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  • Sudden deaths

    Sudden deaths

    Approximately 173,000 deaths occur daily in 2025. As the year runs out soon, it is estimated that about 64 million people would have died this year alone, based on a global crude death rate of 7.67 deaths per thousand population. Of this number, about 15 million were sudden deaths. Whether we like it or not, we will be part of the statistics some day.  

    We may accumulate all the wealth we want now, eat the best foods money can buy, use the best doctors and healthcare facilities in the world, or pray or sacrifice all we want, we cannot avoid death. It is the only certainty we know for sure. That is why at the news of someone’s death, the Yoruba would say ojó á jìnnà sí’ra won o. It is a way of praying for longevity, knowing full well that our turn will come. Nevertheless, we still mourn deaths, especially sudden deaths. This particularly true of the death of someone we saw or spoke with hours ago, who was otherwise hale and hearty and was not involved in an accident. Within the past few months, many such cases have made the news in Nigeria alone.

    Nine months ago, I wondered why more young people were dying prematurely (Why more young people are dying these days, The Nation, March 12, 2025). Today, my focus is on the rise in adult sudden deaths in the world at large but particularly in Nigeria.

    By adult sudden death, I mean a situation in which an apparently healthy adult (say, 50+) suddenly dies, often from natural causes, rather than from an accident. I use the word “apparently” advisedly: There are often undisclosed or unknown underlying causes.

    The most prevalent underlying cause of sudden death has to do with a heart problem. Cardiac arrest occurs when the heart suddenly stops working. When this happens, the person suddenly loses consciousness. If CPR is not available there and then, the organs needed to keep the person alive will stop working because the blood has stopped carrying oxygen to them. As a result, death can happen within minutes, or at most within an hour of onset.

    I always remember a close friend, who was alert enough to get behind the steering and start driving. After driving for about 30 minutes or so, he noticed that he was getting rather weak. He wisely parked his car off the road to take a brief rest. He leaned on the steering wheel and passed on minutes later. What he did not realize was that his heart was shutting down and his organs were failing, even when he felt no pain.

    There are many heart diseases that could lead to cardiac arrest, such as coronary artery disease (for example, due to high cholesterol), plaque disruption, abnormal heart rhythm, and faulty heart’s electrical system. There are also non-cardiac causes of sudden death, such as a massive stroke or blood clot. When clotted blood breaks, small lumps can travel to block the passage of blood to the heart, the lungs, or the brain, depending on the location of the clot and how far it is able to travel.

    In addition to medical conditions, lifestyle, diet, smoking, alcohol consumption, lack of exercise, and irregular or no medical check-ups could trigger or conceal any of various underlying conditions.

    It is possible to die suddenly without a clear symptom. However, some individuals may experience palpitations, chest pain, dizziness, fatigue, or shortness of breath before sudden death. These individuals often have underlying heart or lung problems that are either unrecognized or ignored. Others may have have stopped taking medication for high blood pressure, asthma, or any other medical condition. In such cases, sudden death is a possibility. That’s why anyone experiencing any of these problems is advised to see a doctor at once, especially those who know that they have one underlying condition or the other.

    The possibility of sudden death is heightened by lack of self awareness of their body and health problems; unwillingness to disclose medical problems to those who could help; lack of, or delayed, access to medical care; misdiagnosis; sheer ignorance; poverty; and illiteracy.

    Although precise worldwide data on sudden death varies, depending on data collection methods, autopsy rates, and documentation culture. However, it is estimated that over 15 million people die suddenly every year and that many cases are unreported. Sudden cardiac arrest accounts for about 5 million cases of sudden deaths worldwide.

    Reliable statistics are hard to come by in Nigeria. Nevertheless, a study published in 2013 showed that cardiac arrest accounted for about 50 percent of all cases of sudden death between 2003 and 2011 at the Ladoke Akintola University of Technology Teaching Hospital. While only 4 percent of the cases occurred in less than 24 hours after admission, about 72 percent of cases occurred out of hospital. The data derived from case notes and autopsy reports of cases of sudden death.

    The LAUTECH data cited above were collected over a decade ago. In the last five years, coronavirus hangover, environmental stress, economic pressures, ultra-processed foods, and self-medication have complicated our lives. Besides, silent killers, such as cancers and other noncommunicable diseases, have been on the rise.

    That is why it is important to take certain precautionary measures to avoid premature or sudden death. The usual precautions include (a) a heart-healthy diet, rich in fruits, vegetables, nuts, whole grains, and low in salt, sugar, and unhealthy fats; (b) avoid alcohol and self-medication in managing stress; (c) exercise regularly—walking and stretching will go a long way in toning the body and the heart; (d) keep blood pressure, cholesterol, blood sugar, and complete blood count in check—you should track your base white cell, red cell, and platelet counts; and, above all, maintain regular medical check-ups.

    My heart goes to families who have lost a family member to sudden death. For those who are still here, ojo á jìnnà sí’ra won o. For those on the other side, may their souls rest in peace.

  • What really causes sudden deaths?

    What really causes sudden deaths?

    One moment, someone is laughing, dancing, or chatting with friends. The next, they collapse—gone in seconds. In Nigeria, such sudden deaths are often wrapped in superstition and whispered about in spiritual tones. But for medical experts, these are not mysteries—they are preventable tragedies. The culprits are silent killers: undiagnosed hypertension, diabetes, and heart disease—conditions that thrive in a health system where preventive care is often overlooked, reports CHINYERE OKOROAFOR

    It was supposed to be a joyous afternoon. Under the thick heat of an Abia State sun, the annual August Meeting in Ugwunagbo Local Government Area was in full swing. The women, adorned in vibrant attire, awaited the arrival of the First Lady, Mrs. Priscilla Chidinma Otti. Among them was 65-year-old performer Mrs. Nwandinma Dickson, fondly known as “Nwayi Garri,” whose humour and theatrics had become a highlight of the event. With her signature energy, she danced from canopy to canopy, drawing laughter and cheers.

    But just as her performance peaked, the mood turned. She stooped—briefly—as if for a dramatic pause. The crowd clapped, thinking it part of her act. Then she staggered, collapsed, and began foaming at the mouth. Laughter turned to screams. She was rushed to a hospital in the mayor’s vehicle. But it was too late. The doctors pronounced her dead on arrival. To the stunned community, her death seemed sudden. Doctors know better, saying her collapse was most likely the result of an undiagnosed or unmanaged health condition—an all-too-common occurrence in Nigeria, where medical checkups are rare and silent killers often go unnoticed.

    Mrs. Dickson’s tragic end is not isolated. Legendary singer Onyeka Onwenu reportedly collapsed after performing at the 80th birthday celebration of Emzor Pharmaceuticals founder, Stella Okoli. Abdullahi Bala, former Deputy Governor of Niger State, slumped after returning from his farm. And Dr. Oluwafemi Rotifa, a respected physician at Rivers State University Teaching Hospital, died unexpectedly despite his knowledge of medicine. Each case adds to a growing list of lives cut short—lives that could have been saved. Yet, in many communities, such deaths are still explained away as the work of “village people” or malevolent spiritual forces. This belief persists, even as medical evidence points clearly to preventable causes.

    Hidden drivers of sudden death

    The World Health Organisation (WHO) defines sudden death as one that is non-violent and occurs within 24 hours of symptom onset. The International Classification of Diseases (ICD) lists cardiovascular disease as the most frequent culprit, though not the only one. Other conditions—diabetes, aneurysms, undiagnosed infections, and even certain neurological issues—can be silent until it’s too late.

    Dr. Casmir Ifeanyi, National President of the Association of Medical Laboratory Scientists of Nigeria (AMLSN), insists that no death is truly sudden. “The body often gives warning signs such as chest pain, dizziness, breathlessness, or fatigue, but these are frequently ignored until it is too late,” he said. According to him, what Nigerians commonly refer to as sudden death usually results from long-standing, undiagnosed conditions such as hypertension, diabetes, heart disease, or dyslipidaemia. Grouped under non-communicable diseases (NCDs), these illnesses are often silent because many Nigerians do not undergo routine medical check-ups.

    “Many people walk around with diabetes without knowing. A person can slip into a diabetic coma and die without ever being diagnosed. The same applies to hypertension, rightly described as the silent killer,” Dr. Ifeanyi explained. He also highlighted dyslipidaemia—abnormal levels of fat in the blood—as another invisible danger. “It is symptomless and only detectable through laboratory tests, yet it drives heart attacks, strokes, and ultimately sudden death.”

    Public health expert Dr. Ekiyor Amafah echoed these concerns, stressing that sudden death is largely medical and strongly linked to heart-related conditions and lifestyle factors. “It can strike while a person is awake, active, or even asleep,” he said. For both experts, hypertension and its complications—hypertensive heart disease, congestive heart failure, stroke, and heart attack—remain the leading culprits. Dr. Amafah noted that, “Hypertension doesn’t shout. A person can look very healthy and drop dead tomorrow. That’s how dangerous it is.”

    He added that hypertension alone is responsible for more than 70 per cent of strokes and heart attacks seen in Nigerian hospitals, yet most people do not check their blood pressure until they collapse. Other notable triggers include diabetes, cardiac arrhythmias, aneurysms, and metabolic issues such as dangerously low blood sugar or electrolyte imbalances. Cardiac arrest, often precipitated by cardiovascular disease, is the most common immediate cause of sudden death. Drug overdose and ruptured aortic aneurysm are also contributing factors.

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    Dr. Amafah noted that people at risk of sudden death—outside of lifestyle habits that cause illnesses such as high blood pressure, obesity, and diabetes—include those with genetic risks, like inherited heart problems such as Hypertrophic Obstructive Cardiomyopathy (HOCM), which have caused young athletes to collapse, and congenital risks from birth defects like long QT syndrome or heart block, which affect the heart’s rhythm. He disclosed that over the past 25 years in Nigeria, hypertension cases among adults over 30 have tripled. “Hypertension is now the leading risk factor for cardiovascular diseases, which account for most cases of sudden death in the country.”

    Beyond cardiovascular disease, experts say sudden death can result from other medical emergencies such as electrolyte imbalances, dangerously low blood sugar in people with severe diabetes, severe oxygen deprivation during drowning or high-altitude exposure, extreme cold causing hypothermia, and blood clots traveling to vital organs like the heart, lungs, or brain.

    Sudden death myths and what must change

    In Nigeria, sudden deaths are often attributed to witchcraft, curses, or “village people.” However, experts are urging a shift from superstition to science. “We must stop spiritualising health issues. If you drink soda daily, eat junk, never exercise, and avoid the hospital, don’t blame the devil when your heart fails,” Dr. Amafah said. Dr. Ifeanyi echoed this sentiment: “The common belief is, ‘his enemies killed him.’ That myth is killing more people than the diseases themselves.”

    Experts are sounding the alarm that Nigeria’s fast-paced urban lifestyle is fuelling a silent health crisis. The daily mix of fast food, sedentary office routines, stress, smoking and alcohol is driving up cases of hypertension, diabetes and heart disease—now striking younger Nigerians once thought immune. “Our bodies were not built for endless sitting, junk diets, and relentless stress. These are slow poisons everywhere around us, and unless we act, they will shorten lives,” said Dr. Ifeanyi.

    Dr. Amafah adds that while genetics matter, lifestyle is often the bigger threat. “You may not inherit hypertension, but unchecked salt intake, obesity, smoking, and alcohol can push you straight into danger,” he explains. Both experts decry Nigeria’s poor health culture, where many delay care until it is too late. Men, in particular, neglect routine checks. Rising reliance on processed foods, they warn, is already linked to kidney disease, cancer, and even childhood diabetes.

    For Dr. Ifeanyi, the way forward is clear: Nigeria must shift from a culture of reaction to one of prevention. He advises that Nigerians begin routine health screenings as early as age 20, including checks for blood pressure, blood sugar, cholesterol, kidney and liver function, and full blood counts. Complementing this, he stresses the need for balanced diets, regular exercise, stress management, and adequate sleep. “In the military, you cannot progress without annual medical certification. Civil servants and others should have the same requirement. These simple tests can save thousands of lives,” he said.

    He called for a comprehensive national health strategy that prioritises preventive care. At its core is a proposal for mandatory annual or biennial check-ups for every adult above 20, with key diagnostic tests—blood pressure, cholesterol, diabetes, and certain cancers—covered under national and state health insurance. This, he argued, would eliminate financial barriers and promote early detection. Public awareness campaigns must also play a role, Dr. Ifeanyi insisted, to highlight the dangers of “silent killers” like hypertension and diabetes that often go unnoticed until it is too late. He further recommended workplace reforms, such as mandatory health certifications for employees, particularly in high-stakes sectors. Beyond this, schools, offices, and communities should actively promote healthy lifestyles, from nutrition education to opportunities for physical activity. “Prevention is cheaper than cure. A BP test costs less than N1,000, while treating a stroke can drain millions,” he warned.

    Yet the obstacles are real. At a Lagos market, trader Madam Janet Eze admitted, “Hospital is for rich people. If I go for tests and they find sickness, who will pay? It is better I don’t know.” Similarly, young banker Chidi Okeke recalled discovering dangerously high blood pressure during a company outreach. “The doctor said I could have had a stroke anytime,” he said. Such stories underline how poverty and neglect push many Nigerians to gamble with their health.

    The statistics are sobering: hypertension cases in Nigeria have tripled in the last 25 years, and the World Health Organisation warns that deaths from non-communicable diseases (NCDs) will continue to climb by 2030 unless urgent action is taken. Today, more than one in three adults lives with high blood pressure—many without knowing it. Yet the health system remains reactive, focused more on treatment than prevention. “Our hospitals are overwhelmed with emergencies because we spend more treating late-stage diseases than preventing them. It’s like fetching water with a basket,” observed Dr. Amafah.

    Despite strides toward universal health coverage, the National Health Insurance Scheme (NHIS) covers only about 10 percent of Nigerians, and routine medical checks are excluded. “People only seek care when they are already sick—often too late,” noted Dr. Ifeanyi. He urged the National Health Insurance Authority (NHIA) to include annual routine health checks in its package, stressing that prevention must be the cornerstone of care. Affordable access to standalone laboratories and specialist facilities, he said, would also save lives by reducing delays. “Sudden death is now a menace in Nigeria,” Dr. Ifeanyi warned. Dr. Amafah echoed: “Check your BP, sugar, cholesterol. That is the real prayer against sudden death.”