The Alarming Reason Behind Increased Incidences of Hypertension in Patients
Uncontrolled hypertension—a key risk factor for heart attack and stroke—is likely one of the main reasons why, over the last decade, cardiovascular diseases have emerged as the leading cause of death in India.
According to the India Council for Medical Research, one in every four adults in India has hypertension, and just 10% of patients have their blood pressure under control.
The India Hypertension Control Initiative (IHCI) study was undertaken in two stages. During its first year, IHCI served 26 districts in Punjab, Kerala, Madhya Pradesh, Telangana, and Maharashtra. Phase-2 started in July 2019, and by December 2021, it will have reached 101 districts in 19 states and enrolled more than 20 lakh people in 13,821 health facilities, including 10,222 Health & Wellness Centers (HWC)/Subcenters.
One-fifth of the patients were registered in the first 26 districts. The following states had the highest proportions: Maharashtra (27%), Kerala (22.6%), Madhya Pradesh (18.7%), Telangana (18.6%), and Punjab (18.6%). (14.2 %) The COVID-19 pandemic, on the other hand, hindered enrollment.
"From April 2020 to March 2021, 740,000 patients were cared for at the 4,505 health facilities in five phase I and three phase II states." Nearly half (47 percent) of registered patients under care had blood pressure (BP) under control during their most recent visit in the first quarter of 2021."Blood pressure control was highest (55%) at HWC and second highest (48%) at PHC (primary health centre), followed by 44 percent in hospitals and 37 percent in CHC (community health centre) facilities," said Dr Prabhdeep Kaur, head of noncommunicable diseases at the ICMR-National Institute of Epidemiology in Chennai.
She said that nearly one-fourth (23%) of the patients under her care had uncontrolled blood pressure, and 27% did not return for follow-up in the first quarter of 2021.
Meanwhile, cardiologists stressed that regulating blood pressure for 25 million people could avoid up to 500,000 deaths from cardiovascular disease over the next ten years.
"Undiagnosed or improperly treated high blood pressure relates to a very high disease burden of heart attacks and failure, brain strokes, kidney disease, vascular dementia, aneurysms, and blood channel blocks." Primary care services must be strengthened in order to detect hypertension early, assess co-existing risk factors, and provide ongoing long-term care. We must also build the ability for self-monitoring and care. The benefits of hypertension control will be enormous for India's health, "stated Prof. K. Srinath Reddy, head of the Public Health Foundation of India.
It is a well-thought-out ICMR intervention. detection of hypertension in over 100 districts, establishment of testing facilities, as well as drug availability, follow-up, and correction of flaws such as drug supply problems. Initial results showed that BP had 50 percent control, which will improve now that infrastructure is in place. Also, one-fourth of the patients were lost to follow-up, so efforts to find them will help this endeavour," said Dr. Sandeep Seth, professor of cardiology at the All India Institute of Medical Sciences.
In a COVID-adjusted society, experts consider hypertension treatment to be a critical strategy for averting or mitigating the impending NCD superstorm. Recognizing the need for immediate and incremental action, the Ministry of Health and Family Welfare (MoHFW), WHO representatives, AIIMS doctors, and representatives from other national and international organisations convened in the capital for a national consultation to devise a strategy to combat the alarming rise in hypertension among Indians.
According to experts, uncontrolled hypertension—a key risk factor for heart attack and stroke—is likely one of the main reasons why cardiovascular illnesses have emerged as the leading cause of death in India over the previous decade. Dr Pankaj Bharadwaj, Additional Professor, AIIMS Jodhpur, explained that discontinuing or irregularly taking blood pressure medications leaves people vulnerable. "More than 63% of all deaths in India are due to NCDs, and a large number of these deaths are linked to the underlying condition of hypertension." Even though screening has improved over the past few years, only half of people with high blood pressure have been found, and only one in ten have their blood pressure under control.
Because of the COVID-19 pandemic, many health systems and governments around the world have been forced to prioritise the urgent fight against COVID-19 over the management of chronic disorders. Healthcare systems in India have faced unexpected challenges, slowing or delaying recent progress.In light of this looming public health catastrophe, the Indian government has pledged a 25% relative reduction in hypertension prevalence by 2025. According to Prof. Atul Goel, Director General of Health Services, Ministry of Health and Family Welfare, achieving this target will necessitate efficiently treating at least 15 crore individuals by 2024. "Efforts are underway to boost primary health care, on which at least 50 million Indians rely, to streamline medicine availability at AB-HWCs, to increase follow-ups, and to enable more patients to stay within the treatment net." The MoHFW is implementing innovations and changes that will go a long way toward resolving structural challenges that impede treatment, such as recommendations to ensure that all important medicines, including those for high blood pressure, are dispensed for up to three months. The rapid expansion of e-Sanjeevani, the government's telemedicine service, which recently clocked 3.5 lakh daily consultations, has been a benefit for patients with chronic diseases. "
Hypertensive Indians account for around 33% of urban and 25% of rural Indians. Twenty-five percent of rural Indians and 42 percent of urban Indians are aware of their hypertension condition. Only 25% of rural Indians and 38% of urban Indians are getting treated for hypertension. One-tenth of rural Indian hypertension people and one-fifth of urban Indian hypertension people have their blood pressure under control.