Undetected hypertension adds to India’s rising stroke burden

In India, incidence of stroke ranges from 116 to 163 people per 100,000 population.

Undetected and untreated hypertension is the top risk factor for stroke which is the second leading cause of death and disability after ischemic heart disease across the world.

Studies have shown that at least 64 per cent stroke patients have hypertension which is the most prevalent risk factor for this deadly cardiovascular event.

With stroke burden increasing exponentially in the country, doctors from All India Institute of Medical Sciences (AIIMS) say it is time now to focus on hypertension treatment – a prevention strategy that is achievable and can save millions of lives.”

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“It is time we recognise that hypertension, an easily treatable condition, has far reaching repercussions. Raised blood pressure can result in stroke which not only causes premature death and life-long disability, it can throw families into irrecoverable financial shocks and loss of income. Increasingly in India, the stroke survivors are a relatively younger population. We must bear in mind that this means loss of income and a work life curtailed,” said Dr Pradeep Aggarwal, Professor, Community Medicine, AIIMS Rishikesh.

Stroke is responsible for an estimated 5.6 million deaths and 116.4 million Disability Adjusted Life Years (DALY) worldwide, as per 2016 data.

In India, incidence of stroke ranges from 116 to 163 people per 100,000 population. Studies have revealed that the increasing prevalence of hypertension in India is likely to push up the stroke burden of the country.

Dr Surender Deora, senior cardiologist, AIIMS Jodhpur warns that severe hypertension has been correlated with a poorer prognosis and even higher mortality in stroke patients.

“In majority of cases we see that ischemic stroke is linked to poor control of high blood pressure. What we describe as the stroke burden is not just due to its high mortality rate. Stroke is a massive public health and well-being concern because up to 50 per cent survivors remain disabled for the rest of their lives. This has a devastating socio-economic impact.”

According to a study on stroke epidemiology in India, the incidence of stroke in South Asian countries has increased by more than 100 per cent in the past four decades. By 2050, it is estimated that 80 per cent of the burden of new strokes will be on low- and middle-income countries. As a result of the epidemiological transition sweeping through India, stroke prevalence is all set to rise in the coming years.

Dr Pankaj Bharadwaj, Additional Professor, Dept. of Community and Family Medicine and Dean, School of Public Health, AIIMS Jodhpur, said, “Paying attention to the stroke-hypertension connection now will pay dividends in the future. There is no dearth of evidence from clinical practice and from the grassroots that untreated and uncontrolled blood pressure is the most common cause for stroke. We must do what we can to reign in the damage caused by high blood pressure, treatment for which is affordable and easily available.

Although, high blood pressure has become a health crisis with at least one in four adult Indians suffering from this condition.

To meet India’s commitment of 25 per cent relative reduction in prevalence of high blood pressure by 2025, till June 2022, Indian Council of Medical Research’s India Hypertension Control Initiative (IHCI) has been rolled out in 105 districts across 21 states covering 1500+ health facilities.

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