Editorial Team

In a Covid adjusted world, focus on hypertension treatment has gained prominence as experts call it a key strategy if we are to avert or minimise the impending NCD super storm. Recognising the need for urgent and incremental action, the Ministry of Health and Family Welfare (MoHFW), WHO representatives, AIIMS doctors and various national and global organisations gathered at a national consultation in the capital to brainstorm on a roadmap to stop the alarming rise of hypertension amongst Indians. Although easy to diagnose and relatively simple to treat with low cost medicines, high blood pressure is now a full-fledged health crisis with at least 1 in 4 adult Indians suffering from this condition. It is considered the world’s largest killer, responsible for at least 8.5 million deaths and 218 million disabilities adjusted life years (DALY). World over at least 1.4 billion people live with this chronic condition. In India, untreated and uncontrolled blood pressure, has become a leading cause for premature death and disability.

The recently release National Family Health Survey (NFHS) 5 report reveals several alarming trends. Among them, the growing concern that more and more younger people are falling prey to hypertension. The findings also lend credence to the fact that although easy and affordable to treat, treatment adherence rate is the poorest. Only about 7 per cent women and 6 per cent men who have been diagnosed with high blood pressure are on regular medication. Experts claim that uncontrolled hypertension – a major risk factor for heart attack and stroke, is probably one of the main reasons why over the last decade, cardiovascular diseases have emerged as the top killer in India. Explaining that discontinuing or being irregular with BP medicines, leaves people without a protective cover, Dr Pankaj Bharadwaj, Additional Professor, AIIMS Jodhpur said, “More than 63% of all deaths in India are due to NCDs and a large number of these deaths are linked to the underlying condition of hypertension. Although incremental efforts for screening have been made in recent years, among people with high blood pressure, only half have been diagnosed and of those, only 1 in 10 have blood pressure under control.

The COVID-19 pandemic has increased barriers to achieving hypertension control as many health systems and governments worldwide have had to prioritise the urgent fight against COVID-19 above the management of chronic diseases. In India, health systems faced unforeseen pressures, resulting in the halting or at least delaying of the progress that had been made in recent years. In view of this simmering public health crisis, the Government of India has committed to 25% relative reduction in hypertension prevalence by 2025. Achieving this goal will require effectively treating at least 15 crore people by 2024, pointed out Prof. Atul Goel, Director General of Health Services, Ministry of Health and Family Welfare. “Efforts are on to strengthen primary health care on which at least 50 crore Indians depend, streamline availability of medicines at the AB-HWCs, improve follow ups and help more people stay within the treatment net”. The MoHFW is introducing innovations and reforms that will go a long way in addressing structural issues that obstruct treatment – such as guidelines to ensure all essential medicines, including for BP will be dispensed for up to 3 months. A rapid scale up of e-Sanjeevani, the government’s telemedicine facility which clocked 3.5 lakh daily consultations recently, has been a boon for patients with chronic conditions.”

While strengthening systems is one pillar, experts consider combatting low awareness and achieving widespread behaviour change as a greater challenge. Releasing a set of communication material, including posters, a case study on innovations in Punjab and testimonials from patients, Dr Sudarsan Mandal, Deputy Director General (NPCDCS), Dte GHS, MoHFW said, “A nation-wide awareness campaign for prevention, treatment & adherence of hypertension is the need of the hour. Primordial prevention for 4 major risk factors of hypertension needs to be started among the school children. As a first step, the Ministry in collaboration with civil society organisations is pleased to release these information and communication material.”

Speaking at the event, Ms Vandana Shah, Regional Director, Global Health Advocacy Incubator (GHAI), said, “On World Hypertension Day, we have come together as PRACHI – an initiative to ‘Prioritise Advocacy for Control of Hypertension in India.’ Anchored with the Family Planning Association of India (FPAI) and supported by AIIMS, GHAI and other organisations offering their technical expertise, this is a nation-wide campaign to accelerate hypertension control and treatment in India.” NCD Nodal officers from Telangana, Kerala, Punjab, Haryana and West Bengal brought stories from the field and presented various best practices in tackling the problem of treatment access, adherence and follow up. Notable among these experiences, was the drug logistics model of Punjab which has been short listed as a best practice by the Govt of India.

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