A Retrospective Analysis of Hypertension Screening at a Mass Gathering in India: Implications for Non-communicable Disease Control Strategies

Cardiovascular disease is the leading cause of mortality from noncommunicable diseases (NCD) in India. The government’s National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke seeks to increase capacity building, screening, referral, and management of NCDs across India and includes community-based outreach and screening programs. The government in India routinely provides basic care at religious mass gatherings. However, in 2015, at the Kumbh Mela in Nashik and Trimbakeshwar, the state government extended its services to include a hypertension-screening program. We examine here the value and implications of such opportunistic screening at mass gatherings. At the Kumbh, 5,760 persons voluntarily opted for hypertension screening and received a single blood pressure measurement. In all, 1,783 (33.6%) screened positive, of whom 1,580 were previously unaware of their diagnosis. Of the 303 that previously had hypertension, 240 (79%) were prescribed medications, and 160 were compliant (that is, 52.8% under treatment). Fifty-five (18%) had normal blood pressure readings (BP under control). The data also demonstrated higher prevalence (39%) of hypertension among tobacco users compared to non-users (28%) (P<0.001). Poor recording of phone numbers (0.01%) precluded any phone-based follow-up. The low rates of hypertension awareness, treatment, and control underscore the ongoing challenge of both hypertension screening and management in India.