188.3 million Indians have hypertension, 37% diagnosed: What WHO report on hypertension says

The World Health Organisation has released its first-ever report on the impact of high blood pressure. The condition, also known as hypertension, is often referred to as a “silent killer”. The report, being launched during the 78th Session of the United Nations General Assembly which addresses progress for the Sustainable Development Goals, states that four out of five people with the disease are not properly treated and that 76 million deaths can be prevented until 2050. But what does the report say about India specifically? Let’s take a closer look: What does report say about India? As per Quint, the report estimates that 188.3 million Indians between the ages of 30 and 79 have hypertension. Of these, just 37 per cent have been properly diagnosed.

Worse, just 30 per cent are receiving adequate treatment.

As per Indian Express, many do not begin treatment after being diagnosed Just 30 per cent begin treatment and 15 per cent manage to control their blood pressure. The report found 52 per cent of deaths from heart attacks, strokes and other cardiovascular conditions are caused by uncontrolled hypertension. It estimates that India could avert 4.6 million deaths by 2040 if those with the condition simply kept their blood pressure under control, as per Indian Express. “In order to achieve a 50 per cent control rate, 67 million more people with hypertension would need to be effectively treated,” the report states, as per Indiatimes. Even more lives can be saved if the “aspirational scenario” of 75 per cent control could be achieved, as per Indian Express. As per Hindu, the report states that under a fourth of hypertensive patients in India have managed to get their blood pressure under control from 2016 to 2020. However, this has improved upon previous years and ‘substantial differences’ exist across regions, as per the report. [caption id=“attachment_13148702” align=“alignnone” width=“640”] The report also called on individuals to make lifestyle changes.[/caption] The report quotes data from the National Family Health Survey (NFHS-5) as showing that hypertension has increased in both men and women – from 19 and 17 per cent in 2015-2060 to 24 and 21 per cent in 2019-2020.

The report also calls on individuals to change their lifestyles, as per Quint.

The report also calls for the implementation of a hypertension control programme like HEARTS in India. The WHO said around 5.8 million hypertension patients across 27 states are being treated under the Indian Hypertension Control Initiative (IHCI) as of June 2023, Launched in November, 2017, the Indian Hypertension Control Initiative (IHCI) is a 5-year initiative involving the Ministry of Health & Family Welfare, Indian Council of Medical Research, State Governments, and WHO-India, according to IHCI’s website. The IHCI aims to achieve the government’s objective of reducing premature mortality from non-communicable diseases, including the prevalence of high BP, by 25 per cent by 2025 through evidence-based strategies to strengthen the building blocks of hypertension management and control, the website says. What do experts say? Speaking to Indian Express, Dr V Mohan, chairman of Dr Mohan’s Diabetes Specialities Centre in Chennai, said, “There is actually a rule of halves when it comes to hypertension. In any population, only half the people with hypertension get diagnosed. Of the people who do get diagnosed, half end up taking the treatment. And of the people who receive treatment, only half manage to control their blood pressure. In some of the developed countries, where the whole population is screened and treatment is free, the proportion might be better than half. And, in some lower middle-income countries — and, as this report shows, even India — the outcome is worse than the rule of half.” “It catches people unawares and has proven to be one of the most common causes of mortality and morbidity in India and worldwide,” said Viveka Kumar, principal director & chief of Cath Labs, Pan Max – Cardiac Sciences. Salt intake is an important factor that heightens hypertension risk, even as lack of physical activity, family history of hypertension, external stress and obesity, along with high alcohol consumption, are major contributors towards developing the condition, said the cardiologists. “A diet high in sodium (salt), saturated fats, and low in potassium can contribute to hypertension,” said Kaul.

“Indian foods and food habits include high amount of salt, almost 10 times higher than that recommended by WHO,” said Kumar.

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In a fact-sheet titled “Salt reduction” and issued in September, 2023, WHO has recommended less than 2000 mg/day of sodium or less than 5 g/day salt – just under a teaspoon. “(This is because) its symptoms are often unnoticeable until it has already caused significant damage to the heart, blood vessels, and other organs,” said Ajay Kaul, chairman of Cardiac Sciences, Fortis Hospital Noida. “People may have high blood pressure for years without knowing it, which can lead to serious health complications such as heart disease, stroke, kidney damage, and more,” said Kaul. [caption id=“attachment_13148732” align=“alignnone” width=“640”] WHO has recommended less than 2000 mg/day of sodium or less than 5 g/day salt – just under a teaspoon.[/caption] On an individual’s level, one can monitor for hypertension signs that include severe, sudden headaches, shortness of breath, exertion or fatigue, along with chest pain and irregular heartbeat, the doctors said. They also recommended a regular blood pressure check. “The idea is to check your blood pressure regularly especially after the age of 40 years and before 40 if any of the above symptoms are present and during hospital visit for any other reason,” said Kumar. What about the rest of the world? The report estimates that hypertension affects a third of adults worldwide between the ages of 30 and 79. Of these, just 54 per cent have been diagnosed with the condition, 42 per cent are currently being treated for it, and 21 per cent are estimated to have controlled their hypertension. Treating hypertension is one of the most important interventions to meet the United Nations’s Sustainable Development Goal (SDG) target 3.4 of a one-third reduction in premature mortality from the leading noncommunicable diseases, the report said. The improved coverage could further prevent 120 million strokes, 79 million heart attacks, and 17 million cases of heart failure in the same time period, the report stated. The report said that people living with hypertension across the world – blood pressure of 140/90 mmHg or higher or taking medication for hypertension – doubled between 1990 and 2019, from 650 million to 1.3 billion. It went on to say that nearly half of people with hypertension globally are currently unaware of their condition, with more than three-quarters of adults with hypertension living in low- and middle-income countries. The report said the prevention, early detection and effective management of hypertension are among the most cost-effective interventions in health care and should be prioritised by countries as part of their national health benefit package offered at a primary care level.

The economic benefits of improved hypertension treatment programmes outweigh the costs by about 18 to 1, it added.

The report said that people living with hypertension – blood pressure of 140/90 mmHg or higher or taking medication for hypertension – doubled between 1990 and 2019, from 650 million to 1.3 billion. It went on to say that nearly half of people with hypertension globally are currently unaware of their condition, with more than three-quarters of adults with hypertension living in low- and middle-income countries. The report acknowledged the efforts of more than 40 low- and middle-income countries, including India, Bangladesh, Cuba and Sri Lanka, which have strengthened their hypertension care, enrolling more than 17 million people into treatment programmes. It further asserted that “sustained, systematic national hypertension control programmes can succeed”, citing the examples of Canada and South Korea, which surpassed the 50 per cent mark for blood pressure control in adults living with hypertension through such programmes. “Hypertension can be controlled effectively with simple, low-cost medication regimens, and yet only about one in five people with hypertension have controlled it,” said Tedros Adhanom Ghebreyesus, WHO Director-General. “Strengthening hypertension control must be part of every country’s journey towards universal health coverage, based on well-functioning, equitable and resilient health systems, built on a foundation of primary health care,” said Ghebreyesus. With inputs from agencies