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GS 3 - Polity
Why in the news?
The World Health Organization (WHO) has issued its first-ever report on the global effects of high blood pressure. According to this report, high blood pressure impacts one out of every three adults on a global scale.
About hypertension
- This is a health condition where the pressure in your arteries stays high for a long time. It is commonly known as "high blood pressure" among individuals.
- Blood pressure is usually represented by two numbers: one when the heart beats (systolic) and the other when the heart is resting (diastolic).
- Eating healthily, quitting smoking, and exercising more can lower your blood pressure.
Hypertension is the most important risk factor for death and disability in India, according to a paper in The Lancet, regional health (South-east Asia), published late last year.
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Factors that raise the likelihood of developing high blood pressure comprise:
- being overweight or obese
- not being physically active
- high-salt diet
- older age
- genetics
- drinking too much alcohol
Four stages of the Hypertension
- Elevated blood pressure levels between 120-129/less than 80
- Hypertension stage 1 is 130-139/80-89 mmHg
- Hypertension stage 2 is 140/90 mmHg or more
- Hypertensive crisis is higher than 180/120 or higher
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Key Findings of the Report:
1. Global High Blood Pressure Statistics:
- Approximately 80% of individuals with high blood pressure do not receive proper treatment.
- Expanding healthcare access globally could prevent 76 million deaths between 2023 and 2050.
- High blood pressure is defined as having a blood pressure reading of 140/90 millimeters of mercury (mmHg) or higher or taking medication for it.
- The global number of people with high blood pressure increased from 650 million to 1.3 billion between 1990 and 2019.
- Nearly half of all individuals with high blood pressure worldwide are unaware of their condition.
2. Key Findings About India:
- High blood pressure is the leading cause of health problems and death in India.
- Only 37% of Indians with hypertension are diagnosed, and a mere 30% receive treatment.
- A mere 15% of those with hypertension in India have their condition properly controlled.
- Approximately 52% of heart-related deaths in India, such as heart attacks, are attributed to high blood pressure.
- The primary factors contributing to high blood pressure in India include excessive salt consumption, smoking (28%), obesity, alcohol consumption, and lack of physical activity (34%).
- According to the National Family Health Survey (NFHS-5) conducted from 2016 to 2020, 24% of men and 21% of women in India had high blood pressure, marking an increase from 19% and 17%, respectively, in the previous survey (2015-16).
This organization separates the global findings from those specific to India, making it easier to understand the key points related to each aspect of the report.
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Trend of Hypertension in Adults
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Government Steps in India to Address Hypertension:
- Hypertension Control Initiative Programme:
- The Hypertension Control Initiative Programme operates under the National Health Mission in India.
- It has gained recognition for its positive impact on the country's primary healthcare system.
- The Indian Hypertension Control Initiative (IHCI) is a five-year effort involving multiple stakeholders, including the Ministry of Health & Family Welfare, the Indian Council of Medical Research, State Governments, and WHO-India.
- Program Launch and Coverage:
- As of December 2021, IHCI had been launched in 101 districts across 19 states in India.
- IHCI has successfully enrolled over 2 million patients in more than 13,000 healthcare facilities.
- Enrollment Statistics in Phase I Districts:
- In the initial 26 Phase I districts where IHCI was implemented, approximately 22% of the estimated total number of individuals with hypertension in those districts were enrolled.
These government initiatives demonstrate a concerted effort to address hypertension in India through a collaborative approach involving various agencies and stakeholders, with a focus on expanding access to healthcare and improving hypertension control.
Prominent Drugs for Hypertension
Medicines for high blood pressure include:
- Water Pills (Diuretics): These drugs remove sodium and water from the body and are often the first choice for hypertension. Types include thiazide, loop, and potassium-sparing diuretics like chlorthalidone and hydrochlorothiazide.
- Angiotensin-Converting Enzyme (ACE) Inhibitors: They relax blood vessels by blocking the formation of a chemical that narrows them. Examples include lisinopril, benazepril, and captopril.
- Angiotensin II Receptor Blockers (ARBs): These drugs also relax blood vessels but block the action of a natural chemical. Examples include candesartan and losartan.
- Calcium Channel Blockers: These medications relax blood vessel muscles and some slow heart rate. Examples include amlodipine and diltiazem.
- Alpha Blockers: Reduce nerve signals to blood vessels, lowering the effects of chemicals that narrow them. Examples include doxazosin and prazosin.
- Alpha-Beta Blockers: Block nerve signals to blood vessels and slow the heartbeat, reducing blood volume. Examples include carvedilol and labetalol.
- Beta Blockers: Reduce heart workload and widen blood vessels. Examples include atenolol and metoprolol, often used in combination with other drugs.
- Aldosterone Antagonists: Used for resistant hypertension to block a chemical causing salt and fluid buildup. Examples are spironolactone and eplerenone.
- Renin Inhibitors: Medication like aliskiren slows renin production, a kidney enzyme raising blood pressure.
- Vasodilators: Prevent artery muscles from tightening, preventing narrowing. Examples include hydralazine and minoxidil.
- Central-Acting Agents: These drugs stop the brain from increasing heart rate and narrowing blood vessels. Examples include clonidine, guanfacine, and methyldopa.
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