A9719 Feasible implementation of the ‘Key actions towards essential goals’ suggested by The Lancet commission on hypertension to reduce blood pressure at individual and population level” in low resource rural India

Abstract

Objectives: To implement and analyze the feasibility of “key actions directed towards essential goals” (Key actions) suggested by The Lancet commission on Hypertension (Commission) to reduce blood pressure (BP) at individual and population level in rural Indian villages. Methods: The key actions suggested by the commission were implemented in villages in rural India through conventional approach. Three villages were included in the study (Intervention),three in control group where only Blood pressure (BP) was checked and person was informed of the hypertension status. Adults in the villages were screened for hypertension (HTN). Hypertensive individuals ( > 140/90 mmHg) were called for hypertension clinics (HCs) for advice on HTN management. Key actions were implemented through various integrated programs like education to population, individuals teachers etc... Results: 1950 individuals were screened. Most had agriculture as their social background. Men were 61%. Mean age was 51 years. 59% of diagnosed individuals through screening attended HCs. 39 % visited twice or more; 76% hypertensives required medicines, women were more attendees (68%) for HCs arranged in villages while 67% of them were above 50 yrs of age. Majority people (85%) followed advice to reduce salt, start/increase physical exercise, modify addictions. Compliance to medicines was a challenge which got over by good counseling. Individual BP lowered with every successful visit to HCs. Among a non intervened village 40% people had uncontrolled BP, while among intervened 76% had control on BP. One village opted out. Conclusion: It is feasible to implement the scientific suggestions of commission to reduce BP at population and individual level. The Lancet Commission on Hypertension's key actions are one of implementable guidelines. We need long term data.