India lacks adequate community level data for hypertension control: Lancet

More than 50 per cent of patients in India are unaware of their high blood pressure, finds a study published in Lancet Regional Health Journal

India needs better community level data to understand the problem of Hypertension, finds a recent study published in the Lancet Regional Health Journal. 
 

The study titled "Hypertension control rate in India: Systematic review and meta-analysis of population-level non-interventional studies, 2001-2022" has highlighted that more than 75 per cent of hypertensive patients in India had their blood pressure out of control. Researchers have raised alarm on increasing prevalence of hypertension especially among the poor, young adults, and more than 50 per cent of patients unaware of their high blood pressure in India, and have called for a national program "to revisit its goals and strategies to improve the control rates."
 

"Only 22.5 per cent of hypertensive patients in India have their blood pressure under control during the most recent period in our analysis— 2016 to 2020. The previously published meta-analysis of community-level hypertension control in India with data from 1950 to 2013 showed a control rate of 10.7 per cent for rural India and 20.2 per cent for urban India."
 

The study also found that the control rate in the year 2001-22 was at 17.5 per cent. This rate is a matter of concern because according to  NFHS-4 data (2015–16), only 50 per cent of patients in the age group of 15-49 years in India knew their hypertension status.
 

The study draws from a systematic review on hypertension control in India covering three databases and two sources of grey literature. It has focused on community-based non-interventional studies which provide a realistic picture of control rates at the community level. It has also examined the availability of literature on risk factors of hypertension control including social determinants of health.
 

The study also highlights that even though hypertension control rates have significantly improved in the last two decades, the rates nearly quadrupled from 5.8 per cent in 2001-05 to 22.5 per cent in 2016-20.
 

The study defines hypertension control rate as the proportion of patients with their blood pressure under control.

Another significant finding of the study points to the glaring regional differences that exist in hypertension control across India.

"We found very few studies in the West and the North India compared to the South." the study said.
 

According to the study, south India recorded better control rates. Among the southern states, Kerala and Tamil Nadu showed highest rates of control. 
 

Also, the difference in capacity of health systems across India, to detect and treat hypertension, "varies across the country as much as the level of awareness about the disease, its prevention, and control." 
 

Most importantly, the report highlights that their are very few studies that examine "the association of lifestyle and other risk factors with poor control rates."

The report defines hypertension as an important modifiable risk factor for cardiovascular diseases (CVD). This makes it one of the significant contributors to premature death and morbidity.
 

Hypertension is the most important risk factor for death and disability in India. According to the 2019-20 National Family Health Survey (NFHS-5), hypertension prevailed in 24 per cent of men and 21 per cent of women, an increase from 19 per cent and 17 per cent respectively from the previous round.

According to the Lancet study, hypertension control is strongly influenced by health system factors, lifestyle risk factors, and social determinants, and the lack of data in the Indian literature on these critical factors should prompt serious efforts towards developing nationally representative studies to capture the extent and the key drivers of hypertension control in India.