The Silent Killer: tackling hypertension in India

by Aditya Kumar

High blood pressure, or hypertension, is a dangerous condition that often goes unnoticed until it causes severe health problems such as strokes, heart attacks, kidney damage, and heart failure. The World Health Organization (WHO) recently released its first-ever report on the global impact of hypertension, highlighting the devastating consequences of this widespread, yet often neglected, condition.

According to the report, one in three adults worldwide suffers from hypertension, making it a significant global health concern. The number of people living with the condition has doubled from 650 million in 1990 to a staggering 1.3 billion in 2019, with nearly half of these individuals unaware of their condition. Moreover, almost four out of five people with hypertension are inadequately treated.

The report reveals that hypertension cases have doubled from 1990 to 2019, with over three-quarters of affected adults residing in low- and middle-income countries. Scaling up coverage and improving access to healthcare could potentially save 76 million lives between 2023 and 2050.

Research on hypertension in India paints a similar picture. A recent systematic review published in The Lancet Regional Health, Southeast Asia and a community study published in Cureus highlight the growing prevalence of hypertension in the country, particularly among younger adults and those from lower socioeconomic backgrounds. These studies show that a significant portion of individuals with high blood pressure in India remain undiagnosed due to a lack of awareness and limited access to healthcare services.

The WHO report emphasizes the role of modifiable risk factors in hypertension, such as unhealthy lifestyles, including a high-salt diet, lack of physical activity, and excessive alcohol consumption. This echoes the findings of the Indian research, which also highlights the impact of lifestyle factors on hypertension prevalence. Sedentary lifestyles, poor dietary choices, and high stress levels contribute to the rising incidence of hypertension in India.

The treatment gaps identified in the WHO report and the Indian studies have dire consequences, as uncontrolled hypertension can lead to life-threatening conditions. The report underscores the importance of lifestyle changes and affordable medications in effectively managing hypertension.

In India, the government has made efforts to expand heart care programs throughout the country, particularly in the health and wellness centers under community control. However, regional disparities within India exist, with southern states such as Kerala and Tamil Nadu showing better control rates than western and northeastern states.

Medication adherence is crucial for controlling hypertension, but issues like forgetfulness in the elderly, medication availability, and affordability pose barriers. Limited research exists on lifestyle and risk factors, with social determinants such as education and caste systems playing a role. Better data collection and evidence-based policies are needed to address uncontrolled hypertension in India.

The economic aspect of hypertension management is a vital focus area of the WHO report. Prevention, early detection, and effective management of hypertension are among the most cost-effective interventions. Healthcare accessibility and affordability are significant concerns for India, particularly for those experiencing poverty.

In conclusion, hypertension is a global health concern that affects millions of people, often with severe consequences. The WHO report highlights the need for improved awareness, access to healthcare, and lifestyle changes to effectively manage this condition. In India, regional disparities, medication adherence, and social determinants impact hypertension control rates. Better data collection, evidence-based policies, and economic considerations are crucial for addressing uncontrolled hypertension in the country.

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