Amlendu Bhushan Khan / New Delhi: Hypertension is one of the most common lifestyle diseases today, with one in every 3 people in the world, suffering from it. Currently, estimates put the incidence of hypertension to 20 to 40% in urban areas and 12 to 17% in rural areas of India. Hypertension has been increasing consistently and is likely to assume epidemic proportion. National Medical Forum is launching a National Hypertension Screening Research Program wherein more than 1000 institutions/Stand alone clinics/Nursing Homes /Hospitals all over India have already agreed to participate & have enrolled themselves as research associates. In addition to this, 218 doctors have volunteered to be City Coordinators.Where as Indian Medical Association said maximum number of ambulatory blood pressure readings amongst the medical fraternity in a single day. 26% men and 22% women from 25-35 years age group have reported of pre-hypertension, reveals Indus Health Plus Abnormality Report
About 20,000 readings were taken of 533 doctors including those of the IMA leadership spanning 33 Indian cities. The aim being to raise awareness about the benefits of ambulatory blood pressure monitoring (ABPM) in the timely and correct diagnosis of hypertension on the occasion of the World Hypertension Day 2017.
Dr. Prem Aggarwal, President National Medical Forum said “WHO has marked 17th May as “World Hypertension Day” to draw attention of all stake holders towards this major health issue which has been declared as number one killer in the world. Taking cue from WHO and ICMR, on this special day National Medical Forum is launching a National Hypertension Screening Research Program wherein more than 1000 institutions/Stand alone clinics/Nursing Homes /Hospitals all over India have already agreed to participate & have enrolled themselves as research associates. In addition to this, 218 doctors have volunteered to be City Coordinators.
The duration of research program shall be one month which shall preferably commence on 17th May 2017 & shall continue till 16th June 2017. However, medical institutions are free to choose dates suitable to them but the duration of research project shall be 30 days only. All the participating units shall record blood pressure of non hypertensive normal walk in individuals in a prescribed format, and send back compiled data after culmination of research programme.
They shall be issued a certificate of participation by National Medical Forum
By analysis of data of research programme we will not only be able to estimate Prevalence of disease in India but will also be able to diagnose fresh cases of Hypertension.
Dr KK Kohli, Secretary General, National Medical Forum said, “Observing the World Hypertension month, worldwide program is being run to screen population for hypertension. We hope that with wide participation from the medical fraternity and public at large, this important programme of BP screening shall also contribute towards United Nations achieving its goal of 25% reduction in uncontrolled hypertension by 2025 .”
Often hypertension is misdiagnosed given the difference in blood pressure readings at home and in a clinic. Ambulatory Blood Pressure Monitoring (ABPM) can help in getting a more accurate picture of a person’s BP pattern in a span of 24 hour.
“The IMA National study on ambulatory blood pressure measurement amongst doctors conducted in partnership with HCFI and Eris Lifesciences revealed that 21% of the doctors surveyed had masked hypertension or isolated ambulatory hypertension. In simple terms, their BP readings were normal when evaluated through the conventional clinic measurement technique but high through the ABPM technique. Masked hypertension is associated with an increased long-term risk of sustained hypertension and cardiovascular morbidity. In addition to this, 56% of the doctors evaluated suffered from irregular BP pattern at night making them prone to future adverse cardiac events. 37% doctors had nocturnal hypertension, which can never be diagnosed through in clinic BP measurement. Over 50% physicians had uncontrolled hypertension despite taking hypertensive medicines,” said Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA.
Evaluating both daytime and nighttime blood pressure is crucial for predicting all cardiovascular events. It is a fact that a blood pressure reading obtained during one’s sleep is more accurate in helping predict all causes of mortality when compared to those obtained during waking hours. Ambulatory Blood Pressure Monitoring is globally accepted as the gold-standard method towards detecting hypertension. It evaluates the patient’s BP continuously over a period of 24 hours and helps diagnose masked or white coat hypertension, conditions in which a patient’s BP readings are inaccurate due to certain environments.
Dr Shashank Joshi, President Hypertension Society of India opined, “Your doctor may suggest ABPM for the following reasons: to find out if your blood pressure readings are higher in the clinic than at home; to see the efficacy of your medicines in controlling blood pressure throughout the day, or to note whether your blood pressure increases at night. Since there are no visible signs of masked hypertension, it is always good to let your doctor know if you have a family history of high blood pressure. I congratulate IMA, HCFI and Eris on this initiative and believe that a collaborative effort towards raising mass level awareness on the prevention of hypertension, it’s timely diagnosis and management is crucial in our country where every third person has high BP”.
ABPM involves attaching a small digital blood pressure machine to a belt around your body. This is in turn is connected to a cuff around the upper arm. It does not cause any inconvenience, as it is small enough for you to carry on with your routine. This machine notes blood pressure readings at regular intervals during a 24 hour period: typically, every 15 to 30 minutes during the day and 30 to 60 minutes at night.
Increasing your intake of fresh fruits, vegetables, olive oil, and omega-3 foods can help lower your high blood pressure levels. It is also a good idea to consume sprouted or 100% whole grains. Try to reduce your sodium intake, which does not necessarily come only from table salt or salt added while cooking. Processed and ultra-processed foods are the real culprits behind increased sodium intake.
SILENT KILLER
Hypertension is called a Silent Killer because most of the times there are no symptoms in patients of High Blood Pressure and patients usually report to attending doctors with symptoms of complications of High Blood Pressure ( and not hypertension itself), which include HEART ATTACK, STROKE, KIDNEY FAILURE and damage to RETINA (retinopathy). Therefore, it is important that every normal individual should get his blood pressure checked up and recorded in order to know whether he is suffering from the disease or not. These include even younger healthy individuals especially if they have a family history of the disease
In a developing country like India where patients do not have regular contact with the health service a, mass screening program of blood pressure is important to randomly screen and diagnose fresh cases of Hypertension. While in developed countries, hypertension screening is a part of medical examination, special efforts need to make to create awareness, both among doctors and patients, to make it an integral part of every examination.
WHO has marked 17th May as “World Hypertension Day to draw attention of all stake holders towards this major health issue which has been declared as number one killer in the world.
⦁ Hypertension, accounts for 20-50% of all deaths and risk of myocardial infarction is two times higher & risk of stroke in is four times greater in patients of hypertension.
⦁ Only half of hypertension subjects in general populations are aware of the disease, only half of those aware of the problem where being treated and only half of those treated were considered adequately.
⦁ In India the prevalence of hypertension is more in females as compared to males in urban as well as rural population.
⦁ Blood pressure rises with age, depends on Genetic factors and is more seen in Blacks as compared to Whites.
⦁ High Blood Pressure is more prevalent in individuals who are Obese, have sedentary lifestyle, have increased salt intake, are smokers and consume more Saturated Fats and alcohol and have more environmental stress
⦁ Hypertension can be prevented by Reduction in salt intake to an average of not more than 5gms/day, Weight reduction, Exercise, Cessation of smoking and Reduction of stress by YOGA & meditation.
⦁ General public at large needs to be educated about various aspects of hypertension and its complications. They should also be made aware of importance of getting blood pressure checked up every now and then specially in individuals who have family history of hypertension.
⦁ Early detection of hypertension is important because it rarely causes symptoms until complications have already occurred.
⦁ The complications of hypertension include HEARTATTACK, HEART FAILURE, STROKE, KIDNEY FAILURE and damage to RETINA.
