Medical experts see compliance with treatment biggest problem to control hypertension


Medical experts are of the view that the biggest problem to control hypertension is compliance with the treatment. Despite the availability of effective and safe antihypertensive drugs, experts rue that hypertension and its related risk factors like obesity, high blood lipids, and diabetes mellitus remain uncontrolled in many patients.

Hypertension in the younger age group is altogether a different entity. On the occasion of the World Hypertension Day observed on May 17, with this year’s theme as ‘Know your numbers’, doctors are concerned on the rising incidence. 

Adults with high blood pressure globally was around 972 million in 2000 and this is expected to reach 1.56 billion by 2025. According to a study, about 33% of people in urban India and 25% in rural India are estimated to be hypertensive. 

Lifestyle factors, such as physical inactivity, a salt-rich diet with high processed and fatty foods, and alcohol and tobacco use, are reasons for this increased disease burden, which is spreading at an alarming rate from developed countries to emerging economies, such as India, China and African countries, said Dr Dilip Kumar, Consultant Interventional Cardiologist, Electrophysiologist and Chief Academic Co-ordinator, Medica Superspecialty Hospital. 

When the condition strikes a younger age group, we need to rule out any endocrine dysfunction. Moreover, obesity leads to insulin resistance which causes high blood pressure in youth. Adrenal tumours and renal dysfunction are also tipped to be most common causes of fluctuating high blood pressure. Left uncontrolled in the young, it will lead to Cerebro and Cardiovascular events which adds to morbidity and mortality burden, said Dr. Shylaja Shyamsunder, Consultant, Internal Medicine, BGS Gleneagles Global Hospital.

Adequate treatment of high blood pressure lowers cardiovascular risk. However, the biggest problem for controlling hypertension is compliance with treatment. Despite effective and cost-effective treatments, target blood pressure levels are very rarely reached, even in countries where cost of medication is not an issue. Sadly, many patients still believe that hypertension is a disease that can be 'cured', and they stop or reduce medication when levels fall to normal levels, said Dr. Kumar. 

Hypertension is a common co-morbidity in diabetic patients. As per the National Diabetes Statistics Report 2014, 71% of type 2 diabetes patients have hypertension. According to AstraZeneca, its novel treatment for type 2 diabetes, dapagliflozin – a SGLT2 inhibitor, has shown favourable effects in reducing blood pressure. 

Hypertension is a silent killer, if diagnosed early it can be reversed through lifestyle alterations. Regular check-ups is the key to manage it. While the medicines that are currently available are effective, researchers are continuously investing in developing newer medicines. Earlier this disorder was associated with elderly population, owing to the sedentary lifestyle the incidents of hypertension among people in their 30s are on rise. As per researchers the age group who are getting affected by this condition will drop further. In fact, hypertension will be a common condition even among the teenagers by next decade, said Dr. Rammohan S Bhat, Consultant, Nephrology, Renal Transplant Physician, Narayana Health City.
 
According to Dr BTC Murthy, CMO, Jindal Naturecure Institute, hypertension is a healthcare threat of this century. Our Institute has conducted extensive research utilizing nature cure and yoga for hypertension. 
 
Lifestyle changes are the best way to address high blood pressure. Here Dietary Approaches to Stop Hypertension (DASH) where fruits, vegetables, whole grains, and low-fat dairy foods are most recommended, said Pavithra N Raj, Chief Dietician, Columbia Asia Referral Hospital, Yeshwanthpur.


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