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Verma N, Matsushita N, Salman E, Ohkubo T, Imai Y. GeogRaphic and socioecoNomic Distribution of real-world Indian data of home blood pressure monitoring (GRAND Study): Study protocol for an observational study in 18 medical centers across India. J Clin Hypertens (Greenwich) 2023; 25:1105-1134. [PMID: 37909858 PMCID: PMC10710551 DOI: 10.1111/jch.14713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/19/2023] [Accepted: 08/01/2023] [Indexed: 11/03/2023]
Abstract
One-fourth of death in India is attributed to cardiovascular disease (CVD) and more than 80% is related to ischemic heart disease and stroke. The main risk factor for CVD is hypertension. Every third person in India suffers from hypertension and the prevalence increased drastically in the past 20 years, especially among the youngest age group of 20 and 44 years. Regardless of being under anti-hypertension medication, the blood pressure (BP) control rate in the country is still low ranging between 6% and 28% only. Assessing the "true BP control rate" should be performed using both clinic BP measurement and out-of-office BP measurement as the latter shows better prognosis for patients' hypertension and CVD outcomes. Home blood pressure monitoring (HBPM) shows superiority over ambulatory BP measurement as multiple measurements can be collected at the patient's convenience. Only limited evidence on HBPM in India is available and it's either lacking in hypertension participants or of a small sample size. This study will investigate the real BP control status among 2000 hypertensive patients from 18 centers in 12 states across Pan-India. The outcome of this study will emphasize the value of establishing BP control management practice guidelines suitable for physicians and help policymakers in building proper strategies for hypertension management to reduce the CVD burden on the health situation in India.
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Affiliation(s)
- Narsingh Verma
- Department of PhysiologyOfficiating Head Department of Family MedicineKing George's Medical UniversityLucknowIndia
| | - Noriko Matsushita
- Global Medical AffairsAsia Pacific RegionalOmron Healthcare Singapore, Pte. Ltd.Alexandra TechnoParkSingapore
| | - Ebtehal Salman
- Technical Development HQClinical Development DepartmentOmron Healthcare Co., Ltd.MukoKyotoJapan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public HealthTeikyo University School of MedicineItabashi‐kuTokyoJapan
| | - Yutaka Imai
- Tohoku Institute for Management of Blood PressureStation Plaza BuildingSendaiMiyagiJapan
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Chandrasekaran P, Kuppusamy S, Subramanian SK, Bharathi B, Bansal C, Fredrick J. Altered baroreflex sensitivity at rest and during Valsalva maneuver in healthy male offspring of hypertensive patients. High Blood Press Cardiovasc Prev 2023; 30:73-81. [PMID: 36646925 DOI: 10.1007/s40292-023-00559-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/29/2022] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION A family history of hypertension puts young adults at a higher risk of developing hypertension, that too, at an earlier age than their parents. Recent studies suggest that the baroreflex mechanism, which takes care of the short-term regulation of blood pressure (BP), also plays a role in the long-term regulation of BP. Studies have reported decreased baroreflex sensitivity (BRS) in hypertensives. Reduced BRS is shown to herald the future occurrence of cardiovascular diseases (CVD) and helps in risk stratification AIM: To assess BRS at rest and during the Valsalva maneuver among apparently healthy male offspring (age 18-35 years) of hypertensive patients. METHODS We recruited 37 participants whose parents (either/both) were hypertensive in the study group and whose parents (both) were not hypertensive in the control group. We measured basic anthropometric parameters (height, weight, waist circumference), cardiovascular parameters (heart rate and BP), short-term heart rate variability, and BRS (at rest and during Valsalva). RESULTS We found that BRS at rest and BRS during the Valsalva maneuver were reduced among healthy male offspring of hypertensive parents than in healthy male offspring of non-hypertensive parents. Further, HRV indices and Valsalva ratio showed a sympathovagal imbalance in the form of decreased vagal and increased sympathetic activity. CONCLUSION The reduced BRS and sympathovagal imbalance in male offspring of hypertensive parents reveal the early risk of developing hypertension in the future.
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Affiliation(s)
| | - Saranya Kuppusamy
- Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
| | | | - Bhavithra Bharathi
- Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Charu Bansal
- Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Jean Fredrick
- Department of Physiology, All India Institute of Medical Sciences, Kalyani, West Bengal, India
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Effect of Yoganidra on Blood Pressure, Hs-CRP, and Lipid Profile of Hypertensive Subjects: A Pilot Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:2858235. [PMID: 35003295 PMCID: PMC8739171 DOI: 10.1155/2021/2858235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/28/2021] [Accepted: 12/03/2021] [Indexed: 11/30/2022]
Abstract
Background Yoganidra is a systematic method of promoting a state of complete physical, mental, and emotional relaxation. It is a safe, inexpensive, and very effective method of management of hypertension when used along with standard pharmacological therapy. This study aims to assess the effect of yoganidra on blood pressure (both systolic blood pressure (SBP) and diastolic blood pressure (DBP)), Hs-CRP, and lipid profile of hypertensive subjects at the time of enrollment (subjects that are hypertensive at the time of enrollment). Methods Both treated and untreated subjects (n = 74) with hypertension (blood pressure ≥140/90 mmHg) and age between 35 and 70 years were included in this study after obtaining ICMR-NIN-IEC approval and written informed consent from all subjects. Subjects with critical illness and/or psychological disturbances were excluded from this study. The subjects in the experimental group (n = 31) practiced yoganidra for 45 minutes daily for 12 weeks under strict supervision. There was no intervention in the control group (n = 43). Weekly blood pressure was recorded in the experimental group, whereas it was performed at baseline and at endpoint for control groups. Hs-CRP and lipid profile were estimated at baseline and endpoint for both the groups. Results A significant reduction in mean SBP from 142.9 mm Hg (SD ± 16.46) to 118.68 mm Hg (SD ± 9.21; p value 0.0001) and DBP from 89.84 mm Hg (SD ± 10.42) to 77.03 mm Hg (SD ± 6.47: p value 0.0001) was observed among the experimental group after 12 weeks of yoganidra practice when compared with the control group. A significant reduction in mean Hs-CRP (2.21 ± 1.49 to 1.06 ± 0.82 mg/L, p < 0.001∗∗∗) was observed among the experimental group. There were no significant differences between triglycerides and total cholesterol levels, whereas LDL-C and HDL-C showed a trend of improvement in the experimental group after intervention. Conclusions In this pilot study, we observed a significant reduction in blood pressure and Hs-CRP in the yoganidra group compared with the control group. There were no significant side effects observed in the intervention group during the study period.
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Patil M, Jose AP, More A, Maheshwari A, Verma N, Shah R, Kaur A, Kaushik A, Sepat P, Beaney T, Clarke J, Bagadia L, Jadhav S, Poulter NR, Prabhakaran D. May Measurement Month 2019: an analysis of blood pressure screening results from India. Eur Heart J Suppl 2021; 23:B73-B76. [PMID: 34248432 PMCID: PMC8263079 DOI: 10.1093/eurheartj/suab047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
AIMS May Measurement Month is a global screening campaign to raise awareness regarding elevated blood pressure (BP). With the growing burden of hypertension, it is imperative to regularly assess the disease's prevalence, risk factors, and awareness levels in a country. The current prevalence of hypertension in India as per the National Family Health Survey Data stands at 25.3%. May Measurement Month mobilizes healthcare professionals and sensitizes them to regularly measure BP, and impart lifestyle modification advice to the community. It also complements the deficiency in screening programmes at a national and international level. METHODS AND RESULTS May Measurement Month was carried out in May 2019 as an opportunistic screening campaign for adults (≥18 years). It was carried out by over 5000 trained volunteers across approximately 1000 screening sites (hospitals, public places, pharmacies, villages, and malls) in India. A total of 362 708 (57% males and 42.7% females) people were screened, among whom 68.1% had never measured their BP, and 29.4% (n = 106 522) were found to have hypertension. Of these, only 42.0% were on antihypertensive medication and 23.3% had controlled hypertension. CONCLUSION Almost a third of the screened population had hypertension, and less than half of those with hypertension were aware of it or on treatment for it. Among those on antihypertensive drugs, BP was controlled in only half of them. These results support the need for greater impetus on BP screening initiatives to detect hypertension early in the community and prevent complications due to uncontrolled BP.
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Affiliation(s)
- Mansi Patil
- Asha Kiran Jubilee Hope Centre Hospital, Kalbhor Nagar, MIDC, Chinchwad, Pune 411019, Maharashtra, India
| | - Arun Pulikkottil Jose
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Plot 47, Sector 44, Gurugram 122002, Haryana, India
| | - Arun More
- Rural Health Progress Trust, Murud, 413510 Maharashtra, India
| | - Anuj Maheshwari
- Department of General Medicine, Babu Banarasi Das University, Lucknow 226028, Uttar Pradesh, India
- Indian Society of Hypertension, King George's Medical University, Shah Mina Rd, Chowk, Lucknow 226001, Uttar Pradesh, India
| | - Narsingh Verma
- Indian Society of Hypertension, King George's Medical University, Shah Mina Rd, Chowk, Lucknow 226001, Uttar Pradesh, India
- Department of Family Medicine, King George's Medical University, Shah Mina Rd, Chowk, Lucknow 226001, Uttar Pradesh, India
| | - Rohan Shah
- Kind Edward Memorial Hospital and Research Centre, 411011 Pune, India
| | - Amrit Kaur
- Department of Community Based Rehabilitation Physiotherapy, Dr Vasantrao Pawar Medical College and Research Center, Nashik 422003, Maharashtra, India
| | | | - Priyanka Sepat
- Integrated Disease Surveillance Program, National Health Mission, 110 054 New Delhi, India
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London, W12 7RH, UK
- Department of Primary Care and Public Health, Imperial College London, St Dunstan’s Road, LondonW6 8RP, UK
| | - Jonathan Clarke
- Department of Mathematics, Huxley Building, South Kensington Campus, Imperial College London, London SW7 2AZ, UK
| | - Leena Bagadia
- Rural Health Progress Trust, Murud, 413510 Maharashtra, India
| | - Swati Jadhav
- Rural Health Progress Trust, Murud, 413510 Maharashtra, India
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London, W12 7RH, UK
| | - Dorairaj Prabhakaran
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Plot 47, Sector 44, Gurugram 122002, Haryana, India
- Centre for Chronic Disease Control, C-1/52, 2nd Floor, Safdarjung Development Area, New Delhi 110016, Delhi, India
- Department of Epidemiology, London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury WC1E 7HT, London, UK
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