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Kerala - Thiruvananthapuram Printer Friendly Page   Send this Article to a Friend

Nephrologists seek early detection of hypertension

C. Maya

Increasing incidence of chronic kidney diseases

Thiruvananthapuram: The increasing number of people developing chronic kidney diseases has had nephrologists calling for urgent community-based interventions for early identification and treatment of those at risk for hypertension.

Nephrologists sounded this alert following the results of a community-based survey carried out in the city, which showed about 50 per cent of those in the 20 to 49 years age group to be in the pre-hypertension stage.

Hypertension or high blood pressure has a direct bearing on the functioning of kidneys and is one of the leading causes for chronic kidney diseases. An estimated one lakh people in the country develop end stage renal diseases every year and hypertension accounts for about 5 to 15 per cent of these cases.

The study was carried out in Karamana and Thaliyal in the city early in the year by a group of medical students under the guidance of A. Vimala, the former Head of the Department of Nephrology, Medical College here.

"Diabetes and hypertension are two major causes of chronic kidney diseases and the high prevalence of these two predisposing factors in the community is a cause for worry. Early identification and prevention of kidney diseases is very important because of the high morbidity of the condition and also because treatment options like dialysis or renal transplants are unaffordable to most," says Dr. Vimala, who is currently heading the Nephrology Department at Kozhikode Medical College.

In the study, a population of 7,000 was covered, out of which a random sample of 482 persons was chosen.

About 47.3 per cent of the sample surveyed (228 out of 482) was found to be suffering from hypertension stage I /II.

The finding that 50 per cent of those in the prime age of 20 to 49 are in the pre-hypertension stage indicates that this is the target group where health interventions are urgently required.

Lifestyle modifications

Lifestyle and dietary modifications can prevent this group from progressing to the stage of hypertension.

The study used the international guidelines fixed in 2003 by the Seventh Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure.

According to JNC VII guidelines, a blood pressure of 120-139/80-89 Hg should be considered the pre-hypertension stage.

Lack of awareness was total regarding the pre-hypertension concept in all those who took part in the study. Even among those in stages I and II of hypertension, 98 per cent did not know that their blood pressure was abnormal.

A medical camp was conducted in which 179 persons were evaluated for blood pressure and blood sugar. A random urine sampling for proteinurea was also done. Of those who attended the camp, 59 were in the pre-hypertension stage; 40 were in hypertensive stages I and II, while 38 were already under treatment for blood pressure.

About 14 per cent of those who attended the camp tested positive for proteinurea in a single random analysis of urine.

"This is a very significant finding because proteinurea indicates tissue damage to the kidneys. All are newly detected cases and this group requires immediate medical evaluations. In a similar study carried out by CMC, Vellore, the figure was 11per cent," Dr. Vimala said.

It is estimated that uncontrolled pre-hypertension for 10 years could directly affect the kidneys.

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