LOWERING CUTOFF FOR HYPERTENSION IS RAISING THREE TIMES HEALTH EXPENDITURE IN INDIA. (April 2021)

• Record Type: Journal Article
• Authors: Maheshwari, Anuj; Verma, Narsingh; Gupta, Arvind; Gupta, Vitull Kumar; Patni, Bijay; Gupta, Balkishan; Saboo, Banshi; Kaur, Amrit; Srivastava, Saurabh; Kumar, B. Rajendra; Agarwal, Vivek; Gupta, Amit; Jain, Payal; Singh, Smriti; Chaowdhary, Sandeep; Chandra, Kp; Rangwala, Joozer; Kumar, Santosh; Kumar, Ch Vasanth; Muthusamy, Vv
• Is Part Of: Journal of hypertension. Volume 39(2021)e-Supplement 1
• Publication Date: 2021-04
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000747572.33012.34
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Recently American College of Cardiology (ACC)/AHA high blood pressure guideline drops both the systolic and diastolic blood pressure levels by 10 mm Hg leading the rise of overall crude prevalence of hypertension among U.S. adults from 31.9% to 45.6%. Surely these recommendations suggesting target 130/80 based on almost 50% reduction in CV events and mortality but at the same time clubbed with a rise of hypotension and acute renal failure apart from possible increase in adverse events of hypertension medications. Design and method: Keeping aim to study the impact of reducing cut off for hypertension in developing country like India we screened apparently healthy 129710 individuals, who never checked their blood pressure before, picked at various public places after their due consent to reveal data without disclosing their identity for blood pressure measurement in seated position after five minutes rest with three readings and taken the average of last two readings. Their demographic and details of habit also recorded. Results: There has been a tremendous rise in prevalence from 16.49% to 44.71% while dropping the cut off from 140/90 to 130/80. Interestingly in younger population less than 30 years of age prevalence of hypertension has been 7.7% with classical cut off 140/90 but rising more than four times 33.11% when cut off drops to 130/80. In elderly population above 60 years, a considerable rise of more than double from 28.8% to 59.6% noted. Conclusions: For developing world it is not only a huge rise in health expenditure but also in a country like India where 72% population is less than 40 years of age, it imparts an impression of being sick in a larger part. With this new cut off every third youngster can be labelled hypertensive. As sympathetic overdrive plays a major role in young population with hypertension, it is necessary to find an appropriate cut off for them which can not be similar to elderly. Early use of anti-hypertensive drugs not only opens door to various side effects but also paves way for lightheaded, fatigue, weakness while endeavoring lower targets.