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CRUSADE AGAINST THE SILENT KILLER

CRUSADE AGAINST THE SILENT KILLER. DR.R.BALASUBRAMANIYAM CONSULTANT NEPHROLOGIST KG HOSPITAL. CHANGING HEALTH SCENARIO - MAJOR FACTORS OF MORTALITY. MALNUTRITION INFECTION. CHANGING HEALTH SCENARIO - COMMON CAUSES OF MORTALITY. CARDIO - VASCULAR DISEASES CEREBRO - VASCULAR DISEASES

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CRUSADE AGAINST THE SILENT KILLER

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  1. CRUSADE AGAINST THE SILENT KILLER DR.R.BALASUBRAMANIYAM CONSULTANT NEPHROLOGIST KG HOSPITAL

  2. CHANGING HEALTH SCENARIO - MAJOR FACTORS OF MORTALITY MALNUTRITION INFECTION

  3. CHANGING HEALTH SCENARIO - COMMON CAUSES OF MORTALITY CARDIO - VASCULAR DISEASES CEREBRO - VASCULAR DISEASES RENAL DISEASES

  4. COMMON DENOMINATOR UNDERLYING HYPERTENSION

  5. WHY THIS SHIFT? IMPROVING HYGEINE INFECTION CONTROL STEPS BETTER DRUGS & VACCINES BASIC MEDICAL FACILITY AVAILABLE TO COMMON MAN

  6. THE URBAN LIFE INCREASE STRESS LEVELS SMOKING ALCOHOLISM CHANGING FOOD HABITS SEDENTARY JOBS NO PHYSICAL EXCERCISE

  7. THE PRICE WE PAY 10 - 20% PREVALENCE OF HYPERTENSION ALL OVER THE WORLD APPLY TO INDIAN SCENARIO THE HYPERTENSIVE POPULATION IS APPROXIMATELY 10CRORES

  8. HTN IN INDIA PREVALENCE 1960 - 1.24 to 4.24% Urban 2000 - 3.8 - 30% (Males) 1.45 - 7.65% (Females) Rural 1.57 - 6.93% (Males) 2.38 - 7.5% (Females)

  9. PREVALENCE VARIES ACCORDING TO AGE SEX BP CUT OFF VALUE DEVELOPING vs DEVELOPED COUNTRIES ETHNIC

  10. “WHO” - ON HYPERTENSION A MAJOR HEALTH PROBLEM COMPLEX AND MULTI DIMENSIONAL APPROACH

  11. DEFINITION OF HYPERTENSION FIFTH JOINT NATIONAL COMMITTEE CRITERIA THREE SETS OF READINGS, AT 1 WEEK INTERVAL MINIMUM AVERAGE LEVEL 140 - SYSTOLIC 90 - DIASTOLIC

  12. BAD NEWS Patients with DBP > 105mmHg - 10 fold in stroke 5 fold in Cardio vascular disease

  13. GOOD NEWS PERSISTANT REDUCTION OF DBP DBP  CVD  CORONARY DEATH 5mmHg 34% 21% 7.5mmHg 46% 29% 10mm Hg 56% 37%

  14. AWARENESS ABOUT HTN -(USA) 65% OF HYPERTENSIVES LACK AWARENESS 49% RECEIVE TREATMENT 21% HAVE BP < 140/90 mmHg

  15. THE INDIAN SCENARIO MYTHS & FACTS

  16. MYTH - HYPERTENSIVES ARE SYMPTOMATIC FACT - 90% ARE ASYMPTOMATIC

  17. MYTH - HYPERTENSION IS DISEASE OF ELDERLY FACT - NO AGE FOR HYPERTENSION

  18. MYTH- ONCE DIAGNOSED START DRUGS FACT - EVALUATE FOR SECONDARY HTN, STRESS ON LIFE STYLE MODIFICATION

  19. MYTH - STOP DRUGS ONCE BP IS NORMAL FACT - HTN IS CONTROLLABLE, NOT CURABLE

  20. MYTH- REGULAR INTAKE OF DRUGS CAN PRODUCE SIDE EFFECTS FACT - UNCONTROLLED HTN PRODUCES ENDORGAN DAMAGES

  21. NEED FOR THE HOUR POPULATION APPROACH SCREEN EVERY ONE INDIVIDUAL APPROACH SCREEN THOSE AT RISK

  22. AIM INCREASE AWARENESS ON HTN BY  PUBLIC EDUCATION - RADIO, TV, PAPERS, SCHOOLS ETC  PROFESSIONAL EDUCATION  PATIENT EDUCATION

  23. WHY SHOULD WE DO THIS? PRIMARY PREVENTION - CHEAPER & SAFER THAN SECONDARY & TERTIARY PREVENTION

  24. COST OF ONE HYPERTENSIVE PATIENT MANAGEMENT Drugs Per Month - Rs.250/- Per Year - Rs.5,000/- Evaluation cost - Rs. 1,000/- Per Year

  25. Assume he is going to live for 20 years Investigations for 20 Years - Rs.20,000/- 20 Years of Anti HT drugs - Rs.1,00,000/-

  26. COMPLICATION MANAGEMENT HEART ATTACK } Rs.1.5 - 2.5 lakhs & BY PASS SURGERY KIDNEY TRANSPLANTATION  Rs.2 - 4 lakhs STROKE MANAGEMENT  Rs. 1 lakh

  27. NOT INCLUDED LOSS TO HIS FAMILY LOSS OF HIS EARNINGS HIS CONTRIBUTION TO THE COMMUNITY

  28. IF THIS HAPPEN TO ONE PATIENT - KINDLY EXTRAPOLATE IT TO 10 CRORES OF PEOPLE

  29. DR.MK.MANI’S APPROACH IDENTIFIED VILLAGES INVOLVES HEALTH WORKERS DOOR TO DOOR BP & SUGAR CHECK UPS LOW COST DRUG DISTRIBUTION PERIODIC MONITORING

  30. WHAT CAN BE DONE ENLARGE HIS CONCEPT APPLY TO EVERY VILLAGE IN THE COUNTRY THROUGH GOVT (OR) NON GOVERNMENTAL ORGANISATIONS ROLE OF PRIMARY HEALTH CENTRES HEALTH EDUCATION IN SCHOOLS TRAIN HEALTH WORKERS, STUDENTS

  31. WHAT CAN BE DONE BY OUR GOVT? HEALTH EDUCATION AGRICULTURAL POLICIES - K+ RICH NATURAL FOODS, VEGETABLES, FRUITS LOW SALT & FAT IN FOOD CONTENTS CREATE FACILITIES FOR OUT DOOR ACTIVITIES CONTROL SMOKING ENSURE AVAILABILITY OF CHEAP ANTI - HT DRUGS INTEGRATED PROGRAMMES

  32. WHAT HAVE WE DONE ? STEP - 1 FREE BP CLINIC POPULATION SCREENED - 1,64,685 HTN DETECTED - 16,576 FREE SCREENING, EXAMINATION & MEDICAL ADVICE. INVESTIGATION AT CONCESSIONAL CHARGES

  33. STEP - 2 SCREENING BP BEYOND KG HOSPITAL SCHOOLS , COLLEGES, OFFICES & RESIDENTIAL AREAS TARGET - CITY OF COIMBATORE

  34. WE REQUIRE HUMAN RESOURCES FINANCIAL SUPPORT - TRANSPORT INSTRUMENTS DRUGS

  35. WE REQUEST OUR HONOURABLE DR. K.VENKATASUBRAMANIAN MEMBER OF PLANNING COMMISSION, GOVT OF INDIA YOU SUPPORT US - WE TAKE CARE OF OUR DISTRICT

  36. OUR REQUEST PLEASE SPEND MONEY NOT ONLY TO REDUCE TENSION ACROSS BORDERS BUT ALSO TO REDUCE HYPERTENSION WITHIN BORDERS

  37. THANK YOU

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