| Hypertension in India is considered as a challenge for medical practitioners as it affects all organs of human, thereby leading to morbidity or mortality. Despite new drugs, it is the older molecules which are seen to control the condition better. One in every 5 healthy individuals is hypertensive. On the occasion of the World Hypertension day, which is observed annually on May 17, medical experts term it as a silent killer. According to Dr. Naveen Chandra, consultant cardiologist, Columbia Asia Hospital, new medications are released annually, but the older proven drugs like diuretics, calcium channel blockers, beta blockers and ACE inhibitors still play a major role. A selective AT1 subtype angiotensin receptor antagonist called Azilsartan was released in India last year has shown great promise. Aliskiren is an oral Renin inhibitor introduced few years ago also has proven to be effective and shown to decrease cardiac events. But the biggest challenge for a doctor is to convince the patient who are always in denial. The condition requires life style modifications like diet adjustment, weight loss and exercise which is difficult make patients adhere on a long term basis. Another hurdle to treatment is the compliance to medications which are abruptly discontinued when the blood pressure controlled. But a sudden surge in blood pressure (BP) often leads to complications. The only way to prevent this is through counselling and education, added Dr. Chandra. The threat to vision loss with poorly managed or untreated BP leads to hypertensive retinopathy and retinal vein occlusion. In fact, patients who are suffering from continuous high systolic blood pressure are 280 per cent more prone to developing Central Retinal Vein Occlusion, leading to loss of sight, stated Dr. Rajesh BTJ, Head, Medical Services, Dr. Agarwal's Eye Hospitals. Earlier hypertension affecting the eye manifested only in geriatric patients but now it is diagnosed among those aged between 35-40 years. Typically, the eye ailments due to hypertension are asymptomatic until it becomes severe or diagnosed during a routine eye exam. While different treatment modalities are accessible like retinal laser, injections and retinal surgery, prevention of eye ailments with blood pressure is the best, noted Dr. Rajesh. High BP is not only uncontrolled but also undetected and untreated in India. However, once diagnosed, it is easy to control and manage. At least in 90% of people, hypertension remains asymptomatic. A regular BP check, at least at 2-3 month intervals is an ideal, stated Dr Ravi Chandra MRK, consultant, Internal Medicine, Narayana Health City. It is said that 50% patients with hypertension are not aware of the same. Of these, only 50% are treatment. The most common type is primary hypertension, which is genetic. The secondary hypertension manifests only in 5% of cases and caused by kidney and hormonal disorders which need blood and radiological investigations. An annual echocardiogram to detect for heart enlargement is usually suggested as a surrogate marker to assess blood pressure control, stated Vivek G, consultant, Interventional Cardiologist, Sparsh Hospitals. (PharmaBiz.com) |
