According to a report by the India Council for Medical Research, one in four adults in India suffers from hypertension and only 10% of patients have their blood pressure under control.
The study was conducted in two phases under the India Hypertension Control Initiative (IHCI). In the first year in 2018, IHCI covered 26 districts of Punjab, Kerala, Madhya Pradesh, Telangana and Maharashtra. Phase-II was launched in July 2019 and expanded to 101 districts across 19 states by December 2021, enrolling over 20 lakh patients in 13,821 health facilities including 10,222 Health and Wellness Centers (HWCs)/Sub Centers had gone.
In the 26 initial districts, one-fifth of the patients were enrolled. State-wise proportions were: Maharashtra (27%), Kerala (22.6%), Madhya Pradesh (18.7%), Telangana (18.6%) and Punjab (14.2%). However, the COVID-19 pandemic slowed down enrollment.
“Out of one million patients registered in 4,505 health facilities in five Phase I and three Phase II states as of December 2020, 740,000 patients were being looked after between April 2020 and March 2021. About half (47%) of the patients registered under care had blood pressure. (BP) under control during the most recent tour in the first quarter of 2021. Blood pressure control was highest (55%) in HWCs and second highest (48%) in PHCs (primary health centres), followed by hospitals at 44%. and 37% in CHC (community health centre) facilities,” said Dr Prabhdeep Kaur, head of non-communicable diseases, ICMR-National Institute of Epidemiology, Chennai.
They said that about one-quarter (23%) of patients under care had uncontrolled BP, and 27% did not return for follow-up in the first quarter of 2021.
Meanwhile, cardiologists noted that managing blood pressure for 25 million individuals could prevent half a million deaths due to heart disease over the next 10 years.
“High blood pressure, if not detected or inadequately treated, contributes to a very high disease burden of heart attacks and failure, brain stroke, kidney disease, vascular dementia, aneurysms and blockages of blood vessels. There is a need to improve the capacity of primary care systems to detect blood pressure early, assess co-existing risk factors and provide continuous long-term care. We also need to promote the capacity for self-monitoring and care. “The health benefits of hypertension control will be enormous for India,” said Prof. K. Srinath Reddy, President, Public Health Foundation of India.
“It is a well designed ICMR intervention. Weak points such as high blood pressure detection, setting up testing facilities, drug availability, follow-up and drug supply problems are being addressed in more than 100 districts. Preliminary results showed 50% BP control, and now that the infrastructure is in place, it will improve. Dr Sandeep Seth, Professor of Cardiology at the All India Institute of Medical Sciences, said, “Also, efforts to trace a quarter of patients lost to follow-up will also improve this initiative.”