NEW DELHI: On World Hypertension Day, the WHO South-East Asia Region (WHO-SEARO)) wants to speed up the prevention, detection and control of hypertension, affecting almost 1.28 billion people globally, two-thirds of them in low- and middle-income countries.
An estimated 46 per cent of hypertensives are unaware of their condition. Less than half of all adults with hypertension are diagnosed and treated.
Just one in five adults with hypertension had it under control, which means 80 per cent are at significant risk of complications, including heart attack, stroke, and irregular heartbeat kidney damage.
Hypertension is diagnosed if, when it is measured on two different days, the systolic blood pressure readings on both the days is ≥140 mmHg and/or the diastolic blood pressure readings on both days is ≥90 mmHg.
According to Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia, the region has made targeted efforts to address hypertension and other cardiovascular diseases, in line with its flagship priority of preventing and controlling non-communicable diseases (NCDs) through high-impact and cost-effective "best buys".
Nine countries of the region have made targeted interventions to improve care pathways at the primary level, as per the WHO Package of Essential NCD Interventions for Primary Health Centres (POHCs).
Sri Lanka, Nepal, and Bhutan have in recent years piloted innovative PHC-focused care models in several districts and areas.
India has significantly expanded population-based screening, which now covers more than 600 districts, with more than 110 million people screened since June 2021, she said.
According to the India Hypertension Control Initiative (IHCI), a multi-partner initiative of the health ministry, the Indian Council of Medical Research (ICMR), and the World Health Organisation (WHO) country office in India, one in four Indian adults is hypertensive. Still, only about 10 percent of them have their blood pressure under control.
In 2015, a quarter of all adults in the region had hypertension. In most parts of the region, less than 50 percent of people with hypertension are on treatment, indicating an urgent need to scale up hypertension services, especially at the primary health care (PHC) level.
The theme of this year's World Hypertension Day, celebrated on May 17 every year, is 'measure your blood pressure, control it, live longer.'
Dr Khetrapal said this highlights the need to increase awareness and access for all people in the region to quality hypertension monitoring and treatment.
Last year, WHO issued new guidelines on the pharmacological treatment of hypertension in adults, which countries continue to integrate into PHC services.
The six modules of the WHO HEARTS technical package – healthy-lifestyle counselling, evidence-based treatment protocols, access to essential medicines, risk-based management, team-based care, and systems for monitoring – provide a strategic approach to improve cardiovascular health in all countries of the Region and must be harnessed and applied to maximum effect.
Unhealthy diets that include excessive salt and fat and lack adequate fruit and vegetables are a significant cause of hypertension, as is inadequate physical activity and consumption of tobacco and alcohol.
Among other interventions, increased taxation of unhealthy products can limit consumption and promote healthier choices. Increased access to green and healthy spaces can facilitate physical activity.
In many cases, hypertension has no warning signs or symptoms. All adults must have their blood pressure measured regularly, including at every health care visit.
The focus must be put on increasing the capacity of frontline health workers, including providing healthy lifestyle counselling. Also, countries in the region must ensure hypertension control is included in UHC benefit packages. To do this, policymakers may need to refine financing patterns and explore innovative solutions, she said.
Accelerated action to prevent, detect and control hypertension cannot and must not wait, she added.
In the ongoing Covid-19 response and the recovery that will follow, it is incumbent on all stakeholders to maximise health and well-being, leveraging every opportunity.