India’s first district-level study on hypertension

Recently, a district-wise analysis on hypertension has been conducted which flags disparities in care in India.

• Also, according to a recent WHO report, 3 million people in India suffer from hypertension but only 37% get diagnosed, only 30% start treatment, and only 15% manage to keep their blood pressure under control.

About the study:

• It is the first time that data on hypertension was analysed district-wise.
• Published by: The district-level study, published in JAMA Network, a journal published by the American Medical Association, was conducted by AIIMS Delhi and scientists from Europe and the US who used the hypertension data from NFHS-5, the fifth round report of which was released in May 2022.
• A dashboard was created as a part of the study and has gender-wise, area-wise educational levels data on hypertension.
• Significance:
  • The district-wise level analysis was important as the many state-level analyses done earlier did not highlight “the heterogeneity” within states, even those considered better-performing states.
  • And with the new dashboard, every district can now analyses their data according to gender and socio-demographic disparities.

Key Findings

• The study estimated that at least 6 million deaths in India can be prevented by 2040 if half of those with the condition manage to keep their blood pressure under control.
• In Karnataka, four districts — Chikmagalur, Shimoga, Udupi and Chitradurga — have a similar prevalence of hypertension, but the proportion of participants diagnosed and treated in Chikmagalur and Udupi was higher.
• In Meghalaya, the five districts of Garo Hills, the two districts of Jaintia Hills and the three districts of Khasi Hills all have a similar prevalence of hypertension, but the proportion of those diagnosed is much lower in Garo Hills than in Jaintia Hills and Khasi Hills.
• More significantly, the study found, there were substantial variations across districts in;
  • Blood pressure diagnosis (range: 6.3%-77.5%),
  • Treatment (range: 8.7%-97.1%) and
  • Control (range: 2.7%-76.6%).
• Raising a red flag, the researchers said that the national mean values of hypertension “hide considerable” variation at the district level.

Recommendations:               

• The findings of the study showed that despite health being a state subject, there was a need for more autonomy at the district level.
• Another key finding of the study was the importance of screening hypertension and diabetes using local healthcare workers, including ASHA workers.
• It highlighted the urgent need for a more “targeted” approach to fight the medical condition often referred to as the “silent killer”.
• It recommended a critical public health strategy to improve care — “targeted, decentralised solutions” at the district level.