Hypertension UPSC NOTE

Hypertension

Hypertension (high blood pressure) is when the pressure in your blood vessels is too high (140/90 mmHg or higher).
It is common but can be serious if not treated.
People with high blood pressure may not feel symptoms.
The only way to know is to get your blood pressure checked.
Blood pressure is written as two numbers.
The first (systolic) number represents the pressure in blood vessels when the heart contracts or beats.

The second (diastolic) number represents the pressure in the vessels when the heart rests between beats.
Hypertension is diagnosed if, when it is measured on two different days, the systolic blood pressure readings on both days is ≥140 mmHg and/or the diastolic blood pressure readings on both days is ≥90 mmHg.

Risk factors:

Modifiable risk factors include

Unhealthy diets (excessive salt consumption, a diet high in saturated fat and trans fats, low intake of fruits and vegetables).

Non-modifiable risk factors include

Symptoms:

Most people with hypertension don’t feel any symptoms.
Very high blood pressures can cause headaches, blurred vision, chest pain and other symptoms.
Checking your blood pressure is the best way to know if you have high blood pressure.

If hypertension isn’t treated, it can cause other health conditions like kidney disease, heart disease and stroke.
People with very high blood pressure (usually 180/120 or higher) can experience symptoms including:
severe headaches
chest pain
dizziness
difficulty breathing
nausea
vomiting
blurred vision or other vision changes

Prevention:

World Health Organization (WHO) report on hypertension

It was released on 19 September 2023.
Globally, hypertension affects one in three individuals and four out of five do not have it adequately controlled.

Countries have done little to keep the biggest risk factor for death and disability under check despite the easy availability of inexpensive medicines.
In the WHO report that relies on 2019 data, 188 million Indians adults aged 30-79 years have hypertension.
Of them, the condition has been diagnosed only in 37%, 30% are treated and a meagre 15% of people have hypertension under control.
Women appear to be marginally better than men in having the condition diagnosed, treated and controlled.

Based on sketchy data from parts of India, stroke incidence was found to be 108-172 per 1,00,000 people per year and the one-month case fatality rate was 18%-42%, as per a February 2022 study.
In the Global Burden of Disease report, in 2019, heart attack was the leading cause of death and disability in India.
Studies have shown that excess salt consumption (over five grams a day) is responsible for 17%-30% of hypertension.
While member States are required to achieve a 30% relative reduction in mean population intake of salt by 2025.

India is yet to implement many components of WHO’s prescription to cut down salt intake.
A study in four Indian States published in 2021 found high salt and sugar content in packaged food items.
Making front-of-pack nutrition labelling mandatory, encouraging reformulation of foods to cut down salt, and raising awareness in people to reduce salt intake should be urgently undertaken.
India has, however, done well in improving blood pressure control in people with hypertension through the novel India Hypertension Control Initiative (IHCI).

Launched in 2018, the IHCI has successfully enrolled 5.8 million hypertensive patients for treatment in 27 States, as of June 2023.
Importantly, 48% of patients enrolled at primary health centres and 55% at health wellness centres achieved blood pressure control as of March 2021.
It is now important to greatly increase the number of hypertensive people on treatment and keep blood pressure under control.

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