Hypertension prevalence in India is high, but only 45 per cent of people are aware of their diagnosis, according to a first large-scale population-based study of hypertension care in India. Researchers have used National Health and Family Survey (NFHS-4, 2015-16) data of 731864 individuals aged 15-49 years, which covered each district of 29 states and 7 union territories of India.
The study published in PLOS Medicine suggests that 3 out of 4 individuals with hypertension ever had their blood pressure measured, less than half of individuals (45 per cent) had been diagnosed, 13 per cent reported currently taking hypertensive medication, while 8 per cent had their blood pressure under control.
The study was carried out by researchers at the Public Health Foundation of India (PHFI), Harvard TH Chan School of Public Health, the Heidelberg Institute of Global Health, the University of Birmingham and the University of Gottingen.
The study also found adults living in rural areas, men, and those who were poorer, were even less likely to receive the care they need.
Only 5.3 per cent of hypertensive men and 10.9 per cent of hypertensive women aged 15-49 years have their blood pressure under control (i.e., they are taking medications and have a normal blood pressure), it stated.
There is huge state-level variation in hypertension screening. Screening of hypertensive individuals was lowest in Madhya Pradesh (61.3 per cent) and highest in Haryana (93.5 per cent).
More than half of Indians aged 15-49 years with hypertension are not aware of their hypertension status. Awareness level was lowest in Chhattisgarh (22.1 per cent) and highest in Puducherry (80.5 per cent). 27 major states/union territories have blood pressure control rates below 10 per cent.
Daman and Diu was the highest, but still only 1 in 5 adults there are under control. The study highlighted the urgent need of improvements in hypertension awareness, care and control for all Indians specially amongst the most productive years (15-49 years).
Dr Dorairaj Prabhakaran, Vice President, Research and Policy, at PHFI and one of the authors of the study, said detection of hypertension is straightforward, treatments are simple yet effective, and hence hypertension can be easily controlled.?
“Control of hypertension prevents future stroke, heart attacks and deaths. However, it is an unfortunate paradox that India does not perform well in any of the measures of detection, treatment and control. I believe the new National Health Mission through the health and wellness clinics has the potential to address the issue,” he said.
Dr Lindsay Jaacks, faculty at the Harvard T.H. Chan School of Public Health and visiting faculty at PHFI said, “This is not just an assessment of health systems. We need demand-side interventions to raise awareness in India that hypertension is relatively easy and cheap to treat, and that keeping it under control can have huge benefits in terms of preventing heart attacks and stroke.