Indan Journal of Medical Research Indan Journal of Medical Research Indan Journal of Medical Research
  Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login  
  Home Print this page Email this page Small font sizeDefault font sizeIncrease font size Users Online: 1865       

   Table of Contents      
COMMENTARY
Year : 2012  |  Volume : 135  |  Issue : 4  |  Page : 454-455

Elevated blood pressure & effectiveness of comprehensive risk reduction programme


Department of Cardiology, Christian Medical College & Hospital, Vellore 632 004, India

Date of Web Publication29-May-2012

Correspondence Address:
V Jacob Jose
Department of Cardiology, Christian Medical College & Hospital, Vellore 632 004
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


Rights and PermissionsRights and Permissions

How to cite this article:
Jose V J. Elevated blood pressure & effectiveness of comprehensive risk reduction programme. Indian J Med Res 2012;135:454-5

How to cite this URL:
Jose V J. Elevated blood pressure & effectiveness of comprehensive risk reduction programme. Indian J Med Res [serial online] 2012 [cited 2021 May 18];135:454-5. Available from: https://www.ijmr.org.in/text.asp?2012/135/4/454/96734

Worldwide the non communicable diseases are on the rise across all continents and irrespective of income status. These non communicable diseases now account for 60 per cent of deaths worldwide, and 80 per cent of these deaths occur in low or middle income countries where the effect is devastating because it affects someone in the prime of his life [1] . A recent report from World Health Organization [2] identified six risk factors for death within the non communicable diseases. These risk factors are: high blood pressure, smoking, high blood glucose levels, physical inactivity, overweight and high cholesterol. Of these, hypertension is responsible for death of 7.5 millions and accounts for nearly 12 per cent of total deaths in the world. Data from INTERHEART [3] and INTERSTROKE [4] studies showed that Indian patients enrolled also place hypertension as a major risk factor that we need to worry about to prevent the disability due to cardiac related mortality and morbidity. The population attributable risk - PAR for hypertension was 17.9 for hypertension in the INTERHEART study and 34.6 in the INTERSTROKE study. Added to this is the fact that these risk factors are increasing in our country in both urban and rural populations [5] .

In this issue, the burden of elevated blood pressure in a nation-wide study on more than 10,000 individuals is published [6] . The authors need to be congratulated for the enormous work that was done to get this information. Now we have a reliable data on the epidemiology of hypertension. Isolated hypertension was observed in 2.6 per cent of middle age group and hypertension was seen clustering with other risk factors in another 12.3 per cent individuals in our country. This study is noteworthy because risk factor clustering has not been studied before in India. This is interesting because our methods for prevention will be useful multifold because of this clustering. Also is the fact that the clinicians should screen for the multiple risk factors together for maximum benefit.

The effect of age in clustering of risk factors is significant. Persons above the age of 40 yr and males had more clustering; 40 per cent of participants above the age of 40 yr had 3 or more risk factors.

The study [6] also had some major limitations that the population studied did not represent the group of general population. The persons enrolled were industry group, likely to be more motivated for health care and likely to be of higher socio-economic status. Another major limitation was the fact that this study did not include ageing population - the elderly, namely persons above the age of 60 yr. These risk factors are more likely to have higher prevalence with increasing age.

This study provides data about hypertension and clustering of important risk factors in a group of persons in our country, and fills in the significant gap that exists in the epidemiology of risk factors of cardiovascular diseases (CVD) in our country. The next step is to take this kind of study further to get the CVD mortality data as well. This is one area we are lacking completely. It is interesting to note that even in US [7] and Europe [8] these mortality data differ from region to region. So what we need is to take these types of studies forward in two ways. One is to introduce an interventional group to see the effects of risk reduction in the long run and secondly to study the effects of these risk factors on mortality on all India basis.

 
   References Top

1.Daar AS, Singer PA, Persad DL, Pramming SK, Matthews DR, Beaglehole R, et al. Grand challenges in chronic non communicable diseases. Nature 2007; 450 : 494-6.  Back to cited text no. 1
[PUBMED]  [FULLTEXT]  
2.World Health Organization. Global health risks: mortality and burden of disease attributable to selected major risks. Geneva: World Health Organization; 2009.  Back to cited text no. 2
    
3.Joshi P, Islam S, Pais P, Reddy S, Dorairaj P, Kazmi K, et al. Risk factors for early myocardial infarction in south Asians compared with individuals of other countries. JAMA 2007; 297 : 286-94.  Back to cited text no. 3
[PUBMED]  [FULLTEXT]  
4.O'Donnell M, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P, et al, on behalf of INTERSTROKE investigators. Risk factors for ischemic and intracerbral hemorrhagic stroke in 22 countries. A case control study. Lancet 2010; 376 : 112-23.  Back to cited text no. 4
    
5.Sridharan SE, Unnikrishnan JP, Sukumaran S, Sylaja PN, Nayak SD, Sarma PS, et al. Incidence, types, risk factors and outcome of stroke in developing country. Trivandrum stroke registry. Stroke 2009; 40 : 1212-8.  Back to cited text no. 5
[PUBMED]  [FULLTEXT]  
6.Jeemon P, Prabhakaran D, Goenka S, Ramakrishnan L, Padmanabhan S, Huffman M, et al. Impact of comprehensive cardiovascular risk reduction programme on risk factor clustering associated with elevated blood pressure in an Indian industrial population. Indian J Med Res 2012; 135 : 485-93.  Back to cited text no. 6
    
7.Centres for Disease Control and Prevention (CDC). Estimated country-level prevalence of diabetes and obesity United States 2007. MMWR 2009; 58 : 1259-63.  Back to cited text no. 7
    
8.Mariottti S, Copocaccia R, Farchi G, Menotti A, Verdecchia A, Keys A. Age, period, cohort and geographic area effects on the relationship between risk factors and coronary heart disease mortality. 15 year follow up of the European cohorts of seven countries study. J Chronic Dis 1986; 39 : 229-42.  Back to cited text no. 8
    




 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    References

 Article Access Statistics
    Viewed856    
    Printed39    
    Emailed0    
    PDF Downloaded262    
    Comments [Add]    

Recommend this journal