The Most Screened NCD: Hypertension

The silent killer is not so silent anymore as it crosses the number of diabetics in the country

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New Delhi: According to recent reports, hypertension is now the most common non-communicable disease (NCD), which is screened across India in Health and Wellness Centres (HWCs) followed by diabetes and cancer. According to the Ministry of Health and Family Welfare, the data states that 1,30,03,064 men and women have been screened for hypertension. Out of this number, 9,01,994 cases have been identified newly. The report clearly states that hypertension is a bigger concern than diabetes for India.

Previously, data from Nation Health Profile 2018 had brought to light that of all the patients who visited government clinics in 2017, close to 10% were diagnosed with hypertension, the number was still more than diabetes. A state wide NCD risk factor survey done in Punjab and Haryana recently under Prof JS Thakur from PGIMER Chandigarh, the prevalence of Hypertension is 40% in Punjab and 26% in Haryana, and only 48% and 33% respectively were aware about their hypertension status. Less than one third were taking treatment among the aware and only 18% and 12% respectively were controlled”. Add to that, researchers at Harvard University had also pointed to the fact that hypertension among young adults in India is higher than many other countries. An important fact that emerges from these studies is that not only are the numbers disappointing, but there is a serious lack of awareness around hypertension. The need of the hour is to create an environment where hypertension is understood better and the reasons for its prevalence are well laid out.

“Hypertension is increasingly seen at younger ages in India with many young adults being unsuspicious victims of complications of hypertension, be it stroke or hypertensive heart disease. Increased awareness about hypertension from an early age is necessary to prevent such complications”, says Dr Subhojit Dey, Executive Director, Disha Foundation.

Before starting a dialogue about the need for better treatments, we need to change the course of conversations to “why”. Why is hypertension gripping the nation so intensely and what are we doing about it?

Let’s understand what hypertension is. It is a major cardiovascular risk factor and one of the most important causes of heart strokes and heart disease. Since it is most often silent, regular check-ups are the key to controlling it in its early stages. While lifestyle plays a key role in encountering hypertension, self-monitoring is still crucial. There needs to be more consumer information regarding fat, trans-fat and salt content. People need user-friendly food labelling that helps them understand and know the products they are consuming.

Apart from awareness, early diagnosis is a critical step to reducing hypertension. Diagnosis for hypertension is often untapped due to the lack of awareness, resulting in the delay in getting health check-ups. For instance, as many as 60% people are not even aware that they have high blood pressure. As per Dr Muruganathan who is Governor at American College of Physicians-India chapter stated that “Hypertension is easy to diagnose, easy to treat but the accurate measurement of blood pressure is the key. We must promote home blood pressure monitoring to create awareness, for early diagnosis, for effective management. Proper adherence to treatment, regular follow-up to diagnose early complications is a challenge and must be addressed as a part of increasing awareness and promoting behavior change.”

There is also a dire need for patients to understand hypertension, its risk, nature and the kind of treatment that fits their condition. Some may even need lifelong therapy. There is very little knowledge available to patients about the potential benefits of treatment and proper use of medications.

Another challenge is that of poor interaction of patients with their physicians. These are healthcare system changes that need to happen. Instead of a medicine prescription, they need to be guided on the lifestyle changes they can make. Health expenditure is another worry. In India, the access to medications is poor, and those who cannot afford relatively high costs choose not to address the problem. Talk about infrastructure, and there is an inadequate distribution of physicians and other healthcare professionals between rural and urban areas.

Hypertension, the silent killer is often diagnosed at stages when patients have already suffered major damages to their organs. There is a need for awareness across all levels—schools, colleges, hospitals, communities. Experts stress on the need for early diagnosis if the patients experience any symptoms like frequent headaches, shortness of breath, chest pain, visual changes, nosebleeds. With urbanisation, socio-economic changes, and lifestyle alterations, hypertension could potentially hit a much larger share of the population.