India Hypertension Control Initiative (IHCI)

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Key Takeaways

A project called the India Hypertension Control Initiative (IHCI) finds that nearly 23% out of 2.1 million Indians have uncontrolled blood pressure.

What is Hypertension?

  • Hypertension (HTN or HT), often known as high blood pressure (HBP), is a long-term medical disorder characterised by persistently excessive blood pressure in the arteries.
  • Blood pressure exceeding 140/90 is called hypertension, while pressures beyond 180/120 are considered severe.
  • High blood pressure is frequently accompanied by no symptoms. If left untreated, it can lead to health problems like heart disease and stroke.
  • Lowering blood pressure can be achieved by eating a healthy diet with less salt, exercising regularly, and using medication.

What is India Hypertension Control Initiative (IHCI)?

  • Target Placed by India
    • India has committed to a “25 by 25” goal, which aims to reduce premature mortality due to non-communicable diseases (NCDs) by 25% by 2025. 
    • One of the nine voluntary targets includes reducing the prevalence of high blood pressure by 25% by 2025.
  • Coverage
    • In the first year, IHCI covered 26 districts across five States — Punjab, Kerala, Madhya Pradesh, Telangana, and Maharashtra.
    • In December 2020, IHCI was expanded to 52 districts across ten States — Andhra Pradesh (1), Chhattisgarh (2), Karnataka (2), Kerala (4), Madhya Pradesh (6), Maharashtra (13), Punjab (5), Tamil Nadu (1), Telangana (13) and West Bengal (5).
  • Enrolment into Program
    • As of December 2021, 101 districts across 19 States had commenced project activities. 
    • The project districts enrolled almost 21 lakh patients across 13,821 health facilities. 
    • In the 26 initial districts, one fifth of the expected patients were enrolled.
    •  State wise proportions were Maharashtra (27%), Kerala (22.6%), Madhya Pradesh (18.7%), Telangana (18.6%) and Punjab (14.2%).
  • Findings of Program
    • Managing blood pressure for 2.5 crore individuals can prevent up to five lakh deaths due to cardiovascular disease in the next 10 years
    • Its most important discovery so far is that nearly one-fourth of(23%) patients under the programme had uncontrolled blood pressure, and 27% did not return for a follow-up in the first quarter of 2021. 
    • There were an estimated 20 crore adults with hypertension in the country. 
    • To achieve India’s target of a 25% relative reduction in the prevalence of raised blood pressure, approximately 4.5 crore additional people with hypertension need to get their blood pressure under control by 2025.
    • Of a million patients registered in fve phase I and three phase II States till Dec 2020, 7.4 lakhs were under care between April 2020 to March 2021. 
    • Nearly half (47%) of the registered patients under care had blood pressure under control during the most recent visit in the first quarter of 2021.
    •  Drug availability improved in all phase I States with at least one-month refills for key blood pressure drugs.
    • Punjab, Madhya Pradesh and Telangana had stocks for nearly six months for protocol drugs. 
    • Kerala had only one month stock and Maharashtra had two months stock available in May 2021. 
    • Availability of drugs was a challenge in most phase II States and procurement process took nearly one year from planning.
    • There weren’t enough validated high-quality digital blood pressure monitors in several health facilities, which affects accuracy of hypertension diagnosis.
    • In phase I States, dedicated nurses were insufficient except in Telangana and Maharashtra. 
    • In phase II States, most districts did not have dedicated NCD nurses at public health care centres level except Chennai.

Prevalence of Hypertension in the Society

  • Southern States have a higher prevalence of hypertension than the national average, according to the latest edition of the National Family Health Survey.
  •  While 21.3% of women and 24% of men aged above 15 have hypertension in the country, the prevalence is the highest in Kerala where 32.8% men and 30.9% women have been diagnosed with hypertension. 
  • About one-fourth of women and men aged 40 to 49 years have hypertension. 
  • Even at an earlier age, one in eight women and more than one in five men aged 30 to 39 years have hypertension.
  •  The prevalence of hypertension is higher among Sikhs (37% for men and 31% for women), Jains (30% for men and 25% for women), and Christians (29% for men and 26% for women) than the rest

Content Source : The Hindu

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