World Hypertension Day is marked on May 17 every year. According to WHO, Hypertension is a ‘silent killer’. Blood pressure is the force exerted by circulating blood against the walls of the body’s arteries, the major blood vessels in the body. Hypertension is when blood pressure is too high.
In 2016, WHO and the United States Centers for Disease Control and Prevention launched the Global Hearts Initiative to support governments to prevent and treat cardiovascular diseases.
Of the five technical packages that comprise the Global Hearts Initiative, the HEARTS technical package aims to improve the prevention and management of cardiovascular diseases, including hypertension detection and management. The five modules of the HEARTS technical package (Healthy-lifestyle counseling, Evidence-based treatment protocols, Access to essential medicines and technology, Team-based care, and Systems for monitoring) provide a strategic approach to improve cardiovascular health in countries across the globe.
Fifteen countries have started implementing the HEARTS technical package (Barbados, Bhutan, Colombia, Chile, China, Cuba, Ethiopia, India, Iran, Morocco, Nepal, Philippines, Tajikistan, Thailand, and Viet Nam). By scaling up protocol-based management, improving access to medicines and technologies, and better measuring outcomes, successes are already being achieved.
Hypertension in India:
The hypertension epidemic in India is complicated by the fact that a large proportion of individuals is unaware of their hypertension status.
- High blood pressure (BP) is a major public health problem in India and its prevalence is rapidly increasing among both urban and rural populations. Hypertension is the most prevalent chronic disease in India.
- The prevalence of hypertension ranges from 20-40% in urban adults and 12-17% among rural adults. The number of people with hypertension is projected to increase from 118 million in 2000 to 214 million in 2025, with nearly equal numbers of men and women.
- Dietary interventions include; reducing salt, increasing potassium, and alcohol avoidance. But unlike in Western countries, stress management is often given greater emphasis in India.
- Some safe and effective medications are available for the treatment of high blood pressure. These include older molecules such as thiazide diuretics, beta-blocking agents, calcium channel blockers (CCB), and newer molecules, such as, angiotensin-converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARB). Given the recent clinical trials data, some international guidelines suggest that CCB, ACE inhibitors or ARB and not beta-blockers or diuretics should be the initial therapy in hypertension management.1 The former however, is much more expensive and beyond the affordability in many poor income countries.