Longdom Conferences

Speaker

July 19, 2020    London, UK
Webinar on

Hypertension and Healthcare

Kapardhi PLN
02:00 PM-03:00 PM

Kapardhi PLN

IHS investigator India

Title: India Heart Study – IHS

Abstract:

Background: Measurement of BP is essential for diagnosis of hypertension. There is limited information in India on the type of instrument (mercury, aneroid and oscillometric) used to measure BP. In a newly diagnosed treatment-naive hypertensives the prevalence of white coat hypertension (WCH), masked hypertension (MH), and atrial fibrillation (AF), when both office and home BP measurements are measure is not known. 
Objective: The study the prevalence of WCH and MH by comparing Office BP Measurement (OBPM) with Home BP Measurement (HBPM) in an Indian primary care setting in real world treatment naive subjects with and without hypertension.
Methods: An observational study comprising 18,918 treatment naive subjects with and without hypertension from 1233 primary care clinics across India were included between June 2018 and April 2019. OBPM (Visit 1) was performed by practioner’s.  In addition patients also underwent 7 days HBPM using the oscillometric BP measurement by “Microlife Watch BP Home device” and then another OBPM (Visit 2) was performed. This device also has a validated AF screening algorithm.
Results: The age range was 42.6+11.7 years and male: female 63:37%. hypertension diagnosis based on OBPM visit 1 is inadequate because 2nd OBPM reading showed a discrepancy in 32% cases. The evening BP was higher than the morning Systolic BP (127.8 ± 14.7 vs 129.8 ± 15.3, p<0.001) mm Hg and Diastolic BP (81.9 ± 10.1 vs 82.4 ± 10.2, p<0.001) mmHg. Considering visit 1 and HBPM, the prevalence of WCH was 24%. On the other hand, 18% of the participants had masked hypertension. More than half of the participants,had an elevated resting heart rate (79.8 ± 9.6 bpm . Elevated heart rate was more frequent in WCH. AF was found in 1027 subjects (5.7%) based on CHA2DS2 score. Of the type of instruments used for OBPM, 69% were mercury sphygmomanometers, 22% aneroid and only 9% were oscillometric ones.
Conclusion: The prevalence of WCH and MH in India is higher in comparison with global data which has therapeutic implications. The diagnosis of hypertension based on office blood pressure measurements alone can be fallacious. The evening BP was higher than the morning. Elevated resting heart rate may mean a reconsideration of the use of heart rate lowering anti-hypertensive drugs among Indian hypertensives. HBPM with a validated oscillometric BP measuring device should be preferred over mercury instruments which are still being used in 69% cases for OBPM, despite being banned in India since December 2017.

Biography:

Senior Consultant Cardiologist – Apollo Hospitals, Hyderguda, Hyderabad. Director Cathlab – Apollo Hospitals, Hyderguda, Hyderabad. Rich experience in Complex Coronary Interventions, Chronic Total Occlusions, Left Main & Bifurcation interventions and Cardiac Device therapy. Special Interest in Coronary Imaging and Complex Coronary Interventions. Special Work in Cardiac Stem cell therapy.

Useful Links

News

Health: Worrying rise of hypertension in Indians

2019-10-17

Hypertension is the most important risk factor for chronic disease burden across the world. Global burden of diseases study in year 2017 reported high systolic blood pressure as the leading risk factor across the globe that accounted for 10.2 million deaths. Indians are more prone to hypertension and heart disorders, and are affected at a younger age than the Europeans. The fourth District Level Household Survey reports an overall prevalence 25.3 per cent for hypertension in India that translates to around 207 million individuals.

Hypertension in adults: summary of updated NICE guidance

2019-10-21

Hypertension is a leading global cause of morbidity and mortality. More than 25% of the adult UK population has hypertension, and in about 30% blood pressure remains uncontrolled.1 In August, the National Institute for Health and Care Excellence (NICE) published its updated guideline on the diagnosis and management of hypertension. The guideline reviews further evidence that has emerged since it was last updated in 2011 from randomised trials investigating the initiation, monitoring, and choice of antihypertensive treatment. The scope of the updated guideline has increased to also include people with type 2 diabetes, but does not make recommendations for people with chronic kidney disease, established cardiovascular disease, or hypertension in pregnancy. This article summarises the most recent recommendations from NICE and includes information considered to be most relevant to primary care clinicians. Key changes to current practice include offering drug treatment to people at a lower threshold for 10 year risk of cardiovascular disease, emphasis on maintaining blood pressure below target, and clarifying criteria for same day specialist review in people with accelerated hypertension.

Tobacco Use, Hypertension Make Rural Population Susceptible to Heart Disease

2019-11-03

A study undertaken over the course of eight years in five villages near Chennai has shown that cardiovascular diseases remain quite high even among a rural population, a report in The Hindu says. The study, carried out by Dr. Prabhdeep Kaur of Chennai’s National Institute of Epidemiology and published in the journal BMJ Open has challenged the commonly held notion that those living comparatively ‘stress-free’ lives in non-urban areas are immune to heart attacks and strokes. “The study involved 5,641 adults aged 25-64 years…There were 96 deaths — 79 from heart attacks and 17 from stroke. There were 59 adults who suffered but did not die from heart attack and stroke,” said the Hindu report.

Women with gestational hypertension have elevated cardiovascular risk later in life

2019-11-12

First, women with a history of hypertensive pregnancy had stiffer arteries and two to five times the rate of chronic hypertension later in life across age groups, compared to control subjects. Second, they were more likely to develop cardiovascular conditions over time, including coronary artery disease, which prior research suggested, heart failure, and two kinds of valvular heart disease -- aortic stenosis and mitral regurgitation -- that had not previously been associated with hypertensive pregnancy. Third, the study found that between half and one-third of the risk of coronary disease and heart failure was driven by chronic hypertension

Daily coffee can cut risk of high blood pressure and diabetes

2019-11-27

Drinking up to four coffees a day can significantly reduce the risk of type 2 diabetes, high blood pressure and obesity, according to a study. Even decaffeinated coffee gave the health boost, researchers said, though the effect from either type disappeared after four cups. The team from the universities of Navarre in Spain and Catania in Italy found that there was an “association between coffee consumption and a decreased risk of type 2 diabetes” and added that “long-term coffee consumption is associated with a decreased risk of hypertension”.

Newsletter

© 2024 All Rights Reserved by Longdom