Picture Courtesy: World Health Organization
High blood pressure or Hypertension is a silent killer because many do not know they have it until it’s too late. According to studies, the disease is increasing among the Bhutanese population. Another challenge the health ministry is facing is that patients who are diagnosed with hypertension discontinue their medication due to various reasons. And this can actually be life-threatening according to health experts.
According to the Bhutan Stroke Foundation, high blood pressure is the leading cause of strokes in the country.
The foundation’s executive director says although there are many causes for a stroke, most of the cases he has seen so far involve hypertensive patients who have discontinued their medication.
“Most of the stroke patients here are always hypertensive, and they are people between the ages of 30 and 70. At first, they take medicine, but mostly, they stop eating the medicine and get a stroke,” said Dawa Tshering, executive director of the Bhutan Stroke Foundation.
He said one reason why patients stop taking medicines is because people who go to offices are busy and forget to take the meds. And in rural places, he said people discontinue treatment because they are not aware of the seriousness of the disease.
The foundation is currently compiling comprehensive data on the causes of stroke patients in the country.
Discontinuation of medicine can also lead to other complications such as kidney failure. According to a patient, his kidneys were damaged after he stopped his hypertension medicines based on a rumour.
“I was told that if we continue taking the hypertension medicine, our kidneys will fail and we will get other diseases, so I stopped taking the medicine because I was afraid. For three years, 2008, 2009, and 2010, my blood pressure remained normal. But then I was in Monggar for training once, and I went for a checkup at the hospital and found that both of my kidneys had failed,” said Dawa Tashi, a kidney patient.
Doctors say that because the symptoms of hypertension are normally not apparent, people fail to get timely treatment.
“So basically, if somebody has high blood pressure for a long duration and if it is not treated and if it is not brought under control, then we may develop a heart attack, we may develop a stroke, and we may develop kidney failure. That your kidney might not function as much as it should. And if it continues for a very long time, we might have to even do dialysis or replace the kidney. These are the three risks of having high blood pressure, heart attack, stroke, and kidney failure,” said Dr Guru Prasad Dhakal, the head of the Department of Medicine.
The most recent annual health bulletin says that hypertension cases in the country are increasing. It rose by almost 20 per cent in 2021 as compared to the previous year.
The latest STEP survey report reveals that nearly one in every four Bhutanese has hypertension, with about 65 per cent not even aware that they have high blood pressure.
Meanwhile, to address this issue, the health ministry started the Service with Care and Compassion Initiative or SCCI in 2019.
“SCCI is basically a comprehensive management of non-communicable diseases, starting from prevention to treatment to the follow-up and rehabilitation of the patient with the NCDs. It also includes the screening of further NCDs among the healthy population. Wherever the opportunity comes, we try to screen the people wherever there is a public gathering so that people know their status, whether they are hypertensive, whether they have a high blood sugar level, or whether they are overweight, which leads to those complications of the diseases,” said Tshewang Lhadon, a programme officer of NCD of the Department of Public Health, Ministry of Health.
Basically, the programme ensures that every patient continues their treatment. For instance, if a patient moves to another district, the former health team will inform their counterparts in the new location and make sure he or she does not stop treatment.
The SCCI has been implemented in 16 districts so far, and the rest are expected to be ready by the end of this fiscal year.
As of 2021, there were more than 22,000 people in the country with high blood pressure. According to the WHO, hypertension is a major cause of premature deaths worldwide.
Doctors say the disease is caused by overweight, obesity, unhealthy lifestyle, and excessive alcohol and tobacco consumption, but it is also genetic. However, hypertension or high blood pressure can be prevented if a person maintains a healthy diet and lifestyle.
Singye Dema
Edited by Yeshi Gyaltshen
