Hypertension management together with trans-fat elimination – a route to reducing the burden of cardiovascular disease
Deaths due to cardiovascular diseases like heart attack and stroke are on the rise across the country and in Maharashtra, in specific. Hypertension is the most important preventable cause for developing cardiovascular diseases. In a clarion call for urgent action and widespread awareness among people to reign in this silent epidemic, Disha Foundation held a media dialogue with health experts, policymakers and journalists in Nagpur.
Disha Foundation is Maharashtra based non-profit organization working pan-India with its offices in Nasik and Nagpur, Maharashtra. It works on issues related to migration, education, livelihood and health for marginalized communities. In Health, Disha Foundation is one of the few organizations leading the efforts on Universal Access to Tuberculosis Care (UATBC) beginning with Maharashtra. Disha is also working on issues of accessibility to health services, piloting innovative models in non-communicable diseases and creating health awareness. Disha Foundation is working on a campaign to promote cardiovascular health including trans fats elimination and hypertension.
Presently, the overall prevalence of hypertension in Maharashtra is 25% as per a research article by PLOS journal. Furthermore, the intake of trans-fatty acids has increased the risk of deaths due to heart attacks by 4% that is 8,253 deaths every year. These deaths could have been easily avoided by taking the right measures and building a strategic approach like reducing industrially-produced trans-fats in foods.
Dr. Sanjeev Kumar, Divisional Commissioner, Nagpur giving a call to action to the need to amplify the awareness about hypertension as a growing health concern. “In Maharashtra, approximately 66% of all deaths are due to NCDs. In Nagpur, around 3 lakh people are estimated to have raised blood pressure many of them are unaware that they have raised blood pressure. Those who are aware often do not seek treatment or continue with medication even when the intervention does not cost much. Blood pressure can be easily checked and treated with inexpensive medicines. Therefore, the Government and medical fraternity must work together to ensure the early detection of hypertension so that many lives are saved. We must also screen for blood pressure at the household level in the community, if diagnosed, put them on treatment, monitor that they continue to receive medicines to reduce the disease burden.”
Dr. Abhishek Kunwar, National Professional Officer, Cardiovascular Diseases, WHO Country Office for India, said “Hypertension is the leading cause of death due to non- communicable diseases (NCDs) in India. To make hypertension treatment widely available, the Government of India and several state governments initiated the India Hypertension Control Initiative program (IHCI). In Maharashtra, four districts (Bhandara, Wardha, Satara and Sindhurug) are selected for the implementation of IHCI in the first phase. The program is focused on screening of patients for hypertension at all health facilities. Also, the Government of Maharashtra has initiated population-based screening (PBS) at community level for hypertension and diabetes. The biggest priority for us is to ensure that people with raised blood pressure are detected early and receive treatment. Healthcare providers have been trained to screen people and to ensure that they register for treatment. Making blood pressure medicines available is also a big focus area for us since once detected with hypertension people should continue taking medication lifelong to keep their blood pressure under control.”
Speaking on the need to eliminate TFA, a known cause of cardiovascular diseases, Dr. Eram Rao, Associate Professor, Delhi University said “Removal of industrially-produced trans-fatty acids from the food supply will be a big step in reducing the number of deaths due to arterial clogging and heart attacks. We need to educate the public on trans fats and inform that these fats have no known health benefits. Trans fats can be replaced by healthier fats without changing the taste of the food. Globally, several countries have become trans-fats-free. Technologies such as full hydrogenation and interesterification can produce fats with zero trans fats.”
Ashim Sanyal, COO, Consumer Voice said, “The most effective way to eliminate industrially-produced trans fat in food is through regulatory action. Food Safety and Standards Authority of India (FSSAI) has already put in place such a regulation to limit trans fatty acids in all oils and fats to not more than 2% by January 2022. In the coming days, we will work closely with both central and state governments besides the food industry to accelerate the elimination of industrially-produced trans fats from the entire food chain. There is an acute shortage of TFA testing equipments and capacities across states. Some states like Kerala have been leading the way. I also congratulate Maharashtra for initiating testing of some foods. This is a tall task which will require collaboration across sectors, mobilization of resources and most importantly, awareness generation.”
Emphasising the need to build awareness among consumers, Dr Anjali Borhade, President, Disha Foundation, said: “Awareness plays a key role in controlling the prevalence of Hypertension. As high blood pressure often has no warning signs or symptoms, many people do not realize they have it. Left untreated, hypertension can cause disability or death. We must make people aware of the importance of getting their blood pressure checked at regular intervals. Besides maintaining a healthy lifestyle and diet, it is equally important to continue to take medications regularly.”
Other experts like Manoj Tiwari, Senior Food Safety Officer, FDA, Nagpur and Jayashree Pendharkar, Nutritionist also spoke at the occasion, highlighting the actions which need to be taken in order to improve the health outcomes of the people of Maharashtra.
In May 2018, WHO and Resolve to Save Lives announced the REPLACE initiative to make the world trans-fats-free by 2023. REPLACE provides a six-step action package including enacting regulations to strictly limit the amount of industrially-produced trans fats in foods, fats, and oils.
The common PHVOs in India are Vanaspati, margarines and bakery shortenings, ingredients used for making foods at home but more commonly in bakeries, sweetshops, restaurants, and street foods. Indians are known to be at a high risk of cardiovascular disease. Initiatives like these sessions are helpful to target the population and create awareness on the urgency of screening, bringing down the disease burden and thereby reduce the economic burden caused the morbidity and mortality due to non-communicable diseases.
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