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Recently, the World Health Organisation (WHO) has released its first report on hypertension. According to the first-ever report released by WHO on the global impact of hypertension, at least 4.6 million deaths in India can be prevented by 2040 if half its hypertensive population controls its blood pressure.
What is hypertension?
Blood pressure is the force exerted by circulating blood against the walls of the body’s arteries, the major blood vessels in the body. Hypertension occurs when blood pressure is too high.
Definition- It is defined as having systolic blood pressure level greater than or equal to 140 mmHg or diastolic blood pressure level greater than or equal to 90 mmHg or/and taking anti-hypertensive medication to lower his/her blood pressure.
Read More- Hypertension Forum IAS
What are the causes and consequences of hypertension according to the report?
Causes of Hypertension – High-salt diets, lack of physical activity, and excessive alcohol consumption are significant contributors to hypertension. Genetics is believed to play a role in high blood pressure as well.
Symptoms of Hypertension – Most people with hypertension don’t feel any symptoms. Very high blood pressure can cause headaches, blurred vision, chest pain and other symptoms.
Treatment of Hypertension – Lifestyle changes like adopting a low-salt diet, weight loss, physical activity, and quitting tobacco etc. and medications.
Consequences of Uncontrolled Hypertension –
1. Severe heart issues, including chest pain, heart attacks, heart failure, and irregular heartbeats, as well as increase the risk of stroke by affecting blood flow to the brain.
2. Hypertension can lead to disability, reduced quality of life, and premature death.
3.The socioeconomic costs associated with hypertension are substantial which include both direct costs related to healthcare, as well as indirect costs related to lost productivity and reduced economic growth.
4. Hypertension cuts down people’s most economically productive years.
What are the observations of the WHO report on hypertension?
WHO report on hypertension has made the following observations regarding hypertension globally and with respect to India.
Global Hypertension burden
| Global Impact- One in three adults across the world suffers from hypertension. |
| Growing problem-The number of hypertension cases has doubled from 650 million to 1.3 billion between 1990 and 2019. |
| Impact on young generation- Hypertension affects approximately 33% of adults aged 30-79 worldwide. |
| Under treatment- Approximately four out of every five people with hypertension are not adequately treated. If countries can scale up coverage, 76 million deaths could be averted between 2023 and 2050. |
| Disparities in Treatment Coverage- Treatment coverage for hypertension exhibits significant disparities among countries, with high-income nations having a more favourable coverage rate. More than three-quarters of adults with hypertension live in low- and middle-income countries. |
Indian Hypertension Burden
| Hypertension is the most important non communicable disease risk factor in India. |
| India has an estimated 188.3 million adults aged 30–79 years grappling with hypertension. |
| Southern States have a higher prevalence of hypertension than the national average. Kerala (32.8% men and 30.9% women) has the highest number followed by Telangana. |
| To reach a 50% control rate, India needs to ensure that an additional 67 million people with hypertension receive effective treatment. If the progress scenario were achieved, 4.6 million deaths due to high blood pressure would be averted by 2040. |
What are the initiatives undertaken for controlling Hypertension?
National Initiatives
India Hypertension Control Initiative (IHCI)- India Hypertension Control Initiative(IHCI) focuses on controlling hypertension by screening people, ensuring protocol-based treatment, and providing medicines. Through India Hypertension Control Initiative(IHCI) and the government’s push towards non-communicable disease screening and treatment at the primary healthcare level, India aims to put 75 million patients with hypertension or diabetes on standard care by 2025.
National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) which is being implemented under the National Health Mission.
Ayushman Bharat Health Wellness Centre scheme- Preventive aspect of hypertension and NCDs is being strengthened under Comprehensive Primary Health Care by promotion of wellness activities and targeted communication at the community level.
Affordable Medicines and Reliable Implants for Treatment (AMRIT) Deendayal outlets- These have been opened at 159 Institutions/Hospitals with an objective to make Cardiovascular Diseases drugs and implants at discounted prices to the patients.
Global Initiatives
Global Hearts Initiative – WHO and the United States Centers for Disease Control and Prevention launched the Global Hearts Initiative in 2016 to achieve the global target to reduce the prevalence of hypertension by 25% by 2025.
WHO Global Action Plan for the Prevention and Control of NCDs 2013–2020- This action plan aims to reduce premature mortality from Non Communicable disease(NCDs) by 25% by 2025 and includes a set of nine global targets.
The NCD Alliance- This is a global network of civil society organizations working to prevent and control NCDs. It advocates for policy change and increased investment in NCD prevention and management.
WHO Framework Convention on Tobacco Control- This international treaty aims to reduce tobacco consumption and the related harm to health.
United Nations High-Level Meeting on NCDs- This meeting, held in 2018, focused on accelerating progress on the prevention and control of NCDs and called for increased political commitment and action to combat NCDs.
SDG-3 – The United Nations Sustainable Development Goal 3 (SDG 3) aims to ensure healthy lives and promote well-being for all. This goal has reduction of hypertension as one of its main targets.
What are the recommendations of the WHO report on Hypertension?
Following recommendations of the WHO report on Hypertension must be followed so as to reduce mortality due to hypertension.
Scaling Up Coverage of Hypertension treatment- Countries are urged to scale up coverage of hypertension treatment to reach more individuals with high blood pressure.
Integration with Primary Healthcare systems- Effective hypertension management should be integrated into primary healthcare systems, making it accessible to a broad population.
Using WHO’s HEARTS Package- WHO’s HEARTS technical package for cardiovascular disease management in primary healthcare and guidelines for the pharmacological treatment of hypertension in adults should be implemented for proven and practical steps for hypertension care.
Affordable Medication- Simple, low-cost medication should be made available and affordable to those with hypertension.
Team-Based Care- Collaboration among healthcare teams is encouraged to adjust and intensify blood pressure medication regimens per doctor orders and protocols.
Patient-Centered Service- Reduction of barriers to care through easy-to-take medication regimens, free medications, close-to-home follow-up visits, and accessible blood pressure monitoring can improve patient outcomes.
Development of Information Systems- Simple information systems should be developed to facilitate rapid recording of essential patient-level data and reducing healthcare worker data entry burden.
Read More- WHO report on Hypertension Indian Express
