Findings of India Heart Study (I.H.S) show that 46% of people from Tamil Nadu who participated in the study were unaware of suffering from high blood pressure or hypertension. For the 2293 people studied, it was found that:
25.1% of the respondents had high blood pressure levels but were unaware of it
20.8% were found to have masked hypertension
20.2% were found to have white-coat hypertension
33.90% were found to be normotensive
India Heart Study (I.H.S) findings highlight a high prevalence of masked hypertension and white-coat hypertension in Indians at 42% on first office visit (doctor’s clinic). It was also found that Indians have an average resting heart rate of 80 beats per minute, higher than the desired rate of 72 beats per minute. Another striking finding of the study is that unlike other countries, Indians have higher blood pressure in the evenings than in mornings which should guide doctors to rethink the timing of advising anti-hypertensive drug dosage.
White-coat hypertensives who are misdiagnosed and put on anti-hypertensives have to take unnecessary medication. On the other hand, a masked hypertensive may go undiagnosed running the risk of complications of the heart, kidney, and brain, leading to premature mortality.
Dr. Upendra Kaul, Cardiologist, Chairman and Dean Academics and Research of BHMRC, who was the Principal Investigator of I.H.S, said “India Heart Study points to a need for better clinical management of hypertension in India. This is India-specific data and should help shape the best practices for the diagnosis of high blood pressure among Indians. The study presents exhaustive data on the various aspects of hypertension.”
Throwing light on the study, Dr. Willem Verberk, PhD., Cardiovascular Research Institute Maastricht (CARIM), and a key investigator, said, “For the ‘correct’ detection of hypertension, home blood pressure monitoring is advised. However, different patients may have different co-morbidities, like diabetes, which makes the use of validated devices for home blood pressure monitoring important. Home blood pressure monitors for pregnant women, adolescents and people with kidney disorders needs to be validated separately.”
Dr. Viraj Suvarna, President – Medical, Eris Lifesciences said, “Masked Hypertension, if undetected, is a dangerous phenomenon. It is important to monitor one’s blood pressure, beyond the clinic, even at home, according to prescribed guidelines. Accurate diagnosis of hypertension is an important element of our fight against this disease and improving health outcomes.”
Dr S Shanmugasundaram, Cardiologist, Bilroth Hospital, Shenoy Nagar, and a co-ordinator for I.H.S, said, “It is alarming to see the high prevalence of hypertension in our state. Much worse thing is that majority of such hypertensives are not aware of it. The study reconfirms that hypertension is often asymptotic but detected by routine resting. Early detection and appropriate treatment can prevent stroke, heart attack, kidney failure etc which is made possible and practical with home monitoring using automated apparatus.”
Dr. N Sivakadaksham, Senior Consultant Cardiologist, Siva’s Cardiac and Diabetic Care. Chennai said, “As a practice, it is important to study blood pressure levels over some days for people showing elevated levels of blood pressure. This will ensure that an individual is not incorrectly ‘labelled’ hypertensive for life and put on anti-hypertensive medicines”.
According to Dr R Vijayakumar, Nephrologist, Bilroth Hospital, R. A. Puram, “Elevated blood pressure, or hypertension harms the renal blood vessels over time; it adversely affects the functioning of the kidneys. It is thus advisable that we are cognizant of our blood pressure levels and take necessary precautions to lead a healthier life.”
What sets this study apart is that it was conducted on ‘drug-naive’ set of participants using a comprehensive process of taking blood pressure readings. The investigators examined the blood pressure of 18,918 participants (male and female) through 1233 doctors across 15 states over a period of nine months. The participants’ blood pressure was monitored at home four times in a day for 7 consecutive days.