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Curbing high blood pressure by 2025

A patient has their blood pressure measured in Howrah, West Bengal. Image credit: Biswarup Ganguly [GFDL (http://www.gnu.org/copyleft/fdl.html) or CC BY 3.0 (https://creativecommons.org/licenses/by/3.0)], from Wikimedia Commons
In an ambitious campaign to reduce instance of high blood pressure, the Indian Council of Medical Research (ICMR) and the World Health Organization (WHO) have launched the India Hypertension Control Initiative (IHCI), covering 25 districts across five states.

The 25 districts are only the beginning of the campaign: the ICMR intends to expand the initiative to cover 100 districts across the nation over the next few years. The objective is to achieve a 25 percent reduction in the prevalence of high blood pressure — or hypertension — in the county by 2025.

According to the ICMR, around 10.8 percent of deaths in India are attributable to hypertension. Despite this figure, accurate estimates for the overall prevalence of hypertension are all but impossible. Numerous studies have tried to establish estimates and turned up significantly varied figures. According to Dr Subhojit Dey, the number of people living with hypertension in India is around 224 million – around seventeen percent of the total population. 

Hypertension is both preventable and treatable, though efforts to prevent the condition may be far more beneficial to public health. Slight lifestyle changes such as exercise and healthier diets can go a long way to reduce risks of developing hypertension. Treatment, however, could be an expensive endeavour for many Indians. Even with an insurance policy, many will still pay out of pocket for prescriptions. Concerningly, only eight percent of people with hypertension control their blood pressure. As Dr Dey told Health Issues India on World Hypertension Day earlier this year,there is a huge gap between people knowing they are hypertensive and then actually controlling their blood pressure. This gap needs to be covered.”

This is where the joint endeavour of the WHO and the ICMR can make a significant contribution to helping Indians manage their blood pressure. “The national action plan targets reducing the number of people with uncontrolled hypertension by 25 percent by the year 2025. The IHCI is a model initiative towards that as prevention and treatment is far safer and less expensive than bypass surgery and regular dialysis,” said ICMR director-general Dr Balram Bhargava.

Improving awareness and improving early diagnosis rates could not only be a means of reducing mortality and further illness related to the condition, but could, as Dr Bhargava states, avoid more costly procedures in a patient’s future. Dr Bhargava noted the programme would improve the cardiovascular component of the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke. 

Indeed, improvements in the diagnosis and treatment of hypertension could have a significant impact on other noncommunicable diseases (NCDs). Hypertension is considered the leading risk factor for morbidity and mortality in India. The condition places an individual at a heightened risk for a number of conditions, predominantly cardiac disease — India’s most common cause of death.

The prominence of the condition in India — with roughly one in four adults having high blood pressure — warrants concern in its own right. However, a key aspect to the high mortality rate regarding the condition is due to it slipping under the radar. Only half of individuals with hypertension have been diagnosed and only one in ten have their blood pressure under control. Any programmes to assist in reducing the disease burden could be a considerable boon to the health system.

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