Three out of four Bangladeshis at risk of heart disease

Three out of four individuals in Bangladesh have a risk of developing cardiac disease that can be prevented by simple means, says a policy forum on Monday.

Among these diseases, and hypertension is the most prominent one, as per UNB report.

Hypertension is the leading cause of cardiovascular and kidney diseases and over 1.5 billion are at risk of being affected by hypertension by 2025.

This is especially adverse in South Asia given that the prevalence of hypertension is already at 40 per cent.

According to the World Health Organization (WHO), one out of three adults older than 35 years of age has hypertension, but half of them are not aware of it, according to a message received from ICDDR,B.

The policy forum held on Monday on Hypertension and Cardio-Metabolic Diseases in Colombo observed government ministers, policymakers, economists, researchers and representatives of global health agencies at a single table, addressing steps to prevent, pre-empt and treat hypertension and related co-morbidities, including diabetes, cardiovascular and kidney disease.

The half-day forum was officiated by Dr Harsha de Silva, State Minister for National Policies & Economic Affairs of Sri Lanka, and included presentations and panel discussions by ministers of health from the countries where the studies were conducted.

Dr Aliya Naheed, Head, Initiative for Non-communicable Diseases, International Centre for Diarrhoeal Diseases Research, Bangladesh (ICDDR,B); Dr Abdul Alim, Deputy Program Manager, Non-Communicable Disease Control (NCDC) Programme, Directorate-General of Health Services (DGHS); and Prof Dr SM Mustafa Zaman, Secretary General, Association of Physicians of Bangladesh, represented Bangladesh at the policy forum.

Tazeen Jafar from Duke-NUS' Health Services & Systems Research and overall lead investigator of the multi-country Control of Blood Pressure and Risk Attenuation - Bangladesh, Pakistan, Sri Lanka (COBRA-BPS) study co-hosted the Forum and shared, "Up to three out of four adults with hypertension in South Asia have poorly controlled blood pressure, and one-third have co-existing diabetes."

This is very concerning as complications, including heart attack, stroke and kidney disease, tend to manifest 5-7 years earlier in South Asians than in Caucasian European populations.

COBRA-BPS study is evaluating novel, low-cost solutions for hypertension control and cardiovascular risk reduction in primary healthcare systems in rural communities in South Asia.

Dr Naheed, country principal investigator for the COBRA-BPS study in Bangladesh, said, "The beauty of COBRA-BPS strategy is that it was adapted into the existing government health system and the implementation of the interventions was driven by grassroots-level community health workers and physicians in primary health care facilities."

High-level officials from DGHS and policymakers in Bangladesh showed their enthusiasm for the COBRA strategy as it is fully aligned with the operational plan of the 4th Health, Population and Nutrition Sector Programmme (2017-2022).

Therefore, enhancing the scalability of the COBRA strategy in Bangladesh is quite feasible.

Prof Draman said hypertension and diabetes are conditions that, once diagnosed, need lifelong treatment, otherwise patients may end up with disability or even death.

Dr Sania Nishtar, co-chair, WHO Independent Commission on the UN High-Level Meeting on Prevention and Control of NCDs, underscored the need for universal health access to include hypertension and diabetes care for all segments of the population.

Prof Joep Perk, from the School of Health & Caring Sciences, Linnaeus University; Jill Jones, Head of Global Health Strategy, Medical Research Council, UK; Prof Kate Hunt from the University of Glasgow, UK; Prof Shah Ebrahim from London School of Hygiene & Tropical Medicine, UK; and Dr Richard Smith, Chair of icddr,b Board of Trustees, moderated the sessions and panel discussions.

Dr Shanthi Mendis, a former WHO adviser on NCDs, Prof Jafar as well as representatives from the Ministry of Health, World Bank, WHO, professional societies and policymakers from Bangladesh, Pakistan, Sri Lanka, and global researchers in hypertension spoke at the event.