India heart Study
42% Indians at risk of misdiagnosis of hypertension says India Heart Study
India Heart Study (I.H.S) was aimed to investigate the limitations of office blood pressure measurement in comparison to home (self) blood pressure measurement i.e. identify incidences of white coat hypertension and masked hypertension in the cohort (with no history of hypertension) visiting clinicians.
White-coat hypertensives get misdiagnosed as hypertenisves and put on anti-hypertensives medication, which increases the risk of hypotension (low blood pressure, less than SBP 90/60 DBP) in such persons.
On the other hand, a masked hypertensive may go undiagnosed running the risk of complications for heart, kidney, and brain, leading to premature mortality.
What sets this study apart is that it was conducted in a ‘drug-naive’ set of participants using a comprehensive process of taking blood pressure readings. The investigators examined the blood pressure of 18,918 participants (62.7% male and 37.3% female) through 1233 doctors across 15 states over a period of nine months. The participants’ blood pressure was monitored by themselves at home four times in a day for 7 consecutive days.
IHS findings highlight a high prevalence of masked hypertension and white-coat hypertension in Indians at 42% on first office visit.
- 18.2% of the respondents were found to have masked hypertension and
- 27.5% of respondents were found to have white-coat hypertension and were misdiagnosed
- It was also found that Indians have a higher average resting heart rate of 80 beats per minute, higher than the desired rate of 72 beats per minute.
- 45.7% of respondents ((27.5%) hypertension + (18.2)masked hypertension) were unaware of their high blood pressure
- Another striking finding of the study is that unlike other countries, Indians seem to have higher blood pressure in the evenings than in mornings.
Dr. Willem Verberk, PhD., Cardiovascular Research Institute Maastricht (CARIM), and a key investigator suggests, “For the ‘correct’ detection of hypertension, home blood pressure monitoring is advised. However, different patients may have different co-morbidities, like diabetes, which makes the use of validated devices for home blood pressure monitoring important. Home blood pressure monitors used by pregnant women, elderly and people with kidney disorders or diabetes needs to be validated separately.”
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