Majority of Indians devoid of hypertension treatment: Study

Researchers have said that hypertension is a major risk factor

The prevalence of hypertension is high in India, but the proportion of adults aware with their medical condition, are treated and achieve control is low, findings of a latest study reveal.

The study was done by the Public Health Foundation of India (PHFI), Harvard T.H. Chan School of Public Health, Heidelberg Institute of Global Health, University of Birmingham and University of Gottingen on the basis of National Health and Family Survey (NFHS-4, 2015-16) data of 731864 individuals aged 15-49 years, which covered each district of 29 states and 7 union territories of India.

The research findings of the study titled — Hypertension screening, awareness, treatment, and control in India: A nationally representative cross-sectional study among individuals aged 15 to 49 years — got published in PLOS Medicine journal on Saturday.

Researchers have said that hypertension is a major risk factor for cardiovascular disease, which is a leading cause of death in India and there are no population – based large scale study from India on the steps for screening to successful control of hypertension at which people are lost from care.

The findings of the study suggested while three out of four individuals with hypertension had ever their blood pressure measured, less than half of individuals (45%) had been diagnosed. The study also highlighted that less than 1 in 7 (13%) reported currently taking hypertensive medication and less than 1 in 10 (8%) had their blood pressure under control.

The study also found adults living in rural areas, men, and those who were poorer, were even less likely to receive the care they need. Only 5.3% of hypertensive men and 10.9% of hypertensive women aged 15-49 years have their blood pressure under control (i.e., they are taking medications and have a normal blood pressure), the study said.

The research revealed that there is huge state-level variation in hypertension screening. Screening of hypertensive individuals was lowest in Madhya Pradesh (61.3%) and highest in Haryana (93.5%). More than half of Indians aged 15-49 years with hypertension are not aware of their hypertension status. Awareness level was lowest in Chhattisgarh (22.1%) and highest in Puducherry (80.5%). 27 major states/union territories have blood pressure control rates below 10%. Daman and Diu was the highest, but still only 1 in 5 adults there are under control.

“Detection of hypertension is straightforward, treatments are simple yet effective, and hence hypertension can be easily controlled. Control of hypertension prevents future stroke, heart attacks and deaths. However, it is an unfortunate paradox that India does not perform well in any of the measures of detection, treatment and control,” said Dorairaj Prabhakaran, Vice President, Research and Policy, at PHFI.

The researchers have recommended that there is an urgent need of improvements in hypertension awareness, care and control for all Indians specially amongst the most productive years (15-49 years). They have said, that the government needs to improve hypertension awareness and control amongst households with lower levels of wealth and those living in rural areas. A further important target group is men, they argued.

“While people do not usually notice that they have high blood pressure, the condition raises the risk of heart attacks and strokes substantially. Scaling up screening and treatment for high blood pressure is feasible because the condition is easy to test for and inexpensive to treat. Such a scale-up could result in huge benefits for population health in India.” said author Pascal Geldsetzer from Harvard T.H. Chan School of Public Health.

Hypertension is one of the most common Non-Communicable Disease (NCD) in India. India forms 18% of the world’s population and is expected to be the most populous country by 2025, India’s ability to improve hypertension care will have decisive impact on the world’s ability to achieve the international NCD goals, including Sustainable Development Goals (SDG) and the World Health Organization (WHO)’s Global Action Plan for the Prevention and Control of NCDs.

“Hypertension may not have any symptoms, diagnosis in early phase is untapped due lack of awareness and regular medical checkups. Hypertension can be avoided with regular checkups and life style modifications. India needs to focus on this silent killer to reduce preventable premature morbidity and mortality burden due to cardiovascular diseases.” said author Ashish Awasthi, Assistant Professor (INSPIRE Faculty) at PHFI.