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One in four adults in India suffers from hypertension and only 10% of patients have their blood pressure under control, according to a report by the India Council for Medical Research.

The study under the India Hypertension Control Initiative (IHCI) was conducted in two phases. In the first year in 2018, IHCI covered 26 districts across Punjab, Kerala, Madhya Pradesh, Telangana and Maharashtra. Phase-2 was launched in July 2019 and by December 2021 had expanded to 101 districts across 19 states, enrolling more than 20 lakh patients in 13,821 health facilities including 10,222 Health &Wellness Centes (HWC)/Sub centres.

In the 26 initial districts, one-fifth of the patients were enrolled. State-wise proportions were: Maharashtra (27%), Kerala (22.6%), Madhya Pradesh (18.7%), Telangana (18.6%) and Punjab (14.2%). However, the COVID-19 pandemic slowed down enrolment.

“Of a million patients registered in the 4,505 health facilities in five phase I and three phase II states till Dec 2020, 740,000 were under care between April 2020 and March 2021. Nearly half (47%) of the registered patients under care had blood pressure (BP) under control during the most recent visit in the first quarter of 2021. The blood pressure control was highest (55%) at HWC and second highest (48%) at PHC (primary health centre), followed by 44% in hospitals and 37% in CHC (community health centre) facilities," said Dr Prabhdeep Kaur, head of noncommunicable diseases, ICMR-National Institute of Epidemiology, Chennai.

Nearly one-fourth (23%) of the patients under care had uncontrolled BP, and 27% did not return for follow up in the first quarter of 2021, she added.

Meanwhile cardiologists noted that managing blood pressure for 25 million individuals can prevent up to half a million deaths due to cardiovascular disease in the next 10 years.

“High blood pressure, if undetected or inadequately treated, contributes to a very high disease burden of heart attacks and failure, brain strokes, kidney disease, vascular dementia, aneurysms and blocks of blood vessels. We need to improve the capacity of primary care systems to detect hypertension early, assess co-existing risk factors and provide continuous long-term care. We also need to foster capacity for self-monitoring and care. Health gains of hypertension control will be immense for India," said Prof. K. Srinath Reddy, president, Public Health Foundation of India.

“It is a well-designed ICMR intervention. Detection of hypertension in more than 100 districts, setting up testing facility, and also drug availability, follow-up done and weak points like drug supply problems are being corrected. Initial results showed 50% BP control, and now that infrastructure is in place, this will improve. Also one fourth patients lost to follow up, efforts to locate them will also improve this initiative," said Dr Sandeep Seth, professor of cardiology at All India Institute of Medical Sciences.

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