The Punjab Health Department in January 2020, launched India Hypertension Control Initiative (IHCI), for early identification of patients suffering from hypertension and putting them on treatment, in five districts of the state, namely, Bhatinda, Hoshiarpur, Gurdaspur, Pathankot, and Mansa. The project is a joint collaboration of the Punjab Health Department the World Health Organisation (WHO), Indian Council of Medical Research, and Vital Strategies Organisation.
Objective of the Project
The objective of the project is early identification of cases of hypertension, putting them on treatment, continuing treatment to achieve and maintain control of hypertension so that early mortality due to hypertension could be reduced.
Punjab is the first state to launch the project as a part of National Programme for Prevention and Control of cancer, Diabetes, Cardiovascular Diseases, and strake (NPCDCS).
Some of the salient features of the project are as follows:
(i) The project is based upon the project of central government launched in five states, namely, Punjab, Kerala, Maharashtra, Madhya Pradesh, and Telangana.
(ii) Under the initiative, the procurement of drugs is streamlined and the availability of drugs would be ensured at all levels in the government hospitals and health and wellness centres.
(iii) The programme is to be functional across the state soon.
(iv) A workshop was held at the state level where the district health administrators, including civil surgeons, District Nodal Officers, and Medical Specialists were sensitised towards the project by WHO and state health representatives with inputs from Indian Council of Medical Research (ICMR) and Vital Strategies Organisation.
(v) The project has been able to control hyper tension in about 35 per cent of the people, covered under the initiative.
(vi) The project was first launched in Kerala in 2018 as a multi-partner five-year initiative and the results were found to be most impressive there because of the infrastructure strength across the state.
(vii) Each patient was given a treatment book and the health card was kept at the hospital.
(viii) There was a follow-up on the patient by the hospital over the phone or by visit of an Accredited Social Work Activist.
Understanding Hypertension
Hypertension, also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure is persistently elevated in the arteries. It is usually defined as blood pressure above 140/90, and is regarded severe if the pressure is above 180/120. High BP generally has no symptoms, but it causes health conditions like heart disease or stroke if not treated. Therefore, it is advised that healthier diet, less salt, regular exercise, and taking medication should be adopted at the earliest.
One in four adults have high blood pressure in India. Among then, only half have been diagnosed and only 1 in 10 have blood pressure under control. The programme aims to treat over 15 crore patients over the next four years.
National Action Plan
As per the director general of ICMR, the government has adopted a national action plan for prevention and control of non-communicable diseases with a target of 25 per cent reduction in high blood pressure by 2025. The government has adopted the ’25 by 25’ goal, which aims to reduce premature mortality due to non-communicable diseases (NCDs) by 25 per cent by 2025. Reducing the high blood pressure by 25 per cent by 2025 is one of the nine voluntary targets for NCDs.
The Nine Voluntary Targets
WHO ‘Global Monitoring Framework on NCDs’ tracks implementation of the INCD global action plan’ and reporting on the attainment of the 9 global targets for NCDs by 2025, against a baseline in 2010. These global targets are as follows:
(i) A 25 per cent relative reduction in the overall mortality from cardiovascular diseases, cancer, diabetes, or chronic diseases.
(ii) Minimum 10 per cent relative reduction in the harmful use of alcohol.
(iii) A 10 per cent relative reduction in prevalence of insufficient physical activity.
(iv) A 30 per cent relative reduction in mean population intake of salt/sodium.
(v) A 30 per cent relative reduction in prevalence of current tobacco use in persons aged 15+ years.
(vi) A 25 per cent relative reduction in the prevalence of raised blood pressure or contain the prevalence of raised blood pressure according to national circumstances.
(vii) Halt the rise in diabetes and obesity.
(viii) At least 50 per cent of eligible people receive drug therapy and counselling to prevent heart attacks and strokes, and
(ix) An 80 per cent availability of the affordable basic technologies and essential medicines, including generics, required to treat major NCDs in both public and private facilities.