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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).

  • Physical inactivity

  • Consumption of tobacco and alcohol

  • Being overweight or obese

Non-modifiable risk factors include 

  • A family history of hypertension.

  • Age over 65 years and co-existing diseases such as diabetes or kidney disease.

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

  • anxiety

  • confusion

  • buzzing in the ears

  • nosebleeds

  • abnormal heart rhythm

Prevention:

  • Lifestyle changes can help lower high blood pressure. These include:

    • eating a healthy, low-salt diet

    • losing weight

    • being physically active

    • quitting tobacco and alcohol

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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