Why you may have high BP but not know it

Hypertension is the leading risk factor for cardiovascular diseases and deaths. Yet, new research shows that healthcare providers may not be picking up on it. A study in BMC Public Health states that 16 out of 100 people visiting outpatient departments of primary health centres, community health centres, and district hospitals, as attendees, miss getting diagnosed with hypertension due to inadequate screening coverage.

In the study led by the ICMR-National Institute of Epidemiology, scientists found that 41,012 people eligible for hypertension screening attended the outpatient departments of health centres in 18 districts from nine states. Of them, 13,157 (32.1%) were screened for hypertension in various facilities, and 3,050 were found to be hypertensive.

"Our calculations estimate that we would find 9,515 people with high blood pressure if the screening coverage were 100%. It includes not just the patients, but those who accompany them," says Corresponding Author Dr Archana Ramalingam, a scientist at the National Institute of Epidemiology. Analysis showed that South Andaman in A&N recorded 96% coverage, followed by Balod in Chhattisgarh (66%). While the India average was 32%, Chennai was at 26%.

The biggest barrier for health staff was time, says the study. Staff take anywhere between 58 to 63.5 seconds to measure blood pressure in one person at OPDs that function for five hours a day in hospitals. "Every OPD will need at least one dedicated staff member to measure BP," says the study's First Author Mogan Kaviprawin.

Of the 89 nurses interviewed, 74% reported a lack of staff nurses, and half of the nurses said they were engaged in multiple programme activities. In addition to the challenges faced by nurses, 49% of medical officers reported that the lack of hypertension drug availability led to low screening of individuals attending OPD.

Scientists say at least one dedicated staff member would be needed for BP screening at PHCs and CHCs, and two would be needed at district hospitals. "Screening people when they come to a health facility is far better than going to their homes to do so," says the study's Senior Author Dr Prabhdeep Kaur. "If hiring regular staff is a huge financial burden, states must consider task-sharing among the staff at NCD clinics or utilising volunteers/trainee nurses to take blood pressure."