KARACHI: A study exploring the risks posed by high blood pressure in rural areas of Sindh has found that a significant number of people were not aware that they suffered from hypertension and how it might hurt their health.

It also recorded an alarmingly high number of cases in which patients on medication continued to suffer from uncontrolled high blood pressure, putting them at a greater risk of developing diseases including cardiovascular disease.

Conducted in 10 rural areas of Thatta by Aga Khan University (AKU), the study suggests that hypertension affects large populations not only in urban areas where it is often seen as a health problem associated with poor lifestyle including poor eating habits, stress and lack of exercise; its presence is also felt in rural areas.

One in three adults, according to the World Health Organisation, is living with high blood pressure in Pakistan. The study noted a similar prevalence in rural areas with one in five adults over the age of 40 living with hypertension.

Researchers also found low awareness of the health condition; six out of 10 people suffering from high blood pressure were unaware that they had the disease.

“Even those taking medication were at a high risk of health complications associated with hypertension since the survey found that more than seven out of 10 people on anti-hypertensive drugs continued to suffer from uncontrolled blood pressure,” it says.

One of the striking findings of the study was to record a large number of patients having inadequate treatment for hypertension.

“Almost 90 per cent of individuals in the study were only taking a single blood pressure drug. However, effective control of blood pressure requires most patients to take more than one anti-hypertensive medication,” it says. Moreover, the study found that just under half of all patients (48pc) were not taking their medicines regularly which also increased their vulnerability to various health problems.

High blood pressure, according to experts, is a major contributor to heart disease, the leading cause of death in Pakistan, and can also lead to the onset of other non-communicable diseases such diabetes, stroke and kidney disease.

‘Epidemic levels’

Dr Imtiaz Jehan, associate professor at AKU and principal investigator of the study in Pakistan, said: “Hypertension has reached epidemic levels in Pakistan and other South Asian countries. We must focus on how to prevent new cases and on ways to improve existing hypertension management care.

“We plan to use insights from our ongoing study to determine which solutions can be integrated into the public healthcare systems thereby saving the most lives.”

The control and prevention of non-communicable diseases (NCD) such as hypertension is a global health priority with targets under Goal 3 of the Sustainable Development Goals calling for a one-third reduction in deaths caused by such diseases by 2030.

Sharing her opinion, Dr Sameen Siddiqui, chair of the department of community health sciences at AKU, said: “The burden of non-communicable diseases in Pakistan is growing. This trial will generate evidence on the need to have a programme for non-communicable diseases which will improve the performance of our health systems.”

The study’s principal investigator Professor Tazeen Jafar from Duke-National University of Singapore Medical School said: “The majority of individuals with treated hypertension have uncontrolled blood pressure in rural Pakistan, Sri Lanka and Bangladesh with significant disparities among and within countries. Urgent public health efforts are needed to improve access and adherence to anti-hypertensive medications in disadvantaged populations in rural South Asia.”

The study in Pakistan is part of a multi-country research collaboration called COBRA-BPS (Control of Blood Pressure and Risk Attenuation – Bangladesh, Pakistan and Sri Lanka).

Published in Dawn, May 19th, 2018