Abstract
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.
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Acknowledgements
Ethics and consent: IRB exemption was sought and granted by the Harvard TH Chan School of Public Health Office of Human Research Administration, 90 Smith Street, 3rd Floor Boston, MA 02120S, USA. Consent was obtained from all patients, and recorded by the implementing partner, MGV Dental College. No patient identifiers were available to any of the authors.
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SB and PV wrote the manuscript. MG conducted the data analysis. GG helped with study design and writing. KO, RM contributed to project implementation and data collection. SS was the key public health official overseeing the project. TK provided oversight for entire project. All authors read and approved the final manuscript.
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Balsari, S., Vemulapalli, P., Gofine, M. et al. A retrospective analysis of hypertension screening at a mass gathering in India: implications for non-communicable disease control strategies. J Hum Hypertens 31, 750–753 (2017). https://doi.org/10.1038/jhh.2017.54
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DOI: https://doi.org/10.1038/jhh.2017.54