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