The India Hypertension Control Initiative–early outcomes in 26 districts across five states of India, 2018–2020
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Published:2022-08-09
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ISSN:0950-9240
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Container-title:Journal of Human Hypertension
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language:en
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Short-container-title:J Hum Hypertens
Author:
Kaur PrabhdeepORCID, Kunwar Abhishek, Sharma Meenakshi, Durgad Kiran, Gupta Sudhir, Bangar Sampada D., Bharadwaj Vishwajit, Bharadwaj Rupali, Bitragunta Sailaja, Chintala Sreedhar, Chakma Tapas K., Chandran Deenadayalan, Chavan Tejpalsinh A., Dar Sunil, Das Bidisha, Dhaliwal R. S., Gill Sandeep Singh, Gopal Bipin, Immanuel A. Branch, Jain Tanu, Jogewar Padmaja, Joshi Chakshu, Khanna Abhishek, Khedkar Suhas N., Krishna Ashish, Kumar Navneet, Kumar Vijay, Madhavi M., Ganeshkumar Parasuraman, Pathni Anupam KhungarORCID, Ponna Satyendra N., Puthussery Yannick P., Rafique Mohamed E., Ramakrishnan Sivasubramanian, Reddy Sravan K., Sambandam Gopinath T., Sahoo Swagata K., Saxsena Ashish, Sharma Bhawna, Shrivastava Suyesh, Sivalingam Azhagendran, Singh Shweta, Singh Gurinder Bir, Swarnkar Sunny, Thakkar Jatin, Tullu Fikru T., Venkatasamy Vettrichelvan, Wassey Mohammed, Wankhede Amol B., Bhargava BalramORCID,
Abstract
AbstractHypertension is the leading single preventable risk factor for cardiovascular disease. The India Hypertension Control Initiative (IHCI) project was designed to improve hypertension control in public sector clinics. The project was launched in 2018–2019 in 26 districts across five states: Punjab (5), Madhya Pradesh (3), Kerala (4), Maharashtra (4), and Telangana (10), with five core strategies: standard treatment protocol, reliable supply of free antihypertensive drugs, team-based care, patient-centered care, and an information system to track individual patient treatment and blood pressure control. All states implemented simple treatment protocols with three drugs: a long-acting dihydropyridine calcium channel blocker (amlodipine), angiotensin receptor blocker (telmisartan), and thiazide or a thiazide-like diuretic (hydrochlorothiazide or chlorthalidone). Medication supplies were adequate to support at least one month of treatment. Overall, 570,365 hypertensives were enrolled in 2018–2019; 11% did not have follow-up visits in the most recent 12 months. Clinic-level blood pressure control averaged 43% (range 22–79%) by Jan-March, 2020. The proportion of the estimated people with hypertension who had it controlled and documented in public clinics increased three-fold, albeit from very low levels (1.4–5.0%). The IHCI demonstrated the feasibility of implementing protocol-based hypertension treatment and control supported by a reliable drug supply and accurate information systems at scale in Indian primary health care facilities. Lessons from the IHCI’s initial phase will inform plans to improve screening in health care facilities, increase retention in care, and ensure a sustained supply of drugs as part of a nationwide hypertension control program.
Funder
Indian Council of Medical Research World Health Organization
Publisher
Springer Science and Business Media LLC
Subject
Internal Medicine
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