Stating that hypertension has become the third most common cause of premature deaths in Bangladesh, local and international health experts on Wednesday suggested strengthening primary care services to deal with the non-communicable disease and save many lives.

Speaking at a meet the press event at a city hotel, they also warned that the burden of hypertension in Bangladesh is expected to grow in the coming years due to an ageing population, rapid urbanization, increases in sedentary lifestyle, processed food consumption, and other socioeconomic and lifestyle factors.

The event titled “Bangladesh Hypertension Control Initiatives” was jointly organised by the NCDC Program of the Directorate General of Health Services (DGHS), PROGGA (Knowledge for Progress), the National Heart Foundation of Bangladesh (NHFB), Global Health Advocacy Incubator (GHAI), and Resolve to Save Lives.

“In Bangladesh, one out of every five adults has hypertension,” said Dr Tom Frieden, President and CEO of Resolve to Save Lives and former Director of the US Centers for Disease Control and Prevention.

He said many lives can be saved and heart attacks and strokes can be prevented through investment in strengthening primary care services to provide treatment to Bangladeshi adults suffering from hypertension.

Frieden said non-communicable diseases, including hypertension, are silent killers that are accounting for more premature deaths every year than all infectious diseases combined,  mostly in low and middle-income countries.

Stating that Bangladesh has made real progress in tackling hypertension as it banned artificial transfat, he said, “That’s a wonderful policy. It means you don’t have to worry that some company has put something into your food that could give you a heart attack and kill you. So that is very commendable. We look forward to its full and effective enforcement.”

The ex-US CDC director also praised that doctors and nurses, and community health providers treating more than 100,000 patients suffering from hypertension.

He, however, said many people are dying prematurely from a preventable cause only for lack of awareness and early diagnosis.

Frieden appreciated the government for setting up community clinics across the country. The community clinics could be the key to transforming Bangladesh to become even healthier. But now you have a real challenge with non-communicable diseases, especially hypertension. And scaling up this program in addressing excess sodium intake can make a huge difference in reducing that.”

National Professor Brig (Rtd.) Abdul Malik, Founder and President of the National Heart Foundation of Bangladesh said there is an urgent need to improve control of high blood pressure. “Thirty percent of deaths in Bangladesh are from heart disease, but less than 5% of Bangladesh’s health sector budget is allocated to addressing the non-communicable disease.”

He said hypertension is a serious health concern and the government alone cannot solve this problem. “We need to prevent the disease with united efforts…for the first, we need to create awareness among people about the disease and media can play an effective role in this regard.”

“The hypertension control program piloted by NCDC DGHS, and the National Heart Foundation, in collaboration with Resolve to Save Lives, is succeeding by incorporating the principles of task-sharing and team-based care,” said Professor Md Robed Amin, Line Director, Non-Communicable Disease Control Program, Directorate General of Health Services.

“In the span of two years, the program has registered more than 100,000 patients—averaging more than 4,000 new patients a month—with a 58% blood pressure control rate, almost fourfold the national average.”

“You’ll be surprised to know that hypertension became the third commonest cause of morbidity in our country and diabetes become the sixth commonest cause within the sphere of the 10 years,” Robed said.

Referring to a survey report, he said some 67 percent of all deaths in the country are due to non-communicable diseases and 30% of mortality happens due to cardiovascular disease. “It means many people are dying from the stroke or heart attack or this kind of complication. So, it is a huge burden.”

Besides, he said there are around 20 million adult hypertension patients in Bangladesh. “The bad news is that hypertension is usually a symptomless disease. So whenever a disease becomes symptomless, it needs to be identified through a process of screening…We must put in extensive efforts to control hypertension.”

Citing a study report, the organiser said life-saving care for high blood pressure, also known as hypertension—the leading preventable risk factor for heart disease, heart attacks, and strokes—could be expanded nationwide in Bangladesh for about US$9 per patient per year.

Since 2018, they said the non-communicable Disease Control Program (NCDC), Directorate General of Health Services (NCDC DGHS) of the Ministry of Health & Family Welfare and the National Heart Foundation of Bangladesh (NHFB) have collaborated with Resolve to Save Lives, a global health non-profit organization, to implement a program strengthening the detection, treatment and follow-up of high blood pressure in primary care.

They also said the expansion of the highly successful initial project would save lives in Bangladesh by preventing heart attacks, strokes, kidney failure and expensive hospitalizations for these conditions, and at an affordable cost.