In Tamil Nadu, one in four adults dies of a heart attack or stroke. Many of these deaths are due to high blood pressure. Every third adult living in Tamil Nadu has high blood pressure, making it one of the top priority health problems in the state. But just one out of 10 people with hypertension get their blood pressure under control. Even more worrisome is the high proportion of heart attacks and stroke deaths among working-age adults, which takes a toll on families and the economy.
The India Hypertension Control Initiative (IHCI), a multi-partner initiative involving the Ministry of Health and Family Welfare, the Indian Council of Medical Research, state governments and the World Health Organisation, has been implemented in over 24 states and over 130 districts. The IHCI has demonstrated that high blood pressure could be treated with inexpensive generic drugs close to home at primary healthcare facilities. Treating one patient for one year costs less than `200 if bulk drug procurement is made through the Government Procurement Agency.
The Greater Chennai Corporation has been one of the sites implementing this initiative since 2020. The city’s primary health centres enrolled and followed up with more than one lakh hypertensive patients and achieved blood pressure control in nearly half of the treated patients. The city corporation demonstrated the importance of tracking each patient using a user-friendly Android mobile app. The app helped nurses create a list of people who did not return for visits.
Patients, who had not visited the centre, received a text message or a phone call from a nurse encouraging them to check their BP. In addition, this initiative is complemented by the Government of Tamil Nadu’s flagship programme ‘Makkalai Thedi Maruthuvam’. In this programme, community volunteers bring hypertension and diabetes medicines to people’s doorsteps. Best practices from this experience can be extended to address the high burden of hypertension.
Early treatment with medications can be complemented with lifestyle changes to improve cardiovascular health. Excessive salt intake is also one of the main causes of high blood pressure. WHO recommends 5 grams of salt per day, which is one teaspoon of salt. You can reduce the amount of salt in your diet by making lifestyle changes. A simple strategy is to monitor how many days it takes to use a half-kilogram salt pack in your kitchen. A family of four should consume about half a kilogram of salt in about a month.
Do not add salt when eating, and use less salt while cooking. If you gradually reduce salt while cooking, you will not notice a change in taste. You can avoid salty snacks, pickles, and processed foods. Low-sodium salt options available in the market can be considered for cooking (people with kidney disease can consult their doctor before using low-sodium salts). In addition to dietary changes, staying active, with at least 150 minutes of walking per week, is also beneficial for heart health.
Implementing primary care programmes and raising community awareness can reduce deaths and hospitalisations from heart attacks and strokes. People over the age of 30 should have their blood pressure checked annually. If your doctor tells you that you have high blood pressure, take your medications daily to live a long and healthy life. Let us join hands to tackle the silent killer of hypertension in 2023 and add reducing salt and daily walking to the list of New Year resolutions.
Lifestyle change
Early treatment can be complemented with lifestyle changes to improve cardiovascular health. Excessive salt intake is a major cause for high BP
Dr Prabhdeep Kaur
The author is a Senior Scientist and Head of the Division of Noncommunicable Diseases, ICMR-National Institute of Epidemiology, Chennai