Latest news with #CentreforChronicDiseaseControl
Fashion Value Chain
30-07-2025
- Health
- Fashion Value Chain
TOPSPIN Study by the Centre for Chronic Disease Control (CCDC) Finds Two-drug Combination Therapies Effective in Improving Blood Pressure Control in Indians
A new study, entitled TOPSPIN, coordinated by the Centre for Chronic Disease Control (CCDC) New Delhi, in collaboration with the All India Institute of Medical Sciences (AIIMS) New Delhi, and Imperial College London, examined 1,981 patients with uncontrolled hypertension across 32 hospitals in India. The findings showed that three two-drug combination therapies – Amlodipine plus Perindopril, Amlodipine plus Indapamide, and Perindopril plus Indapamide – were equally effective and safe in lowering both ambulatory and office blood pressure. TOPSPIN is the first-ever randomised study to test the choice of first-line two-drug combination therapy in a single pill among South Asians. The study findings are published in Nature Medicine, one of the top medicine journals. A doctor checking the blood pressure of a patient South-Asians represent one-fourth of the world population, and India alone constitutes one-sixth of the global population. Hypertension is a public health crisis affecting over one billion adults worldwide, including over 300 million living in India. Innovative solutions are needed to curb the growing tide of high blood pressure, which is the single highest risk factor for global deaths, and which requires effective management solutions. Current guidelines widely recommend initiating treatment with two-drug combinations, preferably in a single-pill formulation, to enhance blood pressure control. However, the suitability of these combinations for the South-Asian population remains unknown, as there are no studies in this regard. The key takeaways are that all three combinations were equally effective in reducing blood pressure and were safe for patients. What did the TOPSPIN study find Blood pressure dropped significantly after 6 months, by around 14/8 mmHg when measured over 24 hours and about 30/14 mmHg in clinic settings. Nearly 70% of patients reached the recommended blood pressure target below 140/90 mmHg , five times higher than India's current average control rate. The pills were well-tolerated, with less than 3% of patients reporting side effects serious enough to stop treatment. â What do the Study leaders say 'This study shows that a single daily pill with two drugs can be a simple and powerful way to manage blood pressure in Indian and South Asian patients,' said Prof. Dorairaj Prabhakaran, Executive Director of CCDC and one of the study's lead authors. 'These findings can help guide doctors and policymakers. If added to India's list of essential medicines and made available at primary health centres, these pills could greatly improve blood pressure control in the country.' Prof. Ambuj Roy, Professor of Cardiology at AIIMS Delhi, added, 'Nearly 70% of patients got their blood pressure under control, a huge improvement over the current national average. And the pills were safe and easy to use. This study gives clear guidance for better hypertension care.' Prof. Neil Poulter, Professor at Imperial College London, emphasized the importance of studying how medicines work in different populations. 'Just as earlier research in Africa showed different results, this study gives strong evidence on what works best in South Asians.' â The TOPSPIN study results could help improve treatment not only in India, but also for South Asians living around the world.
The Hindu
26-07-2025
- Health
- The Hindu
Study recommends two half-dose combination of drugs in a single pill for good blood pressure control in Indians
With evidence lacking thus far for guiding optimal combination hypertension therapy in South Asian patients, a recent study has recommended half doses of two drugs in a single pill combination right from the start of treatment for hypertension. The paper, 'Comparison of dual therapies for hypertension treatment in India', published in the journal Nature Medicine, investigated the blood pressure (BP)-lowering efficacy and safety of three commonly-recommended antihypertensive combinations in a single pill in a multi-centre trial across 32 sites in India. Nearly 2,000 adults with uncontrolled or untreated hypertension were studied, and interventions included three single-pill dual combinations: Amlodipine + Perindopril, Perindopril + Indapamide and Amlodipine + Indapamide. All three combinations, in patients aged 30–79, delivered equivalent BP reductions and similar rates of BP control, researchers said. All combinations were equally safe and effective with high tolerability over six months, they wrote in the paper. 'It must be noted that we are not recommending a multi-drug regimen. Polypharmacy will only lead to discontinuation of treatment,' says Prabhakaran Dorairaj, principal investigator of the study, from the Centre for Chronic Disease Control, New Delhi. 'What we are recommending is to start with half doses of two drugs in a single pill combination. If BP control does not happen, then it is important to titrate to full doses. Despite this, if BP continues to be higher than 140/90, then additional drugs are to be added,' he explains. 'It is really astounding that we have been basing treatment on Western guidelines, so far,' Dr. Prabhakaran adds. This study tests the global guidelines for hypertension treatment among patients in India, since these combinations are already available here. These drugs work through multiple pathways and are synergistic, with low side effects, he says. 'Many physicians, even cardiologists, think that they should start with a low dose and then keep escalating it,' says Nagendra Boopathy, co-author and interventional cardiologist, Sri Ramachandra Medical Centre, Chennai. 'Even patients are reluctant to start on drugs, but these combinations we have tested are really effective in bringing down BP, and the side effects are minor,' he adds. The side effects observed during the trial included cough, swelling of feet and lower potassium in some subgroups, and not statistically significant. Dr. Prabhakaran adds, 'The biggest problem in India is poor control of hypertension. Only around 20% of individuals with hypertension are treated to target in urban areas, and it is even lower in rural areas. It is estimated that a 10 mm reduction in BP among people with hypertension can prevent 40% of strokes. A vibrant pharmaceutical industry, which makes these single combinations and pooled procurement via the public health system, should help drive down prices, making this a key strategy in the battle against hypertension.'
Mint
18-05-2025
- Health
- Mint
Access to obesity management not available to most Indian patients: World Heart Federation report
Mumbai: Obesity in India has risen tremendously in the last 35 years, in tandem with rising rates across the world, a new report highlights, and tools to manage obesity are not universally available to most patients. According to a report by the World Heart Federation (WHF), obesity in adults globally has quadrupled since 1990. In 2022, a good 878 million adults lived with obesity, compared with 194 million in 1990. The report, released on Saturday, projected that if the current growth trends continue, nearly two out of three adults (over 25 years) could be overweight or obese by 2050. The World Heart Report 2025—Obesity and Cardiovascular Disease highlights the rising prevalence of obesity and gaps in access to treatment worldwide. In India, obesity among women has grown at least sevenfold from 1990 to 2024, with 10% of adult women over the age of 20, about 44 million, living with obesity in the country. Obesity among men, in comparison, rose by 4.9% since 1990, now affecting 26 million Indian men or 5% of India's male population. India has twice as many obese women as men. Obesity among children and youngsters—between the ages of 5 and 19—is on the rise as well, the report cautioned. In India, 5.2 million, or 3%, girls are obese, an increase of 3% from 1990. On the other hand, around 7.3 million, or about 4%, boys are obese, which is an increase of 3.7% from 1990. As the rate of child obesity continues to increase, children with a high body mass index (BMI) are 40% more likely than their peers to suffer from cardiovascular disease in midlife. BMI helps to assess risk factors for certain health conditions. The onset of obesity at younger ages can significantly reduce life expectancy, the report said. Obesity is recognized as a disease, yet there are still significant gaps in treatment across the world. On one hand, the stigma and misunderstanding of obesity prevent people from receiving adequate treatment. Systemic healthcare gaps compound the problem and contribute to an economic burden worsened by the aggressive commercial practices of companies making cheap, processed food. In India, access to specific management protocols is not universally available to most patients, Dr Prabhakaran Dorairaj, president-elect of WHF, and executive director of the Centre for Chronic Disease Control in New Delhi, told Mint. 'The management of obesity, unlike, say, hypertension, is fragmented and highly heterogeneous. Most are centred on behaviour change of weight reduction through dietary modification and increased physical activity, which in many cases are not sustainable in the long term,' he said. Blockbuster weight loss drugs, like Eli Lilly's Mounjaro, available in the West, have received approval only recently in India, 'but access would be limited to a very few due to the high costs of these drugs,' Dr Dorairaj said. 'In extreme cases, bariatric surgery is available but in limited cities.' Mounjaro, a GLP-1 drug, was launched in India in March. It is still inaccessible to a large number of Indians at ₹ 17,500 monthly for a 5mg dose. GLP-1 drugs are a class of drugs that mimic the glucagon-like peptide-1 hormone which regulates blood sugar and appetite, and are used to treat type-2 diabetes and obesity. However, the drug's sales have picked up—consumption tripled in April. According to data from business-to-business platform Pharmarack, Mounjaro reported sales of ₹ 1.42 crore in March and ₹ 4.80 crore in April. However, as the dosage is once a week, this tripling may be an indicator of adherence to the dosage schedule. Mounjaro is just the first in a slew of launches expected in India. Danish drugmaker Novo Nordisk is likely to announce the launch of its weight loss drug Wegovy this year. As its blockbuster molecule, Semaglutide, goes off patent in 2026, Indian companies are ready to launch generic copies priced at 90-95%. The market for weight-loss drugs is expected to boom once prices go down. However, there is a need for public healthcare interventions to lower the incidence of obesity across the world. 'To tackle the world's mounting obesity crisis, governments must implement cost-effective public health measures that improve public awareness and decrease risk factors, recognising obesity as multifactorial and committing to making full treatment options available, accessible and affordable,' Francisco Lopez-Jimenez, professor of medicine at Mayo Clinic College of Medicine and one of the report's authors, said. The cost of obesity is not just economic; it also leads to a higher mortality rate among susceptible individuals. Global deaths from cardiovascular disease linked to high BMI have more than doubled, the report highlights. While cardiovascular diseases already make up 25% of all deaths in India, 5.6% of these deaths can be attributed to high BMI. This is an increase from 1990, when around 15% of all deaths were from cardiovascular diseases, out of which 2.44% could be attributable to high BMI. Indian women, again, are more likely to die from high BMI-related cardiovascular diseases. In men, 4.6% of all cardiovascular disease deaths can be attributable to high BMI, whereas in women, almost 7% of all cardiovascular disease deaths can be attributed to high BMI. In 2019, the economic impact of overweight and obesity in India was estimated to be $28.95 billion, according to the World Obesity Federation. This is equivalent to $21 per capita and 1% of gross domestic product (GDP). The economic impacts are predicted to increase to $838.6 billion by 2060. This is equivalent to $508 per capita and 2.5% of GDP and represents a 29-fold increase in total costs.
