Kerala, Tamil Nadu best at controlling blood pressure, says a new Lancet study

75% of Indian patients of hypertension have uncontrolled blood pressure. Only a fourth have their BP under control.

BySumit Jha

Published Nov 29, 2022 | 9:03 AMUpdatedNov 29, 2022 | 9:03 AM

Hypertension or high blood pressure is one of the important modifiable risk factor for cardiovascular diseases. (Creative Commons)

A recent study published in The Lancet Regional Health journal has shown that the southern states of Kerala and Tamil Nadu reported the highest rates of controlled blood pressure.

“South India showed better control rates, and southern states of Kerala and Tamil Nadu reported the highest rates of [blood] control,” said the study.

Hypertension, or high blood pressure, is one of the more important modifiable risk factors for cardiovascular diseases.

This makes it one of the significant contributors of premature death and morbidity.

The study, titled Hypertension control rate in India: Systematic review and meta-analysis of population-level non-interventional studies, 2001–2022, finds that 75 percent of Indian patients of hypertension have uncontrolled blood pressure.

Only one fourth of the surveyed population has their blood pressure under control.

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Differences across regions

“Less than one-fourth of hypertensive patients in India had their blood pressure under control during 2016–2020. Although the control rate has improved compared to previous years, substantial differences exist across regions,” the study found.

The research found that 21 studies (41 percent) reported poorer hypertension control rates among males than females, and six studies (12 percent) reported poorer control rates among rural patients.

The rates increased nearly four times from 5.8 percent in 2001–2005 to 22.5 percent in 2016–2020.

However, considering the increasing prevalence of hypertension, especially among the poor and young adults, and very high proportion of patients unaware of their high blood pressure, India’s national programme needs to revisit its goals and strategies to improve the control rates in India.

The study also found that treatment adherence and access to medicine are key determinants of blood pressure control. As many as 23.7 percent of the subjects monitored blood pressure only two to four times a year, while 67.3 percent never monitored their blood pressure.

“A recent review had shown that poor availability of generic medicines in public and private sector and high costs are major barriers to antihypertensive control including in India,” said the study.

Also, around 70 percent of the estimated proportion of adults with hypertension did not receive antihypertensive drugs in 2018. Besides, the high out-of-pocket expenditure and lack of insurance coverage for out-patient services and drugs reduces the access to anti-hypertensive medication, resulting in uncontrolled hypertension.

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Gap between the rich and the poor

The study said a 13 percentage-point gap in hypertension control rate between the rich and the poor, and a clear disadvantage for Scheduled Castes, tribes and backward communities were reported in the recent Longitudinal Ageing Study in India.

The study also found that uncontrolled hypertension was more frequent among obese patients, patients with sedentary lifestyles, and diabetic patients.

“Hypertension is a significant contributor to mortality in India. Achieving better hypertension control rate at the population level is critical in reducing cardiovascular morbidity and mortality,”

The team, including researchers from National Centre for Disease Control, New Delhi, and Boston University School of Public Health, US, conducted a systematic review of 51 studies published after 2001 that reported hypertension control rates in India.