Hypertension a silent
killer in India
World Health Day – 7 April 2013
Theme
for 2013 world health day is hypertension
Dr.M.A.Aleem MD, DM, (Neuro)
Professor of Neurology,
KAPV Government Medical College & MGM Government
Hospital,
Every year, the World Health Organization selects a priority
area of global public health concern as the theme for World Health Day.
The theme for World Health Day 2013 is controlling high blood
pressure, a condition which affect more than one in three adults worldwide. For
millions of people, high blood pressure will lead to fatal heart attacks,
debilitation strokes, and chronic heart and kidney disease.
As the world’s population ages and grows, unhealthy behaviors
– an unbalance diet, a lack of physical activity, and smoking, harmful use of
alcohol – together with stressful lifestyles, all increase the chances of
developing high blood pressure. All regions of the world are affected.
High blood pressure is both preventable and treatable.
Increasing public awareness is key, as is access to early detection. Countries
need systems and services in place to support healthy lifestyles. Access to
medicines of good quality, which are effective and inexpensive, is also vital,
particularly at primary care level.
This year’s campaign provides an opportunity to focus
attention on the prevention and control of high blood pressure, as a means of
reducing the number of people affected, both now and in the future, by
cardiovascular disease.
Cardiovascular diseases are the number one cause of death
globally. They account for approximately 17 million deaths in the world each
year.
Complications of high blood pressure also called Hypertension
or raised blood pressure account for more than nine million of these deaths,
including about half of all deaths from heart disease and stroke. More than one
in three adults worldwide has high blood pressure with the proportion going up
to one in two for people aged 50 and above. The number of people with high
blood pressure rose from 600 million in 1980 to 1 billion in 2008.
Behind the statistics is a silent killer that can affect
anyone; people often have no symptoms, and many are not even aware of high
blood pressure and associated health risks. The result is that many go
undiagnosed.
Many who are diagnosed do not have access to treatment or
their conditions are poorly controlled. Self-care – meaning actions or
behaviors each person can take in his or her daily life – also plays an
important role.
There is social cost to this problem too. In some countries,
money spent on cardiovascular diseases alone can be one fifth of the total
health expenditure. Yet million of people forgo seeking care for high blood
pressure in the early stages because they cannot afford it. The results are
devastating for both families and health systems: early death, disability,
personal and household disruption, loss of income, a diminished workforce, and
medical care expenditures take their toll on families, communities and national
health budgets.
Early detection and treatment are key, along with public
policies and primary health – care services that educate and support people to
prevent them from developing high blood pressure to manage it effectively
High blood pressure
(also known as raised blood pressure or hypertension) can lead to heart attack,
stroke and other serious health problem. It affects more than one in three
adults and leads to more than nine million deaths worldwide every year. High
blood pressure can also cause kidney failure, blindness, rupture of blood
vessels and brain impairment.
Many people do not know that they have high blood pressure
because it does not always cause symptoms. Even though it is easily diagnosed
and treated, many people do not have access to basic health services,
particularly in low – and middle-income countries.
High blood pressure is both preventable and treatable.
Controlling high blood pressure, together with other risk factors, is the main
way to prevent heart attack and stroke.
The risk of developing high blood pressure can be minimized
by: cutting down on salt; eating a balanced diet; avoiding harmful use of
alcohol; getting regular exercise; and avoiding tobacco use.
For many people, lifestyle changes are sufficient to control
blood pressure. For other, medication is required. Inexpensive medication
exists, which is effective when taken as prescribed.
It is essential that detection and control of high blood
pressure (measurement, health advice and treatment) are coupled with
simultaneous reduction of other risk factors that cause heart attacks and
strokes such as diabetes and tobacco use. They should be core elements of
primary health care in all countries and integral to efforts to reduce the
growing burden of no communicable diseases
Facts and figures
·
More than one in three adults worldwide have
high blood pressure, with the proportion going up to one in two for people aged
50 and above.
·
The number of people with Hypertension rose from
600 million in 1980 to 1 billion in 2008.
·
Complications of high blood pressure account for
more than 9 million deaths worldwide every year. This includes 51% of deaths
due to strokes and 45% of death due to coronary heart disease.
·
The prevalence of high blood pressure is highest
in the African Region at 46%. The lowest prevalence is in the Americas Region
at 35%. Globally, overall prevalence of high blood pressure in adults aged 25
and older was around 40%in 2008.
·
Worldwide, raised blood pressure is estimated to
cause 7.5 million deaths, about 12.8% of the total of all deaths.
·
Treating systolic blood pressure and diastolic
blood pressure until they are less than 140/90 mmHg is associated with a
reduction in cardiovascular complications.
·
To reduce premature mortality from NCDs by 25
per cent by 2020 – by reducing intake of alcohol and physical inactivity by 10
per cent each and intake of salt/sodium by 30 per cent. This will reduce high
blood pressure incidence by 25 per cent. Use of tobacco is targeted to be
brought down by 30 per cent in addition to improving medicines, technology and
counseling.
IN INDIA
·
Hypertension is a major contributor to avoidable
death and disease in India, too with an increasing impact in the country and
the number is expected to cross the 214 million mark in 2030.
·
Hypertension
is a major risk factor for cardio – vascular diseases that killed 2.7 million
people in 2004 and will result in the death of over 4 million people by 2030
·
It is estimated that 20 – 40 per cent population
in urban areas and 12 – 17 per cent in rural areas have Hypertension.
·
A WHO estimate in 2008 suggested 33 per cent men
and 32 per cent women older than 25 years had Hypertension in India.
·
An Integrated Disease Surveillance Prevalence
Survey of 2007 – 2008 indicates a very high percentage of Indians are in a pre
– Hypertension stage.
·
Mizoram had 58.5 per cent people in per -
Hypertension stage though the actual population suffering from high blood
pressure was only 19 per cent. This was followed by Uttarakhand with 48.8 per
cent, Kerala (48.1 per cent) and Maharashtra (46.2 per cent). Madhya Pradesh,
Tamil Nadu and Andhra Pradesh are among the other States that have over 40 per
cent of the population in the pre – Hypertension category.
·
Hypertension has serious economic implications also;
it is a leading cause of hospitalization and out – patient visits.
·
A month’s treatment with just one anti – Hypertension
medication cost 1.8 days wages and becomes unaffordable if more than one drug
is prescribed or more than one drug is prescribed or more than one drug is
prescribed or more than one person has Hypertension in the family.
·
As per the World Health Organization (WHO), high
blood pressure affects every third person about the age of 18. The proportion
increases with age, from 1 in 10 people in their 20s and 30s to 5 in 10 people
in their 50s.
·
Public health experts estimated that the number
of patients in India with high blood pressure is likely to rise from about 140
million in 2008 to nearly 215 million my 2030 along with increase in the risk
of complications arising out of high blood pressure such as heart attacks,
strokes, including kidney disease and other serious illnesses.
·
High blood pressure as of today remains
inadequately controlled in India as large number of cases go undetected.
·
The incidence of high blood pressure ranges from
20 to 39 per cent in urban areas and 12 to 17 per cent in rural areas.
·
The problem is further compounded as high blood
pressure is a silent killer as it can remain undetected and manifest years
later as a serious heart problem.
·
However, high blood pressure is both preventable
and treatable. For many people lifestyle changes such cutting down on salt;
eating a balanced diet; avoiding harmful use of alcohol; getting regular
exercise; and avoiding tobacco use are sufficient to control blood pressure.
For other, medication is required which is effective when taken as prescribed.
·
‘Merely sticking to medicine and controlling
dietary and lifestyle regime can easily avert any complications arising out of
high blood pressure.
·
It is important to get BP checked on a regular
basis and avoids self – medication.
·
Cardiovascular diseases caused 2.3 million
deaths in India in the year 1990; this is projected to double by the year 2020.
·
Hypertension
is directly responsible for 57% of all stroke deaths and 24% of all coronary
heart disease deaths in India
In TAMIL NADU
·
Tamil Nadu had started a pilot project in
Sivaganga and Viirudhunagar districts during 2007 – 2010 to screen and treat
people for Hypertension during which about 11,31,000 people were screened for Hypertension
in 98 health facilities. The pilot project has been scaled up in 16 districts
by the Tamil Nadu Health Systems Project (TNHSP).’This year we have been
implementing the phase I of the
programmed to screen and treat people with hypertension in 16 districts.
Preparatory activities, including training are underway in the remaining 16
phase II districts. By March – April 2013, the remaining 16 II districts will
also be implementing the project, thus covering the entire state will be under
the project. Our Tamilnadu chief minister J.Jayalalitha is keen to prevent non
communicable diseases in Tamilnadu. She is strengthening the health
infrastructure in Tamilnadu to tackle all for better health.
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