1. Introduction: The Growing Burden of Hypertension in Nigeria
Hypertension, or high blood pressure, has emerged as one of the most significant non-communicable disease challenges facing Nigeria and the African continent. Hypertension is established when systolic and diastolic blood pressure, which in a normal adult is 120 and 80 mmHg respectively, rise to 140 and 90 mmHg or above in a sustainable manner . This chronic condition, characterized by a continuous rise in arterial blood pressure, leads to damage and scarring of arterial walls, putting individuals at risk for heart attack, stroke, and kidney disease.
The epidemiological landscape in Nigeria is alarming. A report covering all six geopolitical regions of Nigeria revealed that hypertension cases increased by 540% among individuals aged 20 years and above, rising from approximately 4.3 million in 1995 to 27.5 million in 2020 . This dramatic increase reflects the epidemiological transition occurring in Nigeria, where non-communicable diseases are increasingly competing with communicable diseases as leading causes of morbidity and mortality. The prevalence of hypertension is notably higher among socioeconomically disadvantaged populations, with studies showing that diabetes and hypertension are more evident among the poor than the rich.
The economic burden of hypertension management is substantial. Research indicates that patients spend more than 25% of their monthly income on healthcare, creating a significant financial strain on families and contributing to the perpetuation of poverty. The direct costs of managing hypertension and its complications strain already overburdened healthcare systems, while the indirect costs of lost productivity negatively impact national development. In countries with limited healthcare infrastructure, the burden of hypertension can perpetuate cycles of poverty and inequality.
1.1 The Limitations of Orthodox Therapy
Despite the effectiveness of most antihypertensive drugs, including angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers, beta-blockers, diuretics, and vasodilators, their long-term use often leads to adverse side effects. Common side effects include:
| Side Effect | Associated Drug Class |
| Hyperkalemia | ACE inhibitors, ARBs |
| Dry cough | ACE inhibitors |
| Palpitations | Calcium channel blockers |
| Electrolyte imbalance | Diuretics |
| Muscle cramps | Various classes |
| Fatigue | Beta-blockers, others |
| Abnormal heart rate | Various classes |
| Blurred vision | Various classes |
These limitations, combined with the high cost of pharmaceuticals and limited healthcare infrastructure in many parts of Nigeria, have driven a significant proportion of the population toward alternative and complementary approaches, particularly traditional plant-based therapies.
2. Prevalence and Patterns of Herbal Medicine Use
2.1 Extent of Usage
Multiple studies across Nigeria have documented the widespread use of herbal medicines among hypertensive patients, revealing consistent patterns of usage:
| Study Location | Herbal Medicine Usage Rate | Key Findings |
| South-Eastern Nigeria (Teaching Hospitals) | 75.4% | 75% used TMPs concurrently with prescription medicines; most doctors unaware |
| South East Nigeria (Tertiary Centre) | 4.4% (CAM use) | 63.6% used CAM concurrently with orthodox medicine; 81.8% did not disclose to healthcare providers |
The study by Sylver-Francis and colleagues involving over 600 patients found that approximately 75% of participants used traditional medicinal plants concurrently with their prescription medicines, demonstrating alarmingly high prevalence. Perhaps more concerning, most doctors were unaware of this concurrent use, as patients often did not disclose their herbal medicine practices. In the South East Nigeria study, 81.8% of CAM users did not reveal their CAM use to their healthcare provider, with 66.7% citing fear that the healthcare provider would discourage them as the primary reason for non-disclosure. This lack of communication creates significant potential for adverse drug interactions and complications.
2.2 Demographic Factors Influencing Usage
Analysis of demographic patterns across studies reveals several key associations:
| Factor | Finding |
| Age | Older age groups (40 years and above) ranked highest in TMP usage |
| Marital Status | Married participants showed greater interest in traditional medicine |
| Education | No significant association between level of education and TMP usage (P = 0.533) |
| Gender | No significant association between gender and TMP usage (P = 0.636) |
| Religion | No significant association between religion and TMP usage (P = 0.419) |
| Comorbid Conditions | Those with both diabetes and hypertension tended more toward TMP use |
Statistical analysis from the South-Eastern Nigeria study showed that age and marital status had statistically significant associations with TMP usage, while gender, education level, and religion showed no significant associations. The oldest age groups (40 years and above) demonstrated the highest usage, reflecting “deeper knowledge of traditional medicines when compared to the younger population”. The finding that patients suffering from both diabetes and hypertension tend toward TMP use more than those with just one condition is significant, given the high comorbidity between these conditions and the potential for dual-acting medicinal plants to address both simultaneously.
2.3 Reasons for Herbal Medicine Use
The reasons for the widespread use of herbal medicines in hypertension management are multifaceted:
- Economic factors: High cost of orthodox medications and healthcare services
- Accessibility: Medicinal plants are often readily available in local environments
- Cultural acceptance: Deep-rooted tradition of herbal medicine across Nigerian cultures
- Perceived efficacy: Belief that herbal remedies are effective and may have fewer side effects
- Inadequate healthcare infrastructure: Limited access to formal healthcare, particularly in rural areas
- Holistic approach: African traditional medicine addresses both physical and spiritual dimensions of illness
3. Ethnobotanical Surveys: Diversity of Nigerian Antihypertensive Plants
3.1 Ibadan, Oyo State Survey (2025)
An ethnobotanical survey in two markets located in Ibadan Southwest and Ibadan Northeast local government areas documented 61 plant species from 32 different families used for hypertension management. The most predominant plant families were:
| Plant Family | Number of Species |
| Apocynaceae | 9 |
| Fabaceae | 6 |
| Bignonaceae | 3 |
| Meliaceae | 3 |
| Sapotaceae | 3 |
| Solanaceae | 3 |
Some of the most frequently mentioned plant species included:
- Rauwolfia vomitoria Afzel
- Kigelia africana (Lam.) Benth
- Allium sativum L.
- Zingiber officinale Roscoe
- Picralima nitida (Stapf) T. Durand & H. Durand
- Viscum album L.
- Persea americana Mill.
The prominent mode of preparation was decoction and soaking, with all herbals taken orally. In some cases, non-herbal ingredients such as potash and refined camphor were included in the medicinal preparation. Most medicinal plants were sourced from the wild with little cultivation, raising concerns about potential endangerment over time.
3.2 North Central States Survey (2025)
A comprehensive survey across six North Central States (Kogi, Benue, Kwara, Niger, Nasarawa, and Plateau) identified 72 medicinal plant species belonging to 65 genera and 45 families from 180 respondents, of whom 107 were traditional healers. The study revealed important findings regarding indigenous knowledge acquisition and plant usage:
Modes of Knowledge Acquisition:
| Method | Number of Informants |
| Inheritance | 104 |
| Apprenticeship | 56 |
Most and Least Used Plants:
| Plant | Use Value | Fidelity Level |
| Moringa oleifera | 0.95 | 90.00 |
| Anacardium occidentale | 0.57 | 14.29 |
The family Rubiaceae had the highest representation of plant species (7.04%). Most plants were wild (46.48%), and herbs had the most significant representation (42.25%). The preferred mode of administration was oral, with a dosage regimen of 30 ml three times daily. Most respondents were aged between 41 and 50 years.
3.3 Zango Kataf, Kaduna State Survey (2023)
An ethnobotanical survey in Zango Kataf Local Government Area, Kaduna State, documented 23 antihypertensive plants belonging to 21 families from interviews with 17 herbal healers. Key findings included:
Demographics of Herbal Healers:
| Characteristic | Number | Percentage |
| Age 50 years and above | 13 | 76.5% |
| Below 50 years | 4 | 23.5% |
| Practical Knowledge | 8 | 47.1% |
| Inheritance | 7 | 41.2% |
| Herbalist | 2 | 11.8% |
| No formal education | 2 | 11.8% |
| Primary education | 10 | 58.8% |
| Secondary education | 3 | 17.7% |
| Tertiary education | 2 | 11.8% |
Criteria for Prescription :
| Criteria | Percentage of Healers |
| Efficacy only | 47% |
| Availability and efficacy | 29% |
| Efficacy and easy preparation | 12% |
| Availability, efficacy, and easy preparation | 12% |
The study identified plants including Zingiber officinale (ginger), Carica papaya, Moringa oleifera, Vernonia amygdalina (bitter leaf), Hibiscus sabdariffa (Zobo), Allium sativum (garlic), Persea americana (avocado leaves), and Ocimum gratissimum (scent leaf), among others.
3.4 Ibadan North Local Government Survey
An ethnobotanical survey in Ibadan North Local Government Area documented 101 plants belonging to 54 families, with the highest number belonging to the family Compositae. Kigelia africana was identified as a particularly significant plant. The study concluded that Ibadan is a rich source of plants indicated in the management of hypertension, emphasizing the need for further scientific work to ascertain efficacy, toxicity, safety, and appropriate dosage regimens.
3.5 Ibadan Survey (2026): Antioxidant and ACE Inhibitory Activities
An ethnobotanical survey followed by antioxidant and ACE inhibitory evaluation of selected medicinal plants documented seven plants used for managing hypertension:
Picralima nitida
Securidaca longipedunculata
Tetracera alnifolia
Senna fistula
Peperomia pellucida
Kigelia africana
Mangifera indica
Phytochemical screening revealed the presence of saponin, flavonoid, tannin, cardiac glycosides, anthraquinones, and alkaloids in Picralima nitida, Senna fistula, and Kigelia africana.
4. Scientifically Validated Antihypertensive Plants
4.1 Moringa oleifera
Moringa oleifera demonstrated the highest use value and fidelity level among antihypertensive plants in the North Central States survey (0.95 and 90.00 respectively), indicating both high frequency of use and strong traditional belief in its efficacy.
4.2 Picralima nitida
Picralima nitida demonstrated significant antihypertensive potential through multiple mechanisms:
| Activity | Result |
| ACE Inhibition | 64.24% ± 0.56% inhibition |
| DPPH Scavenging | Moderate activity (82.88% ± 0.57%) |
| Phytochemical Content | Saponins, flavonoids, tannins, cardiac glycosides, anthraquinones, alkaloids |
The study concluded that Picralima nitida possesses significant angiotensin-converting enzyme inhibitory activity, supporting its traditional use as an antihypertensive agent.
4.3 Kigelia africana
Kigelia africana demonstrated notable antioxidant properties:
| Activity | Result |
| DPPH Scavenging | 94.55% ± 0.11% |
| Ferric Reducing Power | 5.50 ± 0.41 μg TE/mg |
| Phytochemical Content | Saponins, flavonoids, tannins, cardiac glycosides, anthraquinones, alkaloids |
The results support the traditional use of Kigelia africana as an alternative therapy for hypertension and oxidative stress.
4.4 Mangifera indica
Mangifera indica (mango) demonstrated exceptional antioxidant activity:
| Activity | Result |
| DPPH Scavenging | 95.20% ± 0.03% (highest among tested plants) |
While mango is more commonly consumed as a fruit, its leaves are used traditionally for hypertension management, and this study provides scientific validation for this practice.
4.5 Clerodendrum volubile
Clerodendrum volubile, a plant commonly consumed in Nigeria, demonstrated nephroprotective and blood pressure-lowering effects in a study on rats. Key findings included:
- Decreased blood pressure parameters (systolic and diastolic blood pressure)
- Decreased renal functional markers (BUN and creatinine)
- Decreased oxidative stress markers (malondialdehyde and hydrogen peroxide)
- Increased activities of enzymatic antioxidants and vitamin C
- Decreased podocin and angiotensin-converting enzyme immunohistochemical expressions
The study concluded that C. volubile exerts its effects through anti-inflammatory, antioxidant, and ACE-inhibitory pathways, providing scientific support for its traditional use .
4.6 Vernonia amygdalina, Ocimum gratissimum, and Piper guineense (Black Soup)
An in silico study assessed the antihypertensive potential of phytoconstituents in these three commonly consumed leafy vegetables used in traditional “black soup” in Edo State, Nigeria.
| Plant | Common Name |
| Vernonia amygdalina | Bitter leaf |
| Ocimum gratissimum | Scent leaf |
| Piper guineense | Uziza |
The bioactive compounds were docked against key hypertension targets:
- Angiotensin-converting enzyme (ACE; 1O86)
- Renin (2V0Z)
- Angiotensin II type-1 receptor (AT1R: 4ZUD)
Several phytoconstituents demonstrated binding affinities comparable to reference antihypertensive agents (Lisinopril, Aliskiren, and Olmesartan) with stable interactions observed within the active sites of the target proteins. Pharmacokinetic screening indicated favourable oral bioavailability and drug-likeness profiles. The findings suggest that these commonly consumed vegetables contain bioactive molecules capable of modulating key pathways involved in blood pressure regulation.
4.7 Nauclea latifolia
Nauclea latifolia, used in Nigerian folk medicine for hypertension, was evaluated for cardiovascular activity in rats. Key findings:
| Parameter | Result |
| Vasodilator action on aorta | 40% relaxation on contracted thoracic aorta pre-contracted with phenylephrine |
| Lipid profile | No significant change |
| Serum K⁺ concentration | Significant increase |
| Serum Na⁺ concentration | No significant change |
The study concluded that the increase in serum K⁺ may be contributing to the vasodilator effect of Nauclea latifolia.
4.8 Chenopodium ambrosoides
Chenopodium ambrosoides, used in Nigeria for hypertension and obesity, demonstrated significant antioxidant and antihypertensive activities:
In Vitro Activities:
| Assay | Activity at 2.5 mg/ml |
| Ferric Reducing Power | 77.030% (higher than ascorbic acid at 69.159%) |
| DPPH Scavenging | 81.161% (higher than ascorbic acid at 75.378%) |
| ACE Inhibition | 95.990% |
In Silico Analysis:
GCMS analysis identified 96 bioactive compounds, with 14 exhibiting higher negative binding affinities than lisinopril (−6.8 Kcal/mol). The compound 2,4-Diamino-6,8-bis[3,4-dichlorophenyl]-5,6-dihydro-8H-thiapyrano[4′,3’4,5]thieno[2,3d]pyrimidine had the highest binding affinity (−8.0 Kcal/mol).
The study concluded that “the anti-hypertensive activity demonstrated by C. ambrosoides might be mediated via its anti-oxidant ability and ACE inhibitory potential”.
5. Frequently Used Antihypertensive Plants in Nigeria
Based on available literature, the following plants consistently appear as the most frequently used for hypertension management across Nigeria:
| Plant Name | Common Name | Scientific Validation Level | Documented Use Locations |
| Vernonia amygdalina | Bitter leaf | High (multiple studies, in silico validation) | South East, Kaduna, Edo |
| Allium sativum | Garlic | Documented use | Ibadan, South East, Kaduna |
| Zingiber officinale | Ginger | Documented use | Ibadan, Kaduna |
| Moringa oleifera | Moringa | Highest use value/fidelity level | North Central, Kaduna |
| Hibiscus sabdariffa | Zobo | Documented use | Kaduna |
| Carica papaya | Pawpaw | Documented use | Kaduna |
| Ocimum gratissimum | Scent leaf | In silico validation | Kaduna, Edo |
| Persea americana | Avocado | Documented use | Ibadan, Kaduna |
| Rauwolfia vomitoria | African snakeroot | Documented use | Ibadan |
| Kigelia Africana | Sausage tree | High (antioxidant activity) | Ibadan |
| Picralima nitida | – | High (ACE inhibition) | Ibadan |
| Nauclea latifolia | African peach | Moderate (vasodilator action) | South East |
5.1 Vernonia amygdalina (Bitter Leaf)
Most Common Use: Bitter leaf appears consistently across surveys as the most frequently used antihypertensive plant. In the South East Nigeria study, bitter leaf was used by 90.9% of CAM users.
Preparation: Typically prepared as a decoction or leaf sap and taken orally.
Scientific Validation: In silico studies have demonstrated that phytoconstituents from Vernonia amygdalina bind effectively to key hypertension targets, supporting its traditional use.
5.2 Allium sativum (Garlic)
Prevalence: Garlic was used by 72.7% of CAM users in the South East Nigeria study.
Preparation: Methods include chewing the bulb, consuming powdered bulb on food, or as a cool macerate. It is “mostly use as add up therapy with other herbs”.
5.3 Zingiber officinale (Ginger)
Preparation: Prepared as a hot tea or decoction, sometimes in combination with Hibiscus sabdariffa.
Usage: Widely documented across multiple regions of Nigeria.
5.4 Hibiscus sabdariffa (Zobo)
Preparation: The mature calyx and corolla are prepared as a decoction, sometimes mixed with honey or with ginger.
Usage: Particularly popular in Northern Nigeria; widely consumed as a beverage.
5.5 Persea americana (Avocado Leaves)
Preparation: Leaves are prepared as a decoction.
Usage: Documented in both Ibadan and Kaduna surveys.
6. Mechanisms of Action: How Nigerian Herbs Work
6.1 Angiotensin-Converting Enzyme (ACE) Inhibition
Several Nigerian plants have demonstrated ACE inhibitory activity, similar to the mechanism of action of conventional ACE inhibitor drugs like lisinopril:
| Plant | ACE Inhibition Activity |
| Picralima nitida | 64.24% ± 0.56% |
| Chenopodium ambrosoides | 95.990% at 2.5 mg/ml |
| Clerodendrum volubile | Demonstrated ACE inhibition (immunohistochemical evidence) |
| Vernonia amygdalina, Ocimum gratissimum, Piper guineense | In silico binding to ACE target |
6.2 Antioxidant Activity
Oxidative stress plays a significant role in the pathophysiology of hypertension. Nigerian antihypertensive plants demonstrate potent antioxidant properties:
| Plant | DPPH Scavenging Activity |
| Mangifera indica | 95.20% ± 0.03% |
| Kigelia africana | 94.55% ± 0.11% |
| Chenopodium ambrosoides | 81.161% at 2.5 mg/ml |
| Picralima nitida | 82.88% ± 0.57% |
6.3 Vasodilation
Nauclea latifolia demonstrated 40% relaxation on contracted thoracic aorta, indicating a direct vasodilator effect. The mechanism may involve increased serum potassium concentration.
6.4 Renin Inhibition
In silico studies have demonstrated that compounds from Vernonia amygdalina, Ocimum gratissimum, and Piper guineense bind effectively to the renin target (2V0Z), suggesting a mechanism of action that reduces blood pressure by inhibiting the renin-angiotensin-aldosterone system at an earlier stage than ACE inhibitors.
6.5 AT1 Receptor Blockade
The same in silico study showed binding to the angiotensin II type-1 receptor (4ZUD), suggesting that these plants may also act as natural angiotensin receptor blockers (ARBs), further modulating blood pressure through multiple pathways.
7. Commonly Used Medicinal Plants in Hypertension Management
7.1 Summary of Ethnobotanical Findings
| Region | Number of Plants Documented | Predominant Families |
| Ibadan Southwest/Northeast | 61 | Apocynaceae, Fabaceae |
| North Central States | 72 | Rubiaceae |
| Zango Kataf, Kaduna | 23 | 21 families |
| Ibadan North LGA | 101 | Compositae |
7.2 Most Frequently Mentioned Plants Across Studies
| Plant | Documented in Multiple Studies |
| Vernonia amygdalina | South East, Kaduna, Edo |
| Allium sativum | Ibadan, South East, Kaduna |
| Zingiber officinale | Ibadan, Kaduna |
| Moringa oleifera | North Central, Kaduna |
| Carica papaya | Kaduna |
| Persea americana | Ibadan, Kaduna |
| Ocimum gratissimum | Kaduna, Edo |
8. Safety Considerations and Clinical Implications
8.1 Key Safety Concerns
| Concern | Implication |
| Concurrent use without disclosure | 75.4% use TMPs with prescription drugs; most doctors unaware |
| Potential hypotension | Combined effects may lead to dangerously low blood pressure |
| Drug interactions | May interact with ACE inhibitors, ARBs, diuretics, calcium channel blockers |
| Lack of standardization | Variable potency and possible contamination |
| Limited safety data | Most evidence focuses on efficacy rather than safety |
| Patient knowledge gap | 72.7% of CAM users did not know the constituents of what they were taking |
8.2 Patient Disclosure
Multiple studies have documented concerning patterns of non-disclosure:
| Study | Non-Disclosure Rate | Primary Reason |
| South-Eastern Nigeria | Most doctors were unaware of TMP use | Lack of communication |
| South East Nigeria | 81.8% did not disclose to HCP | 66.7% feared HCP would discourage them |
8.3 Recommendations for Safe Use
For Patients:
- Disclose all herbal medicine use to healthcare providers
- Monitor blood pressure regularly to detect potential hypotension
- Use products from reputable sources, preferably with NAFDAC registration
- Do not replace prescribed medications without medical consultation
- Report adverse effects immediately
- Learn the constituents of herbal remedies being used
For Healthcare Providers:
- Ask about herbal medicine use during clinical consultations
- Provide evidence-based guidance on complementary therapies
- Monitor patients closely for drug interactions and adverse effects
- Document CAM use in patient records
- Consider further research on commonly used herbs
For Policymakers:
- Strengthen NAFDAC regulation of herbal products
- Fund research on antihypertensive plants
- Develop integration guidelines for traditional and orthodox medicine
- Support conservation of medicinal plant species
- Promote health education on safe CAM use
9. Holistic and Complementary Therapies
9.1 Lifestyle Modifications
Lifestyle modifications are foundational for hypertension prevention and management:
- Dietary Approaches to Stop Hypertension (DASH): Rich in fruits, vegetables, whole grains, nuts, legumes, lean protein, and low-fat dairy; markedly reduced in refined sugar, saturated fat, and cholesterol
- Reduced sodium intake: The combination of low sodium intake and the DASH diet provides substantially greater BP reduction than either intervention alone
- Regular physical activity: 150 minutes of moderate exercise weekly
- Moderation of alcohol consumption
- Weight management
9.2 Dietary Practices in Nigeria
The in silico study on “black soup” vegetables demonstrated that commonly consumed leafy vegetables contain bioactive molecules capable of modulating key pathways involved in blood pressure regulation, providing molecular support for their traditional dietary and medicinal relevance in hypertension management . This suggests that dietary practices already embedded in Nigerian food culture may have significant blood pressure-lowering benefits.
9.3 Prayer and Spiritual Practices
All 601 participants in the South-Eastern Nigeria study reported using prayers in addition to their prescribed medications. Prayer and fasting are commonly reported as spiritual methods used alongside other therapies. These practices may contribute to stress reduction and overall well-being, though their direct effects on blood pressure require further study.
9.4 Integration with Conventional Care
The studies reviewed consistently recommend:
- Patient-centered approach to CAM use
- Health education on risks and benefits of concurrent use
- Community engagement to raise awareness
- Workshops for CAM providers on safety and referral
- Strengthening health systems to reduce reliance on unregulated CAM
- Doctor-patient communication about herbal medicine use
10. Research Gaps and Future Directions
10.1 Research Needs
| Area | Priority |
| Human clinical trials | Most evidence from in vitro, in silico, and animal models; human safety and efficacy data needed |
| Long-term safety studies | Chronic use effects on liver, kidney, and other organs |
| Standardized dosing protocols | Defined dosing for herbal formulations |
| Drug interaction studies | Interactions between herbal remedies and ACE inhibitors, ARBs, calcium channel blockers, diuretics |
| Pharmacokinetic studies | Understanding absorption, distribution, metabolism, and elimination |
| Quality control methods | Developing affordable quality assurance methods |
| Mechanism of action studies | Cellular and molecular pathways of antihypertensive activity |
| Double-blind controlled trials | Gold-standard evidence for clinical use |
| Toxicity studies | Comprehensive toxicological profiles |
10.2 Opportunities
- Dual-acting agents: Plants with both antihypertensive and antidiabetic properties present opportunities for development of therapies for concurrent management of both conditions
- Functional foods: Edible plants with demonstrated antihypertensive properties could be developed as functional foods for prevention and management
- Traditional knowledge preservation: Documenting indigenous knowledge before it is lost
- Drug discovery: Nigeria’s flora is a “veritable source of bioactive leads for drug development”
The systematic review by Sylver-Francis and colleagues identified 79 medicinal plant species in 49 families with documented in vivo and/or in vitro pharmacological activities relevant to hypertension and diabetes management . The most represented families were Apocynaceae, Cucurbitaceae, Rutaceae, and Euphorbiaceae.
11. Conservation and Sustainability
According to ethnobotanical surveys, most medicinal plants used for hypertension management in Nigeria are sourced from the wild with little to no cultivation. This practice raises concerns about sustainability and potential endangerment of medicinal plant species over time.
Conservation Recommendations:
- Cultivation programs for frequently used medicinal plants
- Sustainable harvesting practices to prevent overexploitation
- Documentation of medicinal plant knowledge for future generations
- Protected areas for medicinal plant conservation
- Ex situ conservation through seed banks and botanical gardens
- Traditional knowledge preservation through pharmacopoeias and databases
12. Conclusion
Hypertension represents a significant and growing health challenge in Nigeria, with cases increasing by 540% between 1995 and 2020. The condition now affects over 27.5 million Nigerians and contributes substantially to morbidity, mortality, and economic burden. The limitations of orthodox antihypertensive medications, including side effects and high costs, have driven a significant proportion of the population toward traditional and complementary approaches.
The scientific literature reveals a rich diversity of Nigerian plants with antihypertensive potential. Ethnobotanical surveys have documented:
- 101 plant species in Ibadan North Local Government Area
- 72 medicinal plant species across six North Central States
- 61 plant species in Ibadan markets
- 23 antihypertensive plants in Zango Kataf, Kaduna State
Scientific validation of these plants has progressed considerably:
- Picralima nitida demonstrated 64.24% ACE inhibitory activity
- Mangifera indica and Kigelia africana showed DPPH scavenging activity exceeding 94%
- Chenopodium ambrosoides showed 95.99% ACE inhibition and 14 compounds with binding affinities exceeding lisinopril
- Clerodendrum volubile demonstrated blood pressure-lowering effects through anti-inflammatory, antioxidant, and ACE-inhibitory pathways
- Vernonia amygdalina, Ocimum gratissimum, and Piper guineense showed in silico binding to ACE, renin, and AT1 receptor targets, supporting their traditional use
- Nauclea latifolia demonstrated 40% vasodilator action on thoracic aorta
However, the high prevalence of concurrent herbal and orthodox medicine use (75.4% in one study) raises significant safety concerns. The lack of disclosure to healthcare providers (81.8% in another study) compounds these risks, preventing proper monitoring for drug interactions and adverse effects.
The path forward requires:
- Acknowledging and respecting traditional knowledge while subjecting it to scientific scrutiny
- Strengthening regulatory oversight of herbal products through NAFDAC
- Promoting open communication between patients and healthcare providers
- Investing in research on safety, efficacy, and mechanisms of action
- Developing integration strategies that combine the best of both systems
- Preserving and documenting indigenous knowledge before it is lost
- Promoting conservation of medicinal plant species
- Supporting lifestyle modifications including DASH diet and physical activity
As Nigeria continues its fight against hypertension, the careful integration of evidence-based traditional medicine into the healthcare system, combined with strengthening primary healthcare services and promoting healthy lifestyles, offers promising strategies for improving blood pressure control and reducing the burden of cardiovascular disease.
13. References
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- Opone CO, Sonibare MA, Mada OO, Oyagbemi AA. Ethnobotanical study of medicinal plants used in the management of hypertension in Ibadan, Nigeria. Nigerian Journal of Natural Products and Medicine. 2025;28(1).
- Adeoye BO, Ajibade TO, Adesanya A, et al. Ameliorative effects of Clerodendrum volubile on acute kidney injury and associated cardiovascular dysfunctions in rats. Sokoto Journal of Veterinary Sciences. 2025;23(1):28-37.
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- Ethnobotanical survey and evaluation of antioxidant and angiotensin-converting enzyme inhibitory activities of selected medicinal plants. ScienceDirect. 2026.
- Ogbeide UM, Owowenu KO. In Silico Antihypertensive Potential of Phytoconstituents in Indigenous Leafy Vegetables Black Soup of Vernonia amygdalina (Bitter Leaf), Ocimum gratissimum (Scent Leaf), and Piper guineense (Uziza) in Edo State, Nigeria. Journal of Applied Sciences and Environmental Management. 2026;30(5):152