West Bengal at risk of high blood pressure misdiagnosis

Findings of India Heart Study (IHS) show that 22.50 per cent of the respondents from West Bengal were white-coat hypertensive while 17.30 per cent were found to have masked hypertension thereby putting almost 40 per cent people at the risk of misdiagnosis and ‘missed’ diagnosis. There were 862 participants from the state with 622 males and 240 females.

Masked hypertension is a phenomenon when an individual’s blood pressure reading is normal at the doctor's office but high at home; white-coat hypertension is defined as a condition in which people exhibit a blood pressure level above the normal range in a clinical setting only. White-coat hypertensives who are misdiagnosed and put on anti-hypertension drugs have to take unnecessary medication. On the other hand, a masked hypertensive may go diagnosed running the risk of complications of the heart, the kidneys, and the brain, leading to premature mortality.

IHS findings highlight a high prevalence of masked hypertension and white-coat hypertension in Indians at 42 per cent on first office visit (doctors’ clinic). It was also found that Indians have an average resting heart rate of 80 beats per minute, higher than the desired rate of 72 beats per minute. Another striking finding of the study is that unlike other countries, Indians have higher blood pressure in the evenings than in mornings which should guide doctors to rethink the timing of advising anti-hypertension drug dosage.

Dr Upendra Kaulcardiologist, chairman and dean, Academics and Research of Batra Hospital & Medical Research Centre, who was the principal investigator of IHS, said,  “India Heart Study points to a need for better clinical management of hypertension in India. This is India-specific data and should help shape the best practices for the diagnosis of high blood pressure among Indians. The study presents exhaustive data on the various aspects of hypertension.”

Eris Life-sciences commissioned the India Heart Study that was conducted under the aegis of Batra Hospital & Medical Research Centre. Dr Viraj Suvarna, president, medical, Eris Lifesciences said, “Masked Hypertension, if undetected, is a dangerous phenomenon. It is important to monitor one’s blood pressure, beyond the clinic, even at home, according to prescribed guidelines. Accurate diagnosis of hypertension is an important element of our fight against this disease and improving health outcomes.”

Dr Soumitra Kumar, professor and head, department of cardiology, Vivekananda Institute of Medical Sciences and Ramakrishna Mission Seva Pratishthan, Kolkata, and a coordinator for IHS, said, “There is a close linkage between high blood pressure and cardiovascular diseases, which are on the rise in our country. We need to take right measures to cut down on the risks by monitoring our blood pressure regularly and having a healthy lifestyle. The India Heart Study has provided us with insights on the prevalence of white-coat hypertension and masked hypertension, resting heart rates pertinent to Indian population.”

According to Dr Lalit Kumar Agarwal, Nephrologist, Woodland Hospital, “Kidneys, which serve as a critical organ in our body, are at a high risk of damage in people with high blood pressure, or hypertension. In people at risk, achieving lower or optimum target BP is known to be beneficial in reducing chances of kidney disorders.”

What sets this study apart is that it was conducted on ‘drug-naive’ set (people not on any anti-hypertension drug) of participants using a comprehensive process of taking blood pressure readings. The investigators examined the blood pressure of 18,918 participants (male and female) through 1233 doctors across 15 states over a period of nine months. The participants’ blood pressure was monitored at home four times in a day for seven consecutive days.

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