Infections, hypertension major drivers of heart failure deaths in Nigeria —Study

A landmark national review has identified the major factors driving poor heart failure treatment outcomes in Nigeria, with infections, pneumonia, uncontrolled hypertension, and heart rhythm disorders emerging as the biggest threats to patients.

The findings are reported in a study published in SN Comprehensive Clinical Medicine, the first systematic review and meta-analysis to comprehensively examine heart failure treatment outcomes across Nigeria.

The review provides the strongest pooled evidence to date on why many patients continue to experience poor clinical outcomes despite treatment.

The study was jointly led by Professor Adeseye Akintunde of LAUTECH Teaching Hospital and Dr Victor Oluwatomiwa Ajekiigbe, a medical doctor and public health researcher, among other co-authors.

The researchers analysed data from seven studies involving 1,151 patients from across Nigeria, with an average age of about 54 years and an almost equal distribution of male and female participants.

The findings showed that nearly eight in every 10 Nigerian heart failure patients (79.5%) also have hypertension, making it the most common underlying condition associated with heart failure. Diabetes mellitus affected 14.6% of patients, highlighting the growing burden of multiple chronic diseases.

    The review also identified infection (51.3%) as the leading predictor of poor treatment outcomes, followed by community-acquired pneumonia (40.8%), abnormal heart rhythm (25%), and poor medication adherence (5.3%).

According to the research team, many of these poor outcomes could be reduced through better infection prevention, earlier diagnosis, and improved long-term ent care.

Dr Ajekiigbe said the findings highlight the need for stronger public health measures, better management of chronic diseases, and wider access to evidence-based heart failure treatment to improve patient outcomes in Nigeria.

The analysis also showed that ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), and aldosterone antagonists were the most frequently prescribed medicines for heart failure. However, the researchers noted that several guideline-recommended therapies, including beta-blockers, remain underused, which may limit improvements in survival and quality of life.

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The research team said the findings reveal important gaps in heart failure care and support the need for practical, evidence-based interventions.

They recommended improving hypertension and diabetes control, strengthening infection prevention and management, expanding access to recommended therapies, and promoting better medication adherence through patient education and regular follow-up.

With cardiovascular disease placing an increasing burden on Nigeria and other low- and middle-income countries, the study provides important evidence to support clinicians, policymakers, and public health stakeholders working to reduce avoidable hospital admissions and deaths.

Dr Ajekiigbe and his team concluded that unless these challenges are addressed, many Nigerians living with heart failure may continue to experience preventable complications, repeated hospital admissions, and reduced quality of life.