Balsari S, Vemulapalli P, Gofine M, Oswal K, Merchant R, Saunik S, Greenough G, Khanna T
Emergency Department, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Harvard FXB Center for Health and Human Rights, Boston, MA, USA.
J Hum Hypertens. 2017 Nov;31(11):750-753. doi: 10.1038/jhh.2017.54. Epub 2017 Jul 20.
Cardiovascular disease is the leading case of mortality from non-communicable diseases (NCD) in India. The government's National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke seeks to increase capacity building, screening, referral and management of NCDs across India, and includes community-based outreach and screening programmes. The government in India routinely provides basic care at religious mass gatherings. However, in 2015, at the Kumbh Mela in Nashik and Trimbakeshwar, the state government extended its services to include a hypertension screening programme. We examine here the value and implications of such opportunistic screening at mass gatherings. At the Kumbh, 5760 persons voluntarily opted for hypertension screening, and received a single blood pressure measurement. In all, 1783 (33.6%) screened positive, of whom, 1580 were previously unaware of their diagnosis. Of the 303 that had previously known hypertension, 240 (79%) were prescribed medications, and 160 were compliant (that is, 52.8% under treatment). Fifty-five (18%) had normal blood pressure readings (BP under control). The data also demonstrated higher prevalence (39%) of hypertension among tobacco users compared to non-users (28%) (P<0.001). Poor recording of phone numbers (0.01%) precluded any phone-based follow-up. The low rates of hypertension awareness, treatment and control underscore the ongoing challenge of both hypertension screening and management in India.
心血管疾病是印度非传染性疾病（NCD）导致死亡的主要原因。政府的《国家癌症、糖尿病、心血管疾病和中风预防与控制计划》旨在加强印度全国范围内非传染性疾病的能力建设、筛查、转诊和管理，其中包括基于社区的外展和筛查计划。印度政府通常会在宗教集会时提供基本医疗服务。然而，2015年，在纳西克和特里姆巴克什瓦尔举行大壶节期间，邦政府扩大了服务范围，将高血压筛查计划纳入其中。我们在此研究此类在大型集会时进行的机会性筛查的价值和意义。在大壶节上，5760人自愿选择进行高血压筛查，并接受了单次血压测量。总共有1783人（33.6%）筛查呈阳性，其中1580人此前并不知道自己已患病。在之前已知患有高血压的303人中，240人（79%）被开了药，160人遵医嘱服药（即52.8%正在接受治疗）。55人（18%）血压读数正常（血压得到控制）。数据还显示，吸烟者中高血压患病率（39%）高于非吸烟者（28%）（P<0.001）。电话号码记录不佳（0.01%）使得无法进行任何电话随访。高血压知晓率、治疗率和控制率较低，凸显了印度在高血压筛查和管理方面持续面临的挑战。
