Centres (PHCs) in the Federal Capital Territory found that of 243 PHCs assessed, 90 had to be excluded outright due to having fewer than two full-time staff, security concerns, lack of road access, or simple non-functionality. Many of the remaining facilities lack validated blood pressure monitors, making hypertension screening practically impossible where it is most needed.
There is some light, the Hypertension Treatment in Nigeria (HTN) Programme, implemented across 60 PHCs in the FCT, recruited over 21,000 patients and improved hypertension control rates from 22 percent to over 50 percent using community health extension workers, simplified treatment protocols, and drug revolving funds to reduce out-of-pocket costs. It worked. But it covers a fraction of the population that needs it, and has not been scaled nationally.
Medication non-compliance is another silent accomplice. Research from University College Hospital Ibadan found that deaths from hypertension complications occurred with far higher frequency among patients who stopped taking their medication, 40 deaths in the non-compliant group versus 12 in the compliant group. Many Nigerians stop taking antihypertensive drugs because they feel better, because the drugs are too expensive, or because community members told them that “ordinary hypertension” does not require lifelong medication. It does. And stopping it can kill.
Nigeria’s economic hardship is not an abstract background condition, it is an active driver of the hypertension epidemic. Multiple cardiologists have linked the rise in hypertension cases directly to the current cost-of-living crisis: soaring food prices, fuel costs, school fees, and economic uncertainty creating a chronic stress environment that is biologically destructive.
The market woman who discovers at the end of a long market day that she has made less profit than she spent on transport is not just financially stressed. She is physiologically stressed. That stress raises cortisol and adrenaline levels. It constricts blood vessels. It raises blood pressure. Do this every day for five, ten, twenty years without ever checking your BP or receiving treatment, and the body eventually runs out of ways to compensate. Then, one market morning, it doesn’t.
Nigeria does not lack the knowledge of what works. It lacks the political will and the operational infrastructure to implement it at scale.
1. There should be mandatory BP Screening at Markets and Motor Parks
Community health workers should be deployed to major markets, the Kuje market, the Wuse market, the Onitsha main market, every Kango market day across the FCT and beyond, with automated blood pressure machines and referral capacity. Catching a hypertensive patient before she collapses is infinitely cheaper than managing her stroke.
2. Free or Heavily Subsidised Antihypertensive Medication
Cost is the single most cited reason for medication non-compliance. Antihypertensive drugs are not expensive to manufacture, the political will to fund their distribution is what is lacking.
3. Community Health Education in Market Language
Awareness campaigns must go beyond television and radio to reach women who have no time for either. Health talks should happen in markets, during women’s cooperative meetings, at mosques and churches, in the languages people actually speak. “Your BP can be high and you will feel nothing until you collapse” is a message that must be delivered, and repeated.
4. Train Bystanders in CPR
Knowledge of cardiopulmonary resuscitation (CPR) by bystanders can convert a sudden cardiac collapse — which is reversible — into a life saved. Market association leaders, traders, and motor park managers should all receive basic CPR training.
5. Link Health Checks to Trading Licences
State governments and local government area councils that issue trading permits could link those permits to annual blood pressure and basic health screening. This is not punitive — it is protective.
6. Establish a National Registry of Sudden Deaths
Nigeria has no systematic way of counting how many people are collapsing and dying in markets, on the road to market, or in their homes. A community-based sudden death registry, maintained through PHCs and local government health departments, would give us the data we need to demand action. We cannot fix what we cannot measure.
The woman who slumped on the way to Kango market, if the story is true, and evidence suggests something very much like it is happening regularly, did not die because of bad luck or God’s will, the two explanations Nigerians most readily reach for when we do not have better answers.
She likely died because no one ever checked her blood pressure. Because even if they had, and found it dangerously high, she may not have been able to afford the medication. Because the primary healthcare centre nearest to her may not have had a functioning BP machine. Because every public health messaging campaign Nigeria has run assumed she had a smartphone, a television, or leisure time to consume health information, none of which she had.
She died, in the most precise sense, of a policy failure. Of a healthcare infrastructure failure. Of a poverty that is itself a chronic disease. Of a silence that the Nigerian state has not yet been willing to break loudly enough.
The next Kango market day is four days away.
How many more women will not come home?
Halima Imam writes on health, society, and public affairs.
HEALTH ADVISORY: What You Should Know
Visit the nearest primary healthcare centre for a FREE blood pressure check.
Normal blood pressure is below 120/80 mmHg. Blood pressure of 140/90 mmHg or above requires medical attention.
High BP often has NO symptoms, do not wait to “feel sick” before getting checked.
Reduce salt intake, eat more fruits and vegetables, exercise moderately, and avoid excessive alcohol.
If prescribed BP medication, DO NOT stop taking it, even when you feel fine.
If someone collapses, call for help immediately and do not move them unnecessarily.