By Dr. Shraddha Bhure
Hypertension or high blood pressure affects at least one in four adults in India, an estimated 220 million people in country, but only 12% of these have their blood pressure under control. It is one of the leading causes of stroke, kidney failure and heart failure. Long-standing hypertension is a major and significant risk-factor for the development of heart-failure (especially heart failure with preserved ejection fraction), affecting approximately 30% of adults. 1 Hypertension and diabetes are also closely interlinked comorbidities.
The I-CaRe for Diabetes survey, an exploratory work supported by Boehringer Ingelheim India, states that 7 out of every 10 individuals with type-2 diabetes have coexisting hypertension. 2 Thus, hypertension adds to the growing burden of NCDs in
the country. Factors such as sedentary lifestyle, unhealthy dietary habits, stress, and genetic predisposition contribute to the surge in prevalence of hypertension cases.
Due to its gradual onset, hypertension rarely exhibits noticeable symptoms until it reaches concerning level. Hypertension also often goes undiagnosed or untreated due to a lack of awareness about its silent nature and limited access to
healthcare services, particularly in rural areas. In line with India’s target of a 25% relative reduction in hypertension prevalence by 2025, it is imperative to break down silos and adopt collaborative strategies such as community-based interventions, public-private partnerships, and technology.
Raising Awareness and Prevention
Hypertension leads to various cardio-renal-metabolic diseases. The Framingham heart study states that coexisting hypertension in people with type-2 diabetes can increase the risk of cardiovascular death by 90%. 4 Hence the first step towards combating hypertension is to raise awareness about the condition and the associated risk factors. Collaborative efforts involving healthcare professionals, community organizations, and government agencies can play a crucial role in educating the population about the importance of healthy lifestyle choices, such as regular exercise, a balanced diet, and stress management for controlling hypertension and thus reducing the risks of heart failure and other consequences. By disseminating information through various channels, including public campaigns, workshops, and community outreach programs, individuals can be empowered to take proactive measures to prevent hypertension.
Strengthening Primary Healthcare Systems
Effective management of hypertension requires a strong primary healthcare system that ensures timely diagnosis, treatment, and follow-up care. Healthcare providers, policymakers, and medical associations can come together to focus on capacity building, training, and creating standardized protocols for hypertension management. This includes improving the skills of primary healthcare, physicians that can not only assess high blood pressure but can also make timely diagnosis of the
possibility of underlying diseases like heart-failure as high blood-pressure can adversely affect the heart’s structure and function, over a few years. Establishing regular blood pressure screening programs, providing access to affordable medication and integration of electronic health records and telemedicine can facilitate better coordination and monitoring of patients, especially in rural areas with limited access to healthcare facilities.
Public-Private Partnerships
There is a need for public and private sector partnership to better manage the hypertension burden on the Indian healthcare system. Through the PPP model, dedicated hypertension clinics can be set up providing access to timely diagnosis and affordable medications. These collaborations can also facilitate research and data sharing, enabling evidence-based decision making and the development of effective policies.
Research and Innovation
Collaboration between researchers, academia, pharmaceutical organizations, government agencies, and not for profit organizations can facilitate the development of indigenous solutions, including affordable diagnostic tools, patient-centred interventions. Research collaborations can also explore the social determinants of hypertension, including socio-economic factors, cultural influences, and gender disparities, to develop context-specific strategies that address the root causes of the
problem. It is clearly known that hypertension poses a significant health burden in India. However, with collaborative strategies, this burden can be alleviated to a greater extent.
(The author is a Medical Director, Boehringer Ingelheim. Views expressed are personal and do not reflect the official position or policy of the FinancialExpress.com.)
