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Tuesday, May 24, 2022

Explained: India’s hypertension challenge and why we need to be more alert

An analysis of data from the health ministry’s India Hypertension Control Initiative (IHCI) shows that 23% known hypertension patients registered with the programme had uncontrolled hypertension. Why is this cause for worry? And what is the government doing?

Written by Anonna Dutt , Edited by Explained Desk | New Delhi |
May 14, 2022 10:01:19 am
It is estimated that at least one in four adults in India has hypertension but only about 10% have it under control. (File Photo)

Less than half of those with known hypertension have it under control, with almost one in three not visiting a healthcare facility even once in three months to get it checked, shows an analysis of data from the health ministry’s India Hypertension Control Initiative (IHCI). The initiative aims to provide quality hypertension treatment in the country to prevent deaths from heart attacks, strokes, and kidney failure.

What has the analysis found?

The recently released findings suggest that only 47% of the known hypertension patients registered with the programme had their blood pressure under control, during their last visit to a healthcare facility. It shows that 23% had uncontrolled hypertension and 27% did not have a documented health facility visit over the previous three months.

Blood pressure control was lowest in West Bengal (34%) and highest in Telangana (60%). The proportion of patients with uncontrolled blood pressure during the most recent visit was highest in Kerala (40%) and lowest in Telangana (11%).

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The analysis found that over half the people – 55% – received treatment at primary health centre, 18% in community health centre, and 10% in district and sub-district hospitals.

The analysis is based on data for 9.9 lakh registered patients with hypertension across five Phase I and three Phase II states where the programme had been active for at least six months by the end of 2020. The programme has since covered 20 lakh patients with hypertension across 13,821 healthcare facilities in 19 states.

What is the India Hypertension Control Initiative?

It is estimated that at least one in four adults in India has hypertension but only about 10% have it under control. The IHCI was launched in 2017 to achieve the target of 25% relative reduction in prevalence of raised blood pressure. For this, approximately 4.5 crore additional people need to get their blood pressure under control.

The project aims to accelerate implementation of quality hypertension treatment for over 15 crore people.

Nearly 23% of the total estimated hypertension patients have been enrolled in the programme in the five Phase I states, according to the recent analysis. There are 29.1% patients enrolled in Maharashtra, 25.3% in Kerala, 22.4% in Madhya Pradesh, 20.8% in Telangana and 16.3% in Punjab.

The interventions under the programme include ensuring uninterrupted supply and availability of drugs, use of standard drug algorithm for management of hypertension, training of staff at all levels, and opportunistic screening when patients come for treatment of other diseases.

What happens if blood pressure is not controlled?

The biggest challenge, experts said, is that a lot of people are unaware that they have hypertension and those who know are not under regular treatment. “It is a silent killer. Till you get a stroke, heart attack, kidney damage, people do not know that they have hypertension,” said Dr R R Kasliwal, chairman of Clinical and Preventive Cardiology Department at Medanta -The Medicity Hospital.

Apart from the “big three” – heart attack, stroke, kidney damage – it can also cause haemorrhage in the eye (excessive bleeding) and peripheral arterial damage (when the extremities start receiving less blood than needed).

The government’s initiative to open health and wellness centres can help in reducing the burden of these diseases by diagnosing hypertension early on at local health facilities.

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