Hypertension is the number one health risk factor in India. It is the biggest contributor to disease and mortality. It contributes to an estimated 1.6 million deaths annually in India due to ischemic heart disease and stroke.Also read – Follow these 5 steps for good mental health
India’s demographic transition, with increasing proportion of older people and obesity associated with sedentary lifestyle and increasing urbanization, and other lifestyle factors such as high salt intake, alcohol and tobacco consumption are contributing to this burden of hypertension. Also read – Side effects of jamun: Avoid eating Java plum if you have these 4 health conditions
Hypertension is called the “silent killer”. Most people with hypertension are unaware of the problem because it may have some warning signs or symptoms. For this reason, blood pressure needs to be measured regularly.
When symptoms appear, they may include early morning headaches, nose bleeds, irregular heart rhythms, vision changes, and ringing in the ears. Severe hypertension can cause fatigue, nausea, vomiting, confusion, anxiety, chest pain, and muscle tremors. Also read – Dr. Bird flu explained by Ankita Baidya Manipal Hospitals: Symptoms, Risk Factors and more
The only way to diagnose hypertension is to have your health professional measure your blood pressure. Measurement of blood pressure is quick and painless. Although individuals can measure their own blood pressure using automated devices, assessment by a health professional is important for assessing risk and related conditions.
Hypertension is a major modifiable risk factor for cardiovascular and kidney diseases in India.
Awareness of hypertension is low in India while proper treatment and control is also low: Hypertension is a chronic, persistent, mostly asymptomatic disease. Most patients with hypertension in India are unaware of their condition. This is due to the low level of awareness and lack of screening for hypertension in adults.
It is crucial to focus on primary care because our biggest challenge is that most hypertensives cannot be diagnosed because they are asymptomatic, and only by constant attempts to measure BP in adults can the screening be increased in the clinic or by one. Their nearest healthcare provider.
The public health approach to hypertension in India will include 5 population-level interventions for the prevention of hypertension in which reduction in obesity, salt intake and cessation of tobacco use are the most important; Management of hypertension with combined lifestyle changes with screening and treatment of the adult population for hypertension using standard BP measurements with approved devices by trained staff.
Obesity requires population-wide interventions to lose weight, increase sedentary exercise levels, reduce salt intake, stop tobacco use, and moderate alcohol use.
Screening for hypertension in all adults includes opportunistic screening of people over the age of 18 at every point of contact with health professionals or related health workers. This will cover all issues and levels of care – village / multi-purpose health worker, trained non-physician staff in sub-centers, primary health center, community health center and referral hospital (district hospital, medical college).
This screening will also enable people with high normal BP to be identified so that they can be prevented from developing hypertension through the use of appropriate lifestyle changes. Since healthcare facilities cannot be accessed by all potential hypertensives, community-targeted screening initiatives are also suggested, aimed at finding hypertension in people with the highest prevalence of hypertension and the highest risk.
This includes people over the age of 50, obese, diabetics, current smokers, who have a history of any cardiovascular disease (coronary artery disease, stroke, etc.) or a family history of hypertension or premature cardiovascular disease. . A valid electronic BP device and at least 1 trained person per village should be made a reality so that these high-risk groups can be checked for hypertension at least once every 2 years.
Screening will include BP measurements using a standardized procedure and individuals will receive appropriate advice and / or referrals for BP levels.
Assessment of a person diagnosed with hypertension will focus on target organ damage related to hypertension, comorbidities such as diabetes, and reversible risk factors. Initiation of treatment whenever necessary should be a priority over referral for detailed laboratory evaluation.
Diagnosis of hypertension should be based on at least 2 sets of readings on 2 different occasions, at intervals of at least 1-4 weeks, except in cases of hypertensive crisis and urgency. Diagnosis of hypertension in individuals under 80 years of age is documented by continuous elevation of systolic BP of 140 mm and / or 90 mm diastolic.
Efforts should be made to follow long-term therapies for antihypertensive and promote compliance.
(Author by Dr. Kavita Prabhakar Pai, Consultant Endocrinology and Internal Medicine, Masina Hospital, Mumbai)
