Context:

• Recent analysis of National Family Health Survey data in JAMA Network Journal reveals stark disparities in hypertension care across Indian states and districts. 

Hypertension in India

• According to a recent WHO report, 188.3 million people in India suffer from hypertension but only 37% get diagnosed, only 30% start treatment, and only 15% manage to keep their blood pressure under control.
• Nearly 4.6 million deaths can be prevented in India by 2040 if half of the hypertensive individuals can control their blood pressure. This underscores the importance of improving blood pressure control rates.

Hypertension in India: State of Hypertension Care in India

• Diagnosis and Treatment Gaps: A significant proportion of people with hypertension remain undiagnosed, and many diagnosed individuals do not initiate treatment. 
  • For Example: Only one in three receives a diagnosis, and one in five gets treated.
• Poor Blood Pressure Control: Even among those who initiate treatment, just one in twelve achieves blood pressure control.
• Inter-State Variation: Southern states have a higher prevalence of hypertension (29.9%) compared to the national average (26.8%). Diagnosis rates are similar, but the proportion of treatment with controlled hypertension is higher in the southern states.
• Intra-District Variation: Within districts, significant disparities exist. For instance, in Meghalaya, the proportion of diagnosed individuals varies across districts with similar prevalence. Similarly, in Karnataka, districts with similar prevalence show differences in treatment and control rates.

Age, gender, and education impact hypertension care in India

• Gender: Women are more likely to be diagnosed, treated, and have controlled blood pressure, despite men having a higher prevalence of hypertension.
• Age: Those over 65 years have higher rates of prevalence, diagnosis, treatment, and control compared to younger individuals.
• Socio-economic Status: The wealthiest fifth of the population has the highest levels of hypertension prevalence, diagnosis, treatment, and control.
• Education: Those with higher education levels are more likely to be diagnosed, treated, and achieve blood pressure control, regardless of hypertension prevalence.

What initiatives have been implemented to control hypertension in India?

• Indian Hypertension Control Initiative (IHCI): It is a 5-year initiative involving the Ministry of Health & Family Welfare, the Indian Council of Medical Research, State Governments, and WHO-India.
  • IHCI aims to accelerate progress towards the Government of India’s NCD target by supplementing and intensifying evidence-based strategies to strengthen the building blocks of hypertension management and control.
  • The Government of India has adopted the “25 by 25” goal, which aims to reduce premature mortality due to non-communicable diseases (NCDs) by 25% by 2025. One of the nine voluntary targets includes reducing the prevalence of high BP by 25% by 2025.
  • India has won a UN award for its “Indian Hypertension Control Initiative (IHCI)”, a large-scale hypertension intervention under the National Health Mission.
• Government Initiative: The government has launched an ambitious initiative to treat 75 million people with hypertension or diabetes by 2025. 
  • This program aims to increase access to treatment and improve hypertension management.

News Source: Indian Express