Abstract 13816: The Hypertension Care Cascade in 2019-21: A Nationally Representative Study of 1.9 Million Adults in India

Abstract

Introduction: Previous studies from India reported management of hypertension (diagnosed: 45%, treated: 13%) among adults 15-49 years, a fraction of those suffering from disease. This study aimed to provide nationally-representative estimates of (i) the proportion of all adults (18+ years) with prehypertension and hypertension (HTN), and (ii) the heterogeneity in their cascade of care by natal sex, age, and urbanicity. Methods: Using data from non-pregnant women (n = 959,468) and men (n = 935,829) in the National Family Health Survey-V (2019-21), we estimated the sex-specific prevalence of prehypertension and HTN (see footnotes of Figure ), and among adults with HTN, the self-reported care cascade (ever screened, diagnosed, taking medication, under control defined by normotension). All estimates incorporated the complex survey design and were stratified by urban versus rural or by age group (18-39, 40-64, 65+). Results: Nationally, the prevalence of prehypertension and HTN were 19.1% (95%CI: 18.9,19.2) and 27.7% (95%CI: 27.5, 27.8) respectively. The prevalence of prehypertension was similar in urban areas (vs rural) among men (%; 23.2 vs 21.7) and women (%; 16.7 vs 16.1). Prevalence of HTN was higher in urban areas (vs rural) among men (%; 30.9 vs 27.2) and women (28.8 vs 26.2). Both prehypertension and HTN were higher with increasing age. Prevalence of screening in the total population was 56%, and was higher in urban areas, among women and higher with age. Among those with HTN, only 40%, 23%, and 10% being diagnosed, taking medication, and under control, respectively. Diagnosis, treatment and control were higher in urban areas, women, and older age groups ( Figure ). Conclusions: Despite the high prevalence of hypertension, there is a high unmet need at each step of care cascade nationally, especially in rural adults. Moreover, the prevalence of prehypertension is high in rural areas, and those under 40 years, requiring a comprehensive approach for prevention and management.