Required Uniform Assignment: Health Promotion

Traveling to India, one would try flavorful dishes, wander the streets to look at the most beautiful dresses and jewelry and also find something else. Startling evidence shows there is a high rate of adults in India with high blood pressure (“One in five yong adults in India has high blood pressure”, 2018, para. 1). Healthy People 2020 emphasizes the importance of routine screenings, proper nutrition and exercise. These factors influence a person’s susceptibility to high blood pressure. Not being aware of having high blood pressure and not treating it can cause stroke, heart attack, kidney failures and other dangerous effects (“High blood pressure dangers: Hypertension’s effects on your body”, 2019, para 20). I will be discussing the prevalence of this health issue in this specific population and causes for it. I will also offer ways in how to educate this community to prevent high blood pressure and ways to receive proper treatment options to promote a healthy strategies. I will also be describing how high blood pressure is related to Healthy People 202 in regards to screening, proper nutrition and exercise.

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Screenings help reduce the chance of people developing health conditions or diseases. Also, proper nutrition and adequate amount of physical promotes overall health. They describe it as, “decrease a person’s risk of developing serious health conditions, such as high blood pressure, high cholesterol, diabetes, heart disease, stroke, and cancer” (“Nutrition, Physical Activity, and Obesity”, n.d., para. 1). Adult Indians have a high chance of developing high blood pressure and not even know it. Their high salt intake also indicate a risk for high blood pressure. And one of the big reasons for this is because of the late screening program they have in place in india  (“One in five yong adults in India has high blood pressure”, 2018, para. 2). Proper nutrition and little exercise can go a long way in preventing health conditions. Medical Express states, “The level of self-reported risk factors was: smoking 7.5 percent, tobacco chewing 6.6 percent, diabetes mellitus 2.1 percent, and high cholesterol 2.2 percent” (“One in five yong adults in India has high blood pressure”, 2018, para. 5) Some of these risk factors are modifiable. Meaning, one can stop the usage of smoking, chewing tobacco and start eating a low cholesterol diet to reduce their chances of developing high blood pressure and reducing further complications.

Another health promoting approach is to educate communities and health care providers to have patients take screenings for high blood pressure sooner rather than later. This strengthening of primary care will help prevent or reduce the use of secondary and tertiary care, where conditions are worse. This relates to Healthy People 2020 because conducting routine screenings, good nutrition and exercise is currently lacking. Screenings help prevent diseases and treat conditions before they get worse and have fatal consequences. Having screenings completed sooner in Indian adults, even children, can help warn patients of their health status and educate them on a plan to control their blood pressure.  A healthy diet and some physical activity can reduce the chance of high blood pressure.

 High blood pressure in adults Indians is a real health issue and there are three studies that offer evidence based research. A study completed in Varanasi, India assessed prevalence of hypertension in the community. They stated, “This cross-sectional community based study identified a high prevalence of prehypertension and hypertension in urban areas of Varanasi, which was 41.7%   and 32.96%, respectively. Only a quarter of the subjects were in the normal category, which highlights the escalating burden of this silent killer” (Singh, Shankar and Singh, 2017). It’s startling to know there was such a small amount of people who weren’t at risk for high blood pressure. There was another interesting finding in this study as well. They believed things like, “marital status, education, occupation, socioeconomic status, BMI, abdominal obesity, tobacco use, alcohol use, and physical activity…low literacy level and being too rich were associated with hypertension”  (Singh et al., 2017).  These are factors that played an influence on their health. Who one marries, their line of work and how much their income is has a lot to do with high blood pressure.

Another study completed in urban, rural parts of north, easy, west and south India were completed and they stated that, “About 33% urban and 25% rural Indians are hypertensive. Of these, 25% rural and 42% urban Indians are aware of their hypertensive status. Only 25% rural and 38% of urban Indians are being treated for hypertension. One-tenth of rural and one-fifth of urban Indian hypertensive population have their BP under control” (Anchala et al., 2014). A study like this that is region specific has not been done before. There is a clear difference in their numbers in the different regions of India. It suggests that geographic and economic factors are play for these individuals.

Finally, there was another study completed in India who surveyed 731,864 individuals aged 15-49 years. The data suggests that, “those with hypertension who had ever had their BP measured was high (76%), less than half (45%) of individuals with the condition were aware of their diagnosis, less than 1 in 7 (13%) reported currently taking BP-lowering medication, and less than 1 in 10 (8%) had achieved control” (Prenissl et al., 2019). Again, there is evidence of a small group of people properly treating their condition and actually have it under control. It is good that these individuals have taken BP screenings before but less than half weren’t aware of their condition.

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Health promotion strategies for this target population and this health issue starts with education. First, education by schools and health care providers should be advising people to conduct screening as early as 18 years old and check it every two years. They should educate on the health diseases or conditions that can occur if they are not treated for high blood pressure and offer them community resources. Clearly, rural and urban areas have a difference in the amount of people who get treatment for blood pressure. A good guess would be because they don’t have resources, don’t know where to find them or can’t afford it. The community, institutions or health care providers, can guide them to a place they can afford. Another health promotion strategy would be to change their eating habits to less salt and low cholesterol. Encourage them to follow ChooseMyPlate guidelines because it includes, “ It includes guidelines for balancing calories; decreasing portion size; increasing healthy foods; increasing water consumption; and decreasing fats, sodium, and sugars” (Potter, Perry, Stockert, Hall and Ostendorf, 2017).

Healthy People 2020 believes healthy diet, good amount of physical activity and routine screenings promotes a healthy lifestyle. Indian adults are not aware of or not treating high blood pressure. They are also not aware what high blood pressure is and what further complications it could have on someone. Education to the community of different resources available, a change in their diet and exercise can go a long way in reducing and preventing the effects of high blood pressure.

References

• Anchala, R., Kannuri, N. K., Pant, H., Khan, H., Franco, O. H., Di Angelantonio, E., & Prabhakaran, D. (2014). Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension. Journal of hypertension, 32(6), 1170–1177. doi:10.1097/HJH.0000000000000146
• Clinical Preventive Services. (n.d.). Retrieved from https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Clinical-Preventive-Services
• How high blood pressure can affect your body. (2019, January 09). Retrieved from https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20045868
• Nutrition, Physical Activity, and Obesity. (n.d.). Retrieved from https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Nutrition-Physical-Activity-and-Obesity
• One in five young adults in India has high blood pressure. (2018, November 26). Retrieved from https://medicalxpress.com/news/2018-11-young-adults-india-high-blood.html
• Potter, P. A., Perry, A. G., Stockert, P. A., Hall, A., & Ostendorf, W. (2017). Fundamentals of Nursing (9th ed.). St. Louis.
• Prenissl, J., Goehler, J. M., Jaacks, L. M., Prabhakaran, D., Awasthi, A., Bischops, A. C., . . . Geldsetzer, P. (2019). Hypertension screening, awareness, treatment, and control in India: A nationally representative cross-sectional study among individuals aged 15 to 49 years. PLOS Medicine.
• Singh, S., Shankar, R., & Singh, G. P. (2017). Prevalence and Associated Risk Factors of Hypertension: A Cross-Sectional Study in Urban Varanasi. International journal of hypertension, 2017, 5491838. doi:10.1155/2017/5491838