Nigeria’s Cholesterol Crisis: The Young Lives Lost Before the Warning Signs
Oluwatobi Adu 
ABUJA, Nigeria – On a humid Lagos morning, the news spread quickly through a neighbourhood gym: a regular had collapsed mid-workout and died before help could arrive. He was 38, disciplined about exercise, careful with his diet, and faithful with his medication. To many, his sudden death felt inexplicable. To cardiologists, it did not. Across Nigeria, a silent public health emergency is claiming lives long before old age has a chance to arrive. Hidden in blood vessels, building without pain or visible symptoms, dangerously high cholesterol is fuelling heart attacks and strokes among Nigerians in their 20s, 30s and 40s. It rarely announces itself. It simply strikes.
In this report, Oluwatobi Adu speaks with leading cardiologists and affected families to unpack the growing cholesterol burden in Nigeria — why it is worsening, why young people are dying suddenly, and why experts warn the country is edging towards a cardiovascular catastrophe unless urgent preventive action is taken.
A global killer tightening its grip on Nigeria
Cardiovascular diseases remain the world’s number one cause of death. The World Health Organisation estimates that heart disease and stroke kill around 17.9 million people every year — more than cancers, respiratory illnesses and infectious diseases combined. Crucially, more than 80% of these deaths are due to heart attacks and strokes, and about one-third occur prematurely in people under 70.
Nigeria is not immune. In fact, it may be uniquely vulnerable.
As infectious diseases continue to drain health resources and economic pressures shape daily survival, non-communicable diseases have crept steadily into homes, workplaces and places of worship. High blood pressure, diabetes, obesity and physical inactivity — all key drivers of high cholesterol — are rising rapidly, particularly among young adults living urban, stressful, sedentary lives.
Yet routine cholesterol testing remains rare. “Most Nigerians have never had a lipid profile test in their lives,” says Professor Augustine Odili. “They don’t know what their cholesterol levels are — until something catastrophic happens.”
‘Many die without knowing they had high cholesterol’
Professor Odili is President of the Nigerian Cardiac Society, Professor of Cardiovascular Medicine at the University of Abuja, and a Consultant Cardiologist at the University of Abuja Teaching Hospital. In an exclusive interview with Africa Health Report, he offers a blunt assessment of the danger ahead. “Physical inactivity, hypertension and diabetes often begin quietly in the body,” he explains. “There are usually no symptoms. The chances are very high that someone with these conditions also has high cholesterol without realising it.”
High cholesterol, he stresses, is a classic “silent” disease. Unlike infections, it does not cause fever or pain. Fatty deposits accumulate slowly in blood vessels, narrowing arteries and damaging the heart over years — sometimes decades — before the first warning sign appears as a heart attack or stroke.
“The only reliable way to detect it is through a blood test called a lipid profile,” Odili says. “You measure total cholesterol, LDL — the so-called bad cholesterol — HDL, which is the good one, and triglycerides.”
He recommends routine cholesterol checks for people with hypertension or diabetes, those with a family history of heart disease, everyone over the age of 40, and younger adults who carry multiple risk factors.
But even that is not always enough.
When genetics load the gun early
Among the lesser-known threats is Familial Hypercholesterolaemia (FH), a genetic disorder that causes extremely high cholesterol from birth. It does not announce itself with obesity or poor fitness. “It is less common,” Odili says, “but when it occurs, cholesterol levels can be dangerously high from childhood. These patients can have heart attacks as early as their 20s or 30s.”
Slim, physically active and seemingly healthy young Nigerians may still fall victim, leaving families stunned and confused.
‘The damage had been building for years’
The widow of the 38-year-old gym enthusiast says her husband had known about his condition and taken it seriously. “He had mild chest discomfort and did tests, which showed very high lipid levels,” she recalls. “He managed it so well — going to the gym every day, eating healthy and taking his medication faithfully.”
Yet years of silent damage had already been done. “One morning at the gym, he just slumped,” she says. “The doctors said the damage had been building for years.”
Another story has a different ending — because of a simple test.
Miss Tola, 32, spent two years battling persistent skin itching she assumed was an allergy.
“I never imagined it could be related to my heart,” she says.
Eventually, a doctor suggested a lipid profile test. “My cholesterol and triglycerides were very high,” she explains. “Since I changed my diet and started exercising, the itching stopped and I feel much better.”
Her experience highlights critical truth cardiologists often emphasise: early detection saves lives.
The lifestyle trap tightening around the young
According to Professor Odili, Nigeria’s changing lifestyle is accelerating the crisis. Large portions of carbohydrate-heavy meals, increased consumption of fried snacks, red meat, cakes, butter and sugary drinks, combined with long hours in traffic, desk-bound jobs and rising screen time, have created a perfect metabolic storm. Abdominal obesity is now increasingly common, even among those who do not see themselves as overweight.
“The first law of thermodynamics still applies,” he says. “Excess energy from food — whether carbohydrates, fats, sugar or alcohol — that is not used is converted into fat and stored in the body, including as cholesterol.”
In short: the body never forgets what it cannot burn.
Prevention does not have to be expensive
Despite the grim statistics, Odili is emphatic that cholesterol-related disease is largely preventable. “We don’t need expensive drugs at the beginning,” he says. “Lifestyle change is the most powerful medicine.”
He recommends simple but consistent steps: regular checks of blood pressure, blood sugar and cholesterol, smaller food portions, less saturated fat and refined sugar, and daily physical activity — whether walking, climbing stairs, cycling or home exercise.
The government, he argues, also has a role to play. “Walkways, bicycle lanes, green spaces and safe recreational areas are not luxuries,” he says. “They are public health infrastructure.”
Public awareness campaigns on cholesterol and heart disease, he adds, should be as visible as those for malaria or HIV.
A national wake-up call
Nigeria prides itself on having one of the youngest populations in the world. But without intervention, that demographic advantage could dissolve into a surge of premature deaths.
As people grow heavier, more sedentary and more stressed, the cholesterol time bomb continues to tick. Experts warn that without affordable testing, sustained awareness and a cultural shift towards healthier living, sudden deaths will become increasingly common — in offices, churches, gyms and homes.
The message from Nigeria’s cardiologists is stark but simple: get tested early, change your lifestyle, and never wait for symptoms.
Because when cholesterol finally announces itself, it often does so without mercy.
About the Author
Korede Abdullah 
Koko Maxwella