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Checkmating a silent killer

A doctor listening to his patient's heartbeat with a stethoscope

A doctor listening to his patient's heartbeat with a stethoscope  

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Hypertension leads to slow death, and early detection is a must to combat it

Armed with a brand new MBBS degree, my son has become a doctor. The medical officer in charge of the social and preventive medicine department handed over the duty roster for the batch — girls were asked to manage the outpatient department at the primary health centre and boys at the rural satellite centres.

My son reached the centre allotted to him to see a large crowd milling around. People jostled to get a slot closer to the clinic door. The elderly nurse welcomed him.

“Today is a busy OPD day and our usual medical officer has gone on leave. But don’t worry, just be fast. There would be roughly 200 patients,” she said.

“But sister, I have just… I mean today is my first day…”

“Don’t worry, let us start. We have enough paracetamol, one antibiotic, a cough mixture, pantoprazole and antacid,” she said. “You can write medicines for a maximum of five days. Any complicated case, we refer.”

She ushered him to the table, and adjusted the chair.

“One important thing is to keep the BP apparatus out of sight of patients; otherwise, everyone will want their BP checked; and we have no time for it…” She slid the BP apparatus inside the drawer.

Things that are sudden, catastrophic, unexpected or massive impress us, while slow decay doesn’t. A rusting bridge doesn’t make news; it needs to collapse suddenly to make it to the headlines.

So is the case with high blood pressure, which can cause hardening, narrowing and subsequent blockage of arteries in the heart, brain, eyes and kidneys, resulting in stroke, heart attack, kidney failure and visual loss. Hypertension has no symptoms initially. By the time symptoms develop, it would have already done some damage. It can promote blood clotting or end up in the breakage of arteries in the brain, resulting in cerebral haemorrhage.

In India, an estimated 207 million people (24.7% of the population) have hypertension. Of them, 40 million end up with disability every year and 1.7 million die (eight times the 2,50,000 death toll of the 2004 Indian Ocean tsunami) in just one year (Journal of American medical Association, March 2018).

Surprisingly, it takes just about 90 seconds to measure blood pressure. But checking the BP of 200 people needs five hours.

I am on the editorial board of two important hypertension journals, and we strongly advocate screening for hypertension whenever a person comes in medical contact for whatever reason it may be.

At school, I was taught that an ostrich hides its head in the sand when faced with a crisis, which later turned out to be incorrect. I am waiting to see how much time it will take to learn the same about hiding the BP apparatus.

tinynair@gmail.com

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Printable version | Dec 15, 2019 9:40:41 PM | https://www.thehindu.com/opinion/open-page/checkmating-a-silent-killer/article30124025.ece

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