12/04/2026
Most Nigerian doctors are still treating high blood pressure in 2026 the way they were taught to treat it in 1996.
But the science has moved forward.
And there is a piece of the story many patients are never told.
One of the biggest drivers of Hypertension today is not just salt, stress, or family history.
It is Insulin resistance.
This is the condition where your cells stop responding properly to insulin, and your body compensates by producing more and more of it.
When insulin stays high for too long, several things begin to happen at the same time.
Your kidneys start holding on to more sodium, which increases blood volume and raises pressure.
Your blood vessels become less flexible because chronic insulin elevation promotes inflammation in the vessel walls.
Your nervous system stays in a constant low-level âonâ state, keeping your heart rate and vascular tension elevated.
Your body stores more visceral fat around your organs, and that fat releases inflammatory signals that worsen the problem.
You also begin to lose key minerals like magnesium, which your body needs to relax blood vessels properly.
All of this happens quietly.
For years. Sometimes decades.
Then one day, you are diagnosed with hypertension.
You are placed on medication.
Maybe Amlodipine.
Maybe Losartan.
The numbers improve on paper.
But the underlying issue is still there.
So over time, the dose increases.
Another drug is added.
Then another.
Years pass, and the root cause has still not been addressed.
The missing test in many of these cases is simple.
Fasting insulin.
Not just fasting glucose.
Glucose can stay normal for years while insulin quietly rises.
By the time glucose becomes abnormal, the damage is already advanced.
As a general guide:
A fasting insulin above 10 suggests a problem.
Above 15 is more serious.
Above 20 indicates significant metabolic strain.
Many people with long-standing hypertension fall within this range without ever being told.
When insulin resistance is addressed, things begin to shift.
As insulin levels drop, blood pressure often improves.
Kidney function can stabilise.
Mineral balance improves.
And medications that once seemed insufficient may suddenly feel too strong because the underlying pressure has reduced.
This does not mean medication is unnecessary.
Some people will still need it long-term, especially if there are other contributing conditions.
But for many, there is a missing layer that has never been explored.
If your blood pressure has been rising despite âdoing everything right,â it may be time to look deeper.
Ask for a fasting insulin test.
If needed, run it privately.
Then interpret it in context, not in isolation.
And share this with someone whose medication keeps increasing while the real driver remains untouched.
