ItHome Hypertension India’s hypertension initiative substantially improved BP control in 4 states, study finds

India’s hypertension initiative substantially improved BP control in 4 states, study finds

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New Delhi: The India Hypertension Control Initiative — a multi-partner initiative that has implemented hypertension control programmes across India — has brought substantial improvements in controlling the disease, a new study has found.

The initiative, jointly funded by the World Health Organization (WHO) and the Indian Council of Research (ICMR), was launched in 2017 and aims to strengthen hypertension or high blood pressure management and control by surveilling and treating patients. There are 24 IHCI sites in four Indian states — Punjab, Madhya Pradesh, Maharashtra and Telangana.

The study, published in the Journal of Clinical Hypertension on 23 December, documented an improvement in blood pressure control after an average six-month follow-up across health facilities, irrespective of age, sex, type of facility or state.

It also noted a “remarkable finding” wherein a greater improvement was recorded in blood pressure control in primary healthcare facilities.

Also read: Blood pressure medications decrease death in Covid patients

51% registered patients returned for follow-up

The study, by ICMR and WHO scientists, aimed to measure the efficiency of the scalable, multi-component public health hypertension control programme.

It found that between January 2018 and June 2019, a total of 21,895 people with hypertension registered at the IHCI sites.

Madhya Pradesh recorded the most number of registrations at 7,320 while Telangana recorded the lowest with 2,361. The median follow-up duration was found to be 163 days.

Among all the patients registered, 51 per cent returned for a follow-up visit between July 2019 and September 2019. The proportion of registered patients who returned for follow-up visit was highest in Telangana at 72.6 per cent and lowest in Punjab at 27.6 per cent.

Of the patients who came for follow-up visits between July 2019 and September 2019, 59.8 per cent patients had controlled BP.

“Blood pressure improved significantly across all age groups, types of facilities and states,” the study said.

Out of the total registrations made, 55 per cent registrations were in hospitals while 45 per cent were at the primary care level. At the time of registration, 62 per cent patients were previously diagnosed with hypertension. Out of the 21,895 patients, 60 per cent were in the 50-69 age group, while less than 1 per cent were under 30 years of age. Women accounted for 58 per cent of total registered patients.

The study also found 64 per cent patients with uncontrolled grade I hypertension, while 12.4 per cent had uncontrolled grade II hypertension and 3.2 per cent had uncontrolled grade III hypertension.

Blood pressure is considered normal below 120/80 mm Hg. When systolic pressure (pressure of the blood in arteries when heart pumps) ranges between 130 and 139 mm Hg or diastolic pressure (pressure in arteries when heart rests between beats) ranges between 80 and 89 mm Hg, it is considered stage 1 hypertension. In case systolic pressure is 140 mm Hg or higher or diastolic pressure is 90 mm Hg or higher, it is classified as stage 2 hypertension.

Also read: Covid patients with high blood pressure face ‘double risk’ of death, says Chinese study 

BP control highest among patients in Telangana

Blood pressure control among patients coming back for follow-up was highest in Telangana at 78.3 per cent and lowest in Punjab at 54.7 per cent.

BP control at primary care facilities was 70.4 per cent, while in secondary care facilities was 52.2 per cent.

The study, however, noted that half the registered patients did not return for a follow-up and going forward, the programme will attempt to improve this.

“We demonstrated substantial BP control improvements in a cohort of hypertension patients at sentinel sites within four Indian states implementing the IHCI…However, nearly half of the patients did not return for a follow-up visit, limiting the population health impact of the program, and will be the focus of program improvement efforts,” said the study.

“A limitation of this study was that we could not collect reliable information on adherence to lifestyle modification, which might have influenced the BP control,” it added.

According to government data, high blood pressure or hypertension is the most common reason for sudden heart attack and is a leading cause of death in the country.

The data highlights that one in four adults have high blood pressure in India. An estimated 20 crore adults have hypertension and only 2 crore of them have it under control.

Also read: 19 SARS-CoV-2 mutations in India can evade antibodies, 1 causes reinfection — CSIR study


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