Rural Sindh Under Threat from Uncontrolled High Blood Pressure

KARACHI-  A study surfaced, exploring the risk posed by high blood pressure in rural areas of Sindh and discovered several cases of uncontrolled blood pressure despite the use of medication.

High blood pressure or hypertension, is often seen as a disease that’s common in urban areas, where risk factors such as stress, poor dietary habits and lack of exercise are common, further terming it as a lifestyle disease.

However, Aga Khan University conducted a study in 10 rural areas of Thatta, to mark World Hypertension Day, in order to raise awareness regarding this disease.

Statistically, based on WHO’s surveys, 1 in 3 Pakistani adults are already living with high blood pressure. This particular study noted a similar prevalence in rural areas with 1 in 5 adults over the age of 40, living with hypertension.

Researchers found out that 6 out of 10 people were unknowingly suffering from high blood pressure, highlighting the issue of lack of awareness. Those on hypertensive medications were at high risk of health complications associated with hypertension since it was found that, more than 7 out of 10 people on anti hypertensive drugs continued to suffer from uncontrolled blood pressure.

The baseline survey was part of an ongoing multi-country collaborative trial, Primary Care Strategies to Reduce High Blood Pressure: A Cluster Randomized Trial in Rural Bangladesh, Pakistan and Sri Lanka.  

One of the distinctive finding of the study was the prevalence of inadequate treatment for hypertension, as nearly 90% patients were only taking a single blood pressure drug. However, effective control of blood pressure requires more than one anti-hypertensive medication. Moreover, the study found that just under half of all patients (48%) were not taking medicines regularly, increasing chances of future complications.

Hypertension is a major contributor to heart disease, the leading cause of death in Pakistan, with a probability of leading to the onset of other non-communicable diseases such diabetes, stroke and kidney disease.

“Hypertension has reached epidemic levels in Pakistan and other South Asian countries,” said Dr. Imtiaz Jehan, Associate Professor, AKU and Principal Investigator of the study in Pakistan.

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 year 2030.

“The growing burden of non-communicable diseases in Pakistan means that this trial will generate evidence that is likely to inform much needed NCD care program planning which will improve the performance of health systems,” said Dr. Sameen Siddiqui, Chair of Department, Community Health Sciences, AKU.

Prof Tazeen Jafar, study’s Principal Investigator from Duke National University of Singapore Medical School stated that, "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.”

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