High blood pressure or hypertension kills nearly 1.5 million people every year in South-East Asia making it the single-most important risk factor for non communicable diseases like heart attack and stroke, according to the World Health Organisation.

“Every individual has the power to prevent high blood pressure by adopting a healthy lifestyle – eating a balanced diet, reducing salt, regular exercise, avoiding harmful use of alcohol, quitting tobacco and checking their blood pressure regularly” says Dr Samlee Plianbangchang, WHO Regional Director for South-East Asia.

The WHO is raising the alarm about high blood pressure on World Health Day 2013 which fell on April 7 this year.

In India, among adults one in three was found to have a raised blood pressure and about half of them remained undetected during WHO surveys.

“The number of hypertensives in India was expected to nearly double from 118 million in 2000 to 213 million by 2025.

"However, recently we estimated that among those aged 25 years in 2013, there are already about 199 million hypertensives currently (103 million men and 96 million women).

“In addition, many more have pre-hypertension; a precursor condition which if left unaddressed will convert to hypertension in about 4 years. Another recent analysis of global data also indicated an increase in hypertension in developing countries like India compared to declines in most developed countries,” says Dr Sailesh Mohan, Senior Research Scientist and Associate Professor at the Public Health Foundation of India (PHFI).

He further added that hypertension prevalence in adults had risen dramatically across India over the past three decades from about 5 per cent in certain rural and urban communities to between 20 per cent-40 per cent in urban areas and 12 per cent-17 per cent in rural areas.

“A number of reasons, most important the influence of rapid urbanisation has resulted in profound changes in people’s lifestyles leading to increased consumption of unhealthy diets (diets high in calorie, sugar, salt and fat, and low in vegetables and fruits), reduced physical activity levels due to mechanization of work and motorization.

“In addition, being overweight, alcohol and tobacco use are also other major contributing risks. With these non desirable lifestyle changes increasingly penetrating in rural areas, we are observing a narrowing of this difference,” says Mohan.

Programmes to reduce hypertension cases

Acknowledging hypertension as a serious global issue, in September 2011, the United Nations General Assembly adopted the political declaration of the high-level meeting on the Prevention and Control of Non-communicable Diseases, and committed governments to a series of actions.

Member states have agreed to nine global targets for prevention and control of noncommunicable diseases, which include reducing the prevalence of hypertension by 25 per cent by 2025.

“The government has recently initiated the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), with its coverage expected to increase from 100 to all 640 districts across India during the course of the 12th 5 year plan. It has hypertension as a key focus area,” says Mohan.

WHO is now developing a global plan of action for non-communicable diseases and will be assisting countries to develop national action plans to track progress in preventing and controlling such diseases, including hypertension, and their key risk factors.

Cardiovascular disease is the leading cause of death and disease in India currently both in urban and rural areas, accounting for 33 per cent and 23 per cent respectively of all deaths among those aged 25-69 years, and 24 per cent and 35 per cent respectively of all deaths among those aged 70 years or older. Since hypertension is the primary risk factor driving CVD, it is very critical to address it effectively.

“Maintaining a healthy lifestyle and getting regular blood pressure check ups once-a-year of self as well as of near and dear ones is a must. It is needed more frequently if one is over fifty years of age or if the blood pressure in the high normal range. Do not wait for symptoms to develop as by then it would be too late,” says Dr Anand Krishnan, Head, WHO Collaborating Centre for NCD Prevention and Control, All India Institute of Medical Sciences.

(This article was published on April 8, 2013)
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