59% of hypertension patients see BP come under control in primary care

Highlights:

• 2.2 crore people in Bangladesh are suffering from high blood pressure 
• Only 49% of them have been diagnosed, 35% are receiving treatment, and 14% have their blood pressure under control
• 30% of deaths in Bangladesh are caused by heart diseases
• High BP can be controlled by maintaining a simple medication regimen

The hypertension control programme being jointly implemented by the Non-Communicable Disease Control (NCDC) department of the health directorate and the National Heart Foundation of Bangladesh (NHFB) has achieved remarkable success, with 59% of patients registered for treatment under the programme witnessing their blood pressure coming under control in primary care.

Since 2018, NCDC and NHFB have collaborated with Resolve to Save Lives, a global health non-profit organisation, to implement the programme in 54 upazila healthcare centres of the country, strengthening the detection, treatment, and follow-up of high blood pressure in primary care. 

Professor Md Robed Amin, line director at the NDC wing of the Directorate General of Health Services (DGHS), said, "More than 100,000 patients have been registered under the programme – averaging more than 4,000 new patients a month – with a 59% blood pressure control rate, which is almost fourfold the national average." 

"But there were some challenges as nearly 34% did not return for their follow-up till June 2022. We are planning to strengthen the referral and reduce the loss to follow-up rate," he added while sharing the findings at a press conference, entitled "Bangladesh Hypertension Control Initiatives", at Pan Pacific Sonargaon Hotel in the capital on Wednesday. 

Expansion of the highly successful initial project would save lives in Bangladesh by preventing heart attacks, strokes, kidney failure, and expensive hospitalisations for these conditions, and at an affordable cost, according to people.

One in every five (21%) adults in Bangladesh is currently suffering from hypertension, according to Bangladesh NCD Steps Survey, 2018. 

Even though most people's high blood pressure can be controlled by maintaining a simple medication regimen, of the estimated 2.2 crore people suffering from high blood pressure in Bangladesh, only 49% have been diagnosed, 35% are receiving treatment, and 14% have their blood pressure under control.

Dr Tom Frieden, president and CEO of Resolve to Save Lives and former director of the US Centers for Disease Control and Prevention, said, "Many lives can be saved – and heart attacks and strokes prevented – by investing in strengthening primary care services to provide blood pressure treatment to Bangladeshi adults."

"30% of deaths in Bangladesh are caused by heart diseases, but less than 5% of Bangladesh's health sector budget is allocated to addressing non-communicable diseases," said National Professor Brig (retd) Abdul Malik, founder, and president of the National Heart Foundation of Bangladesh. 

"There is an urgent need to improve high blood pressure control and the pilot programme shows this can be done at low cost through primary health care, even at the national level."

Hypertension could be expanded nationwide in Bangladesh for about $9 per patient per year, according to a new study published in the British Medical Journal. 

Wednesday's Meet the Press event was jointly organised by the NCDC Programme, DGHS, PROGGA (Knowledge for Progress), the National Heart Foundation, Global Health Advocacy Incubator, and Resolve to Save Lives. 

According to a study, titled "Cost of primary care approaches for hypertension management and risk-based cardiovascular disease prevention in Bangladesh: a HEARTS costing tool application", hypertension treatment remains among the leading cost-effective ways to combat heart diseases. 

The study says the annual medication expenditure per patient treated with medications for hypertension, diabetes, and cholesterol is $18, $29 and $37, respectively.