From CK Nayak
NEW DELHI, Nov 2: Ten out of the 12 districts in Meghalaya have been identified as having high levels of hypertension and significant disparities in treatment, a World Health Organization report said.
Many affected persons are not diagnosed and less than half of them could keep their blood pressure under control like many other parts of India, the report said.
There is a wide district-wise variance on treatment in the state, a study, published in JAMA Network, which is a journal published by the American Medical Association, said.
The study was carried out by AIIMS Delhi and scientists from Europe and the US who used hypertension data from NFHS-5.
The five districts of Garo Hills, two districts of Jaintia Hills and three districts of Khasi Hills 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, the study found.
These are among the key findings of the exhaustive study which, for the first time, mapped and assessed the variation in hypertension care at the district-level in India. This highlights the urgent need for a more “targeted” approach to fight the medical condition, often referred to as the “silent killer”.
According to the report, 188.3 million people in India suffer from hypertension but only 37 per cent get diagnosed, 30 per cent start treatment and 15 per cent manage to keep their blood pressure under control. It estimated that at least 4.6 million deaths in India can be prevented by 2040 if half of those with the condition manage to keep their blood pressure under control.
The researchers have created a dashboard of district and state-wise hypertension caseload in India, which, they said, will help stakeholders identify priorities for reducing burden and tracking progress.
Analysing the data of nearly 17 lakh respondents across socio-demographic groups in 707 districts, the study found that one in four adults had hypertension. Of these, only one in three came to know of their condition after being diagnosed with it, less than one in five were treated, and only one in 12 had their blood pressure under control.
More significantly, the study found, there were substantial variations across districts in blood pressure diagnosis. According to Dr Ambuj Roy, Professor of Cardiology at AIIMS and one of the investigators of the study, the district-wise analysis was important as many state-level analyses done earlier did not highlight “heterogeneity” within states, even those considered better-performing states.
With the new dashboard, Dr Roy said, every district can now analyse its data according to gender and socio-demographic disparities.
“We took the variables relevant to hypertension, such as age, gender, socio-economic status, and it is the first time that data on hypertension was analysed district-wise,” he said.
The findings showed that despite health being a state subject, there was a need for more autonomy at the district-level.
Dr Roy said: “Chief Medical Officers should know where they are failing in terms of hypertension management and what measures they could take, rather than having a similar approach for all districts in a state.”
Another key finding of the study was the importance of screening hypertension and diabetes using local healthcare workers, including ASHA workers.
“Instead of people coming to the hospital, you go to them and do hypertension screening in a door-to-door survey, and even the treatment should be provided through the nearest healthcare facility rather than them coming to the tertiary healthcare facility and district hospitals,” he added.
NEIGRIHMS Director Dr Nalin Mehta had earlier called Meghalaya the “cancer capital of India” during a consultative meeting with the religious leaders and state health authorities. Esophageal cancer, common in the state, is caused by use of tobacco, alcohol and betel nut.