Abstract
BackgroundHypertension (HTN) is one of the major causes of cardiovascular morbidity and mortality. The objective of the study was to investigate the burden and predictors of HTN in India.Methods6120 subjects participated in the Screening and Early Evaluation of Kidney disease (SEEK), a community-based screening program in 53 camps in 13 representative geographic locations in India. Of these, 5929 had recorded blood pressure (BP) measurements. Potential predictors of HTN were collected using a structured questionnaire for SEEK study.ResultsHTN was observed in 43.5% of our cohort. After adjusting for center variation (p < 0.0001), predictors of a higher prevalence of HTN were older age ≥40 years (p < 0.0001), BMI of ≥ 23 Kg/M2 (p < 0.0004), larger waist circumference (p < 0.0001), working in sedentary occupation (p < 0.0001), having diabetes mellitus (p < 0.0001), having proteinuria (p < 0.0016), and increased serum creatinine (p < 0.0001). High school/some college education (p = 0.0016), versus less than 9th grade education, was related with lower prevalence of HTN. Of note, proteinuria and CKD were observed in 19% and 23.5% of HTN subjects. About half (54%) of the hypertensive subjects were aware of their hypertension status.ConclusionsHTN was common in this cohort from India. Older age, BMI ≥ 23 Kg/M2, waist circumference, sedentary occupation, education less, diabetes mellitus, presence of proteinuria, and raised serum creatinine were significant predictors of hypertension. Our data suggest that HTN is a major public health problem in India with low awareness, and requires aggressive community-based screening and education to improve health.
Highlights
Hypertension (HTN) is one of the major causes of cardiovascular morbidity and mortality
Of the SEEK cohort Thirteen academic and private medical centers in India participated in the study under the name of “Screening and Early Evaluation of Kidney disease- SEEK”
The main finding of this study is that hypertension prevalence in our SEEK cohort is 43.5%, and 41.5% of subjects had blood pressure in the range of “pre-hypertension”
Summary
Hypertension (HTN) is one of the major causes of cardiovascular morbidity and mortality. The burden of hypertension varies remarkably throughout the regions of the world and is a serious public health problem in both developed and developing countries [1,2]. Both systolic and diastolic hypertension are important predicting risk factors of cardiovascular disease, chronic kidney disease and stroke. Detection is feasible using a simple and accurate screening test and aggressive blood pressure management. This has not received adequate attention or allocation of public health resources for planning effective preventive strategies. In India, as a developing country with a population estimated at 1.1 billion, the prevalence of hypertension has been estimated to be 3% to 34.5% in males and 5.8% to 33.5% of females [10,11,12,13]
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