Within the dynamic landscape of public health in India, an alarming reality unfolds – statistics indicate that at least one in every four individuals is grappling with hypertension¹. Hypertension, commonly known as uncontrolled blood pressure, is a paramount risk factor for cardiovascular diseases (CVDs), such as heart attacks, strokes etc. Hypertension can result from a combination of factors, including genetics, lifestyle choices, and underlying health conditions such as diabetes, kidney disease, and hormonal disorders. Family history, unhealthy diets, sedentary lifestyles, excessive alcohol consumption, and tobacco use also contribute to elevated blood pressure levels.

Cardiovascular disease is the leading cause of death and morbidity worldwide, accounting for a staggering one-third of all deaths in India. Of the estimated 220 million people in India grappling with hypertension, a mere 12% are able to effectively diagnose and manage their blood pressure.

Hypertension, a chronic and persistent disease, often goes unnoticed due to its asymptomatic nature. In India, many individuals with hypertension remain unaware of their condition. This lack of awareness is due to limited knowledge and the absence of comprehensive hypertension screening programs for adults². Consequently, both systematic initiatives and opportunistic screenings during healthcare visits are lacking. The prevalence of hypertension awareness is disconcertingly low, with only one-fourth of rural and two-fifths of urban Indians being aware of their hypertension. The proportion of controlled hypertension is distressingly low, with only around 10% and 20% of rural and urban patients achieving optimal control, respectively. Moreover, treatment is received by only a quarter and a third of those diagnosed in rural and urban areas. Even when hypertension is diagnosed, appropriate care is frequently lacking, leading to poor adherence to therapy and uncontrolled blood pressure levels.

In pursuit of proactive public health initiatives, India has set forth an ambitious objective to attain a remarkable 25% reduction in the prevalence of hypertension by the year 2025 through the launch of the Indian Hypertension Control Initiative (IHCI)³, a 5-year program involving the Ministry of Health & Family Welfare, Indian Council of Medical Research, State Governments, and WHO-India. IHCI aims to accelerate the progress towards the Government of India’s non-communicable diseases target by intensifying evidence-based strategies to strengthen the building blocks of hypertension diagnosis, management and control.

Hypertension management encompasses early detection and regular measurement followed by lifestyle modifications and pharmacological interventions that are determined by healthcare providers. Known as the silent killer, early diagnosis of hypertension is critical as the condition shows little to no symptoms. The primary way to detect hypertension is to have a healthcare professional measure blood pressure, conduct a physical examination and review your medical history. Once diagnosed three methods of monitoring prove useful. The first and most conventional method is clinic measurement, which despite its usefulness shows significant variability. The other two commonly employed methods are home blood pressure monitoring and 24-hour ambulatory blood pressure monitoring. Additionally, healthcare professionals may also recommend routine tests, including blood and cholesterol or a lipid test to assess the heart’s cardiac profile. Effective continuum of care from early detection through monitoring and improved adherence to follow-up every 3–6 months for reassessment minimizes adverse cardiovascular events and associated mortality.

Poor control greatly increases the risk of cardiovascular events and mortality, so methods to improve adherence must be identified. Over the last few years, digital therapeutics (DTx) has emerged as a promising way to enhance adherence to hypertension treatment. By harnessing the power of digital technologies, the approach offers new avenues to promote monitoring, create awareness and enable adherence. Through personalized and interactive interventions, DTx holds the potential to revolutionize the landscape of hypertension management and foster better health outcomes.

Prevention is key, and it starts with a healthy lifestyle. Regular exercise, a nutritious diet, and effective stress management can help prevent hypertension. If diagnosed, individuals should follow the prescribed treatment plan, monitor blood pressure regularly, and maintain open communication with healthcare providers.

World Hypertension Day serves as a reminder to prioritize cardiovascular health and raise awareness about hypertension. Understanding the causes, risks, and effective treatment strategies can help control blood pressure and reduce the risk of complications. Promoting healthy lifestyle choices and encouraging regular check-ups can make a significant impact in the fight against hypertension. On World Hypertension Day, let’s work with the IHCI and through collective action take proactive measures against hypertension for a future where people are free from the burdens of uncontrolled blood pressure and its associated cardiovascular risks to lead longer and healthier lives.

References:

• https://www.thelancet.com/journals/lancet/article
• https://www.who.int/india/health-topics/hypertension
• https://www.who.int/india-hypertension-control-initiative

This article was first published in Financial Express on 17^th May 2023