Lok Sabha Question No. 3030 (UNSTARRED), answered on 2021-08-06
Subject: Prevention and Control of High Blood Pressure/ Hypertension
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Supriya Sadanand Sule, Deepak Baij

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 3030 TO BE ANSWERED ON 6 th  AUGUST, 2021

## PREVENTION AND CONTROL OF HIGH BLOOD PRESSURE/HYPERTENSION

## 3030. SHRIMATI SUPRIYA SULE : SHRI DEEPAK BAIJ:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether the Government has launched any National Action Plan for prevention and control of Hypertension/High Blood Pressure in the country and if so, the details thereof along with the current status thereon and the success achieved for treatment adherence and control;
- (b)  whether  National  Action  Plan  for  prevention  and  control  of  Non  communicable  diseases which targeted a reduction in the prevalence of Hypertension/high blood pressure cases by 10 per cent by 2020 has been achieved and if not, the reasons therefor;
- (c)  whether  the  Government  is  cognizant  that  Hypertension/High  Blood  pressure  is  spreading among lower age groups/younger people causing long term health complications such as heart disease;
- (d) if so, the details thereof and the steps taken to check the same including public awareness for the targeted reduction of cases; and
- (e) the additional measures taken to ensure that treatment of High Blood pressure/hypertension, a major COVID co-morbidity are prioritized and further improve the adherence and continuance of regular treatment by the affected people?

## ANSWER

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND

## FAMILY WELFARE

(SMT. BHARATI PRAVIN PAWAR)

- (a)  Health is  a  state  subject.  The  Department  of  Health  &  Family Welfare, however, provides technical and financial support to the States/UTs under the National Programme for Prevention and  Control  of  Cancer,  Diabetes,  Cardiovascular  Diseases  and  Stroke  (NPCDCS),  as  part  of

National Health Mission (NHM), based on the proposals received in Program Implementation Plans  (PIPs)  from  the  States/UTs  and  subject  to  the  resource  envelope.  Hypertension  /High Blood  Pressure  is  an  integral  part  of  NPCDCS.  The  programme  focusses  on  strengthening infrastructure,  human  resource  development,  health  promotion  &  awareness  generation  for prevention,  early  diagnosis,  management  and  referral  to  an  appropriate  level  of  healthcare facility for treatment of the given Non-Communicable Diseases including Hypertension.

A  population-based initiative for prevention, control and screening  for  common  NonCommunicable  Diseases  (NCDs)  i.e.  Diabetes,  Hypertension  and  common  Cancers  viz.  Oral, Breast and Cervical Cancers, has been rolled out in the country under NHM and also as a part of Comprehensive Primary Health Care under Ayushman Bharat  - Health and Wellness Centres (AB-HWC).  Under  the  initiative  persons  more  than  30  years  of  age  are  targeted  for  their screening for common NCDs including Hypertension.

'The  India  Hypertension  Control  Initiative  (IHCI)'  is  also  being  implemented  with  primary focus  on  the  control  of  high  blood  pressure,  a  leading  risk  factor  for  CVDs  among  adults  in India.  The  project  has  been  initiated  in  83  districts  of  18  states  and  has  registered  1.4  million patients across the country.

(b) As per National Action Plan and Monitoring framework for prevention and control of NonCommunicable Diseases (NCDs), there is a target to achieve relative reduction in prevalence of raised blood pressure by 10% by year 2020.

The prevalence of hypertension can be determined by periodic surveys. National Family Health Survey (NFHS) - 4 provided the first baseline data and reported a prevalence of 8.8 % in female and 13.6 % in male in the year 2015-16 in 15-49 years of age group. The latest results of NFHS5 are awaited.

(c) and (d) As per the report of NHFS-4, the prevalence of Hypertension is lower in younger age group as compared to older age group. The details for the same are as below:-

| Age Group   |   Male |   Female |
|-------------|--------|----------|
| 15-19       |    3.4 |      2.8 |
| 20-29       |    9.4 |      5.6 |
| 30-39       |   18   |     13   |
| 40-49       |   27   |     23   |

Preventive aspect of Hypertension is being strengthened under Comprehensive Primary Health Care under Ayushman Bharat - Health and Wellness Centers, by promotion of wellness activities and  targeted  communication  at  the  community  level.  Other  initiatives  for  increasing  public awareness about the risk factors for Hypertension and for promotion of healthy lifestyle include observation  of  World  Hypertension  Day  and  use  of  print,  electronic  and  social  media  for continued community awareness. Furthermore, healthy eating is also promoted through FSSAI. Fit India movement is being implemented by Ministry of Youth Affairs and Sports, and various Yoga related activities are being carried out by Ministry of AYUSH. In addition, NPCDCS gives financial support under NHM for awareness generation (IEC) activities for Hypertension to be undertaken by the States/UTs as per their Programme Implementation Plans (PIPs), subject to resource envelope.

(e)  Under NPCDCS, 640 NCD Clinics at District level and 5148 NCD Clinics at Community Health Centre level have been set up to ensure the treatment of common NCDs including high blood pressure/hypertension.

The screening for common Non-Communicable Diseases (NCDs) including hypertension is also being done as a part of Comprehensive Primary Health Care under Ayushman Bharat - Health and  Wellness  Centres.  The  focus  is  on  continuum  of  care.  The  patient  with  severe  illness  is screened  and/or  diagnosed  and  referred  to  appropriate  higher  health  care  facilities  for  further treatment and management. Further, the patient is referred back to the HWCs for follow up by front-line workers to ensure continuation of treatment compliance.

High Blood pressure/hypertension patients are diagnosed and treated at various health facilities in  the  health  care  delivery  system  including  District  Hospitals,  Medical  Colleges,  Central Institutes like AIIMS, etc. The treatment in Government health facilities is either free, or highly subsidized  for  the  poor  and  needy.  Under  Free  Drugs  Service  Initiative  of  NHM,  financial support is provided to States/UTs for provision of free essential medicines. Furthermore, quality generic  medicines  are  being  made  available  at  affordable  prices  to  all,  under  Pradhan  Mantri Bhartiya Janaushadhi Pariyojana in collaboration with the State Governments.

Guidelines  and  advisories  were  sent  by  Ministry  of  Health  and  Family  Welfare  to  State/UT Governments from time to time emphasizing the need for continuation of non-COVID essential health services for management of NCDs including hypertension during COVID pandemic.

States/UTs  were  also  advised  to  utilize  the  Population  Based  Screening  (PBS)  data  during containment activities in order to identify those with NCDs including hypertension, and to place them under health surveillance.