Discuss latest perspectives and management strategies in hypertension to prevent complications related to heart, stroke and kidney
Leading cardiologists, physicians and medical academics from across the country discussed the concern arising from growing burden of hypertension in India and across the world at a Symposium supported by Association of Physicians of India, Delhi Chapter.
Hypertension contributes to the burden of heart disease, stroke and kidney failure and premature mortality and disability. When combined with another rising epidemic of our times — diabetes — it makes for a deadly combo. In a recently published study 45 per cent of population in metro cities including Delhi have blood pressures more than 140/90 mms and 20 per cent population suffered from a combination of diabetes and hypertension – also called a deadly duo.
Dr Upendra Kaul, (Executive Director & Dean, Fortis Escorts Heart Institute and Research Centre And Fortis Hospital, Vasant Kunj), discussed the major complications arising out of the dual onset of diabetes and hypertension.
“Hypertension and diabetes are major challenges even when they go solo. However, when afflicted by both these ailments together, a person automatically becomes a high risk category for several ailments. The major cause of excess mortality in diabetes is cardiovascular disease. When combined with hypertension, this risk multiplies severely while making the patient more vulnerable to kidney failures as well. With both hypertension and type 2 diabetes on the rise in India, we are staring at a major health crisis. Besides improving treatment modalities (which is being done on war footing), we need heavy stress on preventive aspects,” said Dr Kaul.
“The increasing incidence of hypertension can be attributed to increasing population of elderly, unhealthy diet, excessive use of alcohol and tobacco, growing lack of physical activity, obesity and high stress lifestyles. These lifestyle factors are also responsible for a huge growth in type 2 diabetes. We need serious preventive interventions to fight these twin evils of health,” said Dr Kaul.
Recent years have witnessed a rapid rise in the prevalence of diabetes and hypertension in India. A recent study conducted on over 15,000 subjects across 8 states in India, in which Dr Kaul participated as an expert, found diabetes and hypertension co-existent in more than 20 per cent of them, pointing to a huge burden of consequences.
This twin epidemic could be attributed to the increasing levels of sedentarism, urbanisation, and consumption of energy-dense and fiber/micronutrient-poor food. Additionally, Indians have a high intake of salt. Some ethnic Indian foods like chutneys, papads, and pickles that are regular and popular household dietary choices increase daily, concluded the study.
Treating the complications of hypertension entails costly interventions such as cardiac bypass surgery, carotid artery surgery and dialysis, draining individual and government budgets. Addressing behavioural risk factors, e.g. unhealthy diet, harmful use of alcohol and physical inactivity, can prevent hypertension. Tobacco use increases risk of its complications.
“Since hypertension does not often cause symptoms in early stages, many people go undiagnosed. In fact, some discover they are hypertensive only after they are hit by a heart related event. At the same time, there are others who do not have access to correct management and treatment mechanisms, or those who do not adhere to prescribed medication. Greater awareness is also required in educating people about the need for prevention which can result in significant health an economic gains,” said Dr Venkata Ram, Director, Apollo Institute of Blood Pressure Management and Director, Blood Pressure Clinics, Apollo Group of Hospitals and Director, Texas Blood Pressure Institute, Dallas, Texas, US Vice-president, American Society of Hypertension and past chairman, board of governors, American Society of Hypertension.
Dr Venkataram emphasised on the magnitude of the problem of this silent killer disease and challenges to bring the BP levels to targets by using life style modifications and drugs.
Other experts including Dr Vijay Kher, Director of Nephrology, Medanta Hospital spoke about hypertension and its repercussions on kidney and heart health. A panel discussion was also held to debate different subjects such as refractory hypertension, pregnancy and hypertension, newer drugs and hypertension in elderly.
EH News Bureau
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