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WHO report on Hypertension

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September 28, 2023

Why in news?

Recently, World Health Organisation (WHO) released its first-ever report on global impact of hypertension.

What is Hypertension?

  • Hypertension (high blood pressure) is when the pressure in your blood vessels is too high (140/90 mmHg or higher).
    • Systolic pressure – The first number represents the pressure in blood vessels when the heart contracts or beats.
    • Diastolic pressure – The second number represents the pressure in the vessels when the heart rests between beats.
  • Modifiable risk factors – It includes unhealthy diets, physical inactivity and being overweight or obese.
  • Non-modifiable risk factors – It includes a family history of hypertension, age over 65 years and co-existing diseases such as diabetes or kidney disease.
  • Symptoms - Hypertension is often noted as silent killer’ as it does not show any symptoms.
  • Complications – Cardiovascular diseases. kidney damage, Preeclampsia and many other health problems.
  • Treatment – Lifestyle changes such as eating a healthier diet, quitting tobacco and increasing physical activity.
  • Once diagnosed, regular intake of medicines can control it effectively and prevent related complications.

According to the Lancet research, 2022, hypertension is the most important risk factor for death and disability in India.

What are the findings of WHO on hypertension?

  • Global Status – The number of people living with hypertension doubled between 1990 and 2019, from 650 million to 1.3 billion.
  • More than 3/4th of adults with hypertension live in low and middle income countries.
  • 1 in 3 adults gets affected with hypertension.
  • Nearly 50% of people are currently unaware of their condition.
  • Only about 1/5th people with hypertension have controlled it.
  • 76 million deaths could be averted between 2023 and 2050, if countries scale up their coverage.
  • The economic benefits of improved hypertension treatment programmes outweigh the costs by about 18 to 1.
  • In India – It relies on 2019 data by which 188 million Indians adults aged 30-79 years have hypertension.
  • Of them, only 37% were diagnosed and many do not start their treatments even after diagnosis.
  • Only 30% starts treatment and a meagre 15% of people manage to keep their bp under control.
  • Women’s status was marginally better than men in having the condition diagnosed, treated and controlled.
  • If 50% of people with hypertension manage their bp under control, at least 4.6 million deaths in India can be averted by 2040.
  • More lives can be saved if around 75% of the patients keep their hypertension under control.

hypertension

What steps were taken to manage hypertension?

  • India Hypertension Control Initiative programme (ICHI) - It is a 5-year initiative that was launched in 2017 under the National Health Mission.
  • It is a collaborative initiative of Ministry of Health and Family Welfare, Indian Council of Medical Research (ICMR), state governments and WHO Country Office for India.
  • It is being implemented in 138 districts of 23 states.
  • It was awarded the 2022 UN Interagency Task Force and the WHO Special Programme on Primary Health Care Award at a UN General Assembly in 2022.
  • 25 by 25 goal - The Government of India has adopted the "25 by 25" goal, which aims to reduce premature mortality due to non-communicable diseases (NCDs) by 25% by 2025.
  • One of the 9 voluntary targets includes reducing the prevalence of high BP by 25% by 2025.
  • Under this initiative, India has committed to reduce salt intake by 30% in the mean population by 2025. (WHO’s Target)
  •  75/25 initiative - It is an initiative in which 75 million people with hypertension and diabetes is put on standard care by 2025 through primary health care centres.
  • Food related measures - The Food Safety and Standards Authority of India (FSSAI) has implemented the ‘Eat Right India’ movement, which strives to transform the nation’s food system to ensure secure, healthy, and sustainable nutrition for all citizens.
  • In line with this goal, the FSSAI launched a social media campaign called ‘Aaj Se Thoda Kam.’

Average daily sodium intake of Indians is approximately 11 grams.

What lies ahead?

  • The report underscores the importance of implementing WHO-recommended effective hypertension care to save lives, which include the following 5components:
    1. Protocol: Practical dose- and drug-specific treatment protocols can streamline care and improve adherence.
    2. Medication and equipment supply: regular, uninterrupted access to affordable medication is necessary for effective hypertension treatment.
    3. Team-based care: Patient outcomes improve when a team collaborates to adjust and intensify blood pressure medication regimens.
    4. Patient-centred services: Free medications and close-to-home follow-up visits provides easy-to-take medication regimens.
    5. Information systems: User-centred, simple information systems facilitate rapid recording of patient data while maintaining or improving the quality of care.

QUICK FACTS

Rule of Half            

  • Only 50% the people with hypertension get diagnosed in any population.
  • Only 50% end up in treatment among the diagnosed people.
  • Only 50% manage to control their blood pressure among people getting treatment.
  • In India, the outcome is worse than the rule of half.

 

References

  1. The Hindu| First WHO report on Hypertension
  2. IE| India’s status of Hypertension
  3. WHO | Hypertension
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