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Public awareness on Hypertension: A National Priority

High blood pressure doesn’t show symptoms unless a major cardiovascular complication occurs

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Dr. Santanu Guha

Sr. Cardiologist

Nightingale Hospital, Kolkata

Dr. Venkat S Ram

Director of Apollo Institute for Blood Pressure Management

Apollo Blood Pressure Clinics,Hyderabad

Dr. HK Chopra

Senior Cardioloigst

Moolchand Medcity, New Delhi

Did you think high blood pressure was no big deal? Well, so did the medical fraternity and the government of India. Termed as a ‘silent killer’, hypertension doesn’t get medical attention in India unless it develops into a cardiovascular complication. A conversation with Dr. C Venkat Ram, a world authority on hypertension and Dr. Santhanu the incoming President of Cardiology Society of India (CSI), throws light on a much neglected, yet most common problem of hypertension. Citing huge government campaigns for communicable diseases like malaria and tuberculosis, which also involve primary health centres in rural areas, Dr. Guha tells Dr. HK Chopra, President CSI, about the epidemic of hypertension not getting the attention it deserves. “To address the pandemic of cardiovascular disease that has engulfed India, public awareness has now become a national priority. And for awareness to percolate to grass root levels, government intervention becomes indispensable.” To further this mission, Dr. Venkat Ram has also launched a Journal of Hypertension which aids medical professionals in understanding practical applications of scientific advances for the treatment and diagnosis of hypertension.

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Dr. HK Chopra

Dear friends, today it is an honor for me to be here this morning and I have very, very important people in the studio here today. We have with us Sir, Dr. C. Venkat Ram. He does not need any introduction. He is a world authority of hypertension and I am very happy to say that he is the first man in India to bring the <a href=""

Dr. C Venkat S Ram

Thank you Dr. Chopra, greetings to ladies and gentleman and my respective Dr. Santhanu. In response to Dr. Chopra, what I would like to say is that the medical profession in India has to promote the importance of high blood pressure in the community. Among the cardiovascular diseases unfortunately,high blood pressure is not considered as a very glamorous condition. It is not a condition where too many procedures are needed and unfortunately, the patients have no symptoms until a cardiovascular complication occurs. So, the shift in our culture should be to make high blood pressure unfortunately to use the term glamorous and the entire medical community in the county should bind together to make a noncommunicable disease as a national priority so that we can control and contain this pandemic of cardiovascular disease that India is engulfed in at this time, so professor Chopra in summary then we need to increase the public awareness and we need to increase the noise level of high blood pressure in India, so that the public and private institutions bind together to control hypertension more efficiently than what we are doing at the present time.

Dr. HK Chopra

Thank you very much Dr. Venkat Ram, I think it is very clear and very vivid in the statement that the time has come to create a voice in control of hypertension.We have to create a voice in the community as a doctor, people listen to us and if we educate them well effectively both from the treatment point of view and prevention point of view, I am sure we are going to definitely halt the rising menace of hypertension and its morbidity and mortality.Ladies and gentleman, we have with us Dr. Santhanu who prepared the whole gamut of the program this year, the huge task and a Herculean task. Dr. Santhanu, I would just like to ask you in this conference which you are doing now in Chennai as a chairman of scientific committee,what is your focus on hypertension.

Dr. Shantanu Guha

Well, hypertension has been adequately represented in the scientific program. We have kept a section in the CME, we have kept some symposiums on hypertension and on top of it, we have kept one session that is either a case-based discussion or an issue-based discussion that have not yet finalized, but one session will be there on discussing on different issues of hypertension by some eminent hypertension patients. Coming to your previous question, I have some comments on that. Firstly, we are trying to make some noise heard relating to hypertension, but this is absolutely urban section where only one-third of our population lives. This voice is not going to be heard across the country to what the matters most. We have some ideas earlier because in the era of communicable diseases, Government of India met several disease control programs,malaria control program, tuberculosis control program and they spread it all across the country to the level of the primary health centers. I feel government should be involved for the non-communicable diseases very important being hypertension and this should be discussed, treated and the level of awareness increase at the grass-root level, not only in the urban areas, in urban areas, many voices are heard, but in the rural areas, this can emanate from primary health centers if the government comes on, so government has a very important role to play. Without government’s intervention on health, I think this entire process will be fruitless.

Dr. HK Chopra

Thank you. Santhanu has given a very important message that hypertension control is the need of the our. Government of India has to be involved and Santhanu has mentioned it very, very clearly that it should not percolate confine only to an urban population. We should go round up to the rural areas and it just heard in a joint workshop of World Heart Federation as well as CSI which has shown very clearly that the CVD mortality is high in the highest level in the poor, higher level in the rich and lowest level in certain poor people, so we should not say that the CVD is the disease of rich people. It also percolate down in the poor people also. Santhanu has mentioned very clearly. We must think of a global approach, not confined to only rich population. I think it is very, very important. A time has come. We are not to underestimate hypertension. We should not under-diagnose hypertension. We have to have a timely intervention and enormous awareness is required upon hypertension. I would like to ask Santhanu one more question."Santhanu in what way you think is the right approach to enhance the awareness of hypertension in the public from your perspective?"

Dr. Shantanu Guha

We should demarcate it into a few segments. Awareness about the latest developments amongst the doctors that can be done through conferences, CMEs, and others. Amongst, the educated people particularly urban centric approach, we can make some workshops, we can make some awareness programs by which the awareness about hypertension will certainly increase in the urban areas, but for our rural form, this is not going to be helpful. For them, I feel what is necessary is to make some program based on primary health centers at the grass-root level,some doctors or the persons who is managing that health center or the paramedics who is there, they can make this impossible by raising the awareness of hypertension among the rural population, by that I think, we can improve in this particular aspect.

Dr. HK Chopra

Thank you Santhanu. I think it is very, very clear that we need to change the mind set of everyone, not of the rich only, but of the poor only, it is a change in mind set that will increase the awareness on the control of hypertension. Ladies and gentleman, as I mentioned to you,Venkat has done a lot of work on hypertension and he is the first man in India to bring ina journal on hypertension.Dr.Venkat Ram,I would like to ask you, you have launched the journal on hypertension very recently. I have just gone through first issue of journal on hypertension. In what way you think you are going to alliance with CSI so that this hypertension journal go in a big way and we become more and more educated in knowledge in view of alliance and reach of this hypertension from India to go to all over the globe.

Dr. C Venkat S Ram

Dr. Chopra, there is a natural alliance between any cardiovascular journal and Cardiological Society f India. Cardiological Society of India is a largest society of cardiology in Asia much more even in Japan and people always feel that high blood pressure is a cardiovascular disease and that is the reason why lot of patients would like to see a cardiologist for hypertension because they feel it is a cardiovascular disorder which is correct.The reason why a medical journal dedicated to hypertension has been launched is to provide a service to the medical profession and is a tool to the medical profession to convert the scientific advances to practical realities. There are so many journals that are published everymonth but thepractical implications of some articles are availableonly in few journals.So,this journal ismainly a vehicle for medical practitioners in South Asia where the latest scientific advances on hypertension both treatment and diagnosis are published and hopefully read by the readers and ultimate beneficiary of the journal, I feel should be the patient.

Dr. HK Chopra

I have just one question to ask you since I am talking of journal and we have a lot of discussion on hypertension when we are talking of CSI, I think we want to know from you, what exactly your planning so that more members of CSI are incorporated in the editorial boardso that we impart more education on hypertension through your media of the journal since I know that the journal going worldwide, is going to Southeast Asia various parts, it is also going to Europe, it has gone to America, I really want the reach should be quicker and faster if we have some kind of alliance with CSI.

Dr. C Venkat S Ram

That is very natural and actually, this is very first issue and CSI being the voice of cardiovascular disorders in Asia will be a good partner for the journal and now the journal is supported by World Hypertension League a partner of WHO,editorial consultants, ultimately my wish on behalf of the publishers and the three sponsoring institutions is that the journal should become a sister journal for the Indian heart journal, so that it becomes a companion of Indian heart journals, as both of you know our Dr. Santhanu and HK that American College of Cardiology has several journals, but their main journal is Jack, but there are sister and companion journals and the idea is ultimately for us to follow that model where hypertension journal becomes integrated with the Cardiological Society of India as a sister journal and it could have more space for hypertension articles whereas Indian heart journal has to provide space for other cardiovascular disorders also.

Dr. HK Chopra

So, I am really very happy, Dr. Venkat Ram has really spelled out very clearly that this journal is a companion journal to the CSI organ as an Indian heart journal and he also mentioned that the CSI journal, it will be partnering CSI. Our objective is partnering the CSI, we can reach to bigger number of people and we enhance the academic potential of India in a messy manner and I am very happy that Dr. Venkat Ram as a chief editor of this journal has spelled out very clearly, that this was only a first issue. This is just a beginning, and in the years to come, we are going to have a partnership in CSI in a big way for which I feel very proud. It is not my proud, it is also the proud of Santhanu and the most important proud is of Venkat Ram. He is coming to the CSI meeting for the last 35 years and is a very, very active member of CSI, so we should feel very proud as an Indian that we have our own journal on hypertension, the companion journal which is a part and parts of CSI and Indian Heart Journal. I think this is what I want to share today, that hypertension is going to be controlled in a big way in the years to come, this is our major road map in the years to come and I am sure that Santhanu when takes over as a president very shortly, he will have a very important component of his road map on the control of hypertension. Thank you very much Dr. Santhanu and thank you very much Dr. Venkat Ram.

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