The World Health Organisation (WHO) is finalising a set of nine voluntary global targets that will help in reducing non-communicable diseases (NCDs), particularly hypertension which is a major contributor to cardio-vascular diseases.
The voluntary targets being discussed are reduction in premature mortality from NCDs by 25 per cent by 2020 — by reducing intake of alcohol and physical inactivity by 10 per cent each and intake of salt/sodium by 30 per cent. This will reduce high blood pressure incidence by 25 per cent. Use of tobacco is targeted to be brought down by 30 per cent in addition to improving medicines, technology and counselling.
Hypertension is a major contributor to avoidable death and disease in India, too, with an increasing impact in the rural areas. Over 140 million people are believed to be suffering from high blood pressure in the country and the number is expected to cross the 214 million mark in 2030. Hypertension is a major risk factor for cardio-vascular diseases that killed 2.7 million people in 2004 and will result in the death of over 4 million people by 2030.
According to Dr. Sailesh Mohan, Associate Professor, Public Health Foundation of India, it is estimated that 20-40 per cent population in urban areas and 12-17 per cent in rural areas have hypertension. A WHO estimate in 2008 suggested 33 per cent men and 32 per cent women older than 25 years had hypertension in India.
An Integrated Disease Surveillance Prevalence Survey of 2007-08 indicates a very high percentage of Indians are in a pre-hypertension stage. Mizoram had 58.5 per cent people in pre-hypertension stage though the actual population suffering from high blood pressure was only 19 per cent. This was followed by Uttarakhand with 48.8 per cent, Kerala (48.1 per cent) and Maharashtra (46.2 per cent). Madhya Pradesh, Tamil Nadu and Andhra Pradesh are among the other States that have over 40 per cent of the population in the pre-hypertension category. “If these people take corrective measures like adopting a healthy lifestyle, they can be prevented from actually getting hypertension,” Dr. Mohan said.
Hypertension has serious economic implications also, as it is a leading cause of hospitalisation and out-patient visits. The annual income loss (calculated in 2004) was Rs.43 billion and accounts for 64 per cent of out-of-pocket expenses. A month’s treatment with just one anti-hypertensive medication cost 1.8 days wages and becomes unaffordable if more than one drug is prescribed or more than one person has hypertension in the family.
“Our aim is to provide cost-effective interventions at the primary health care level for early diagnosis and treatment of NCDs and improve the availability of basic diagnostics and essential medicines required to treat major hypertension and associated diseases,” says Dr. Renu Garg, Regional Adviser, WHO’s Regional Office for South-East Asia.