PHYSICAL AND BIOCHEMICAL RISK FACTORS OF HYPERTENSION: FINDINGS FROM MULTI-SITED POPULATION-BASED STUDY FROM INDIA

Abstract

Objective: Studies have shown variations in the degree of association between hypertension and its risk factors in different populations. Both genetic and environmental factors are thought to play roles in modulating the relationship between hypertension and its physical and biochemical risk factors/markers. The present study aims to investigate the association of hypertension with body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), very low-density density lipoprotein (VLDL), and apolipoprotein B (Apo B) in three tribal (Liangmai, Mizo, and Bhil) and two non-tribal (Jat and Meitei) populations of India. Design and method: The present study is an outcome of four cross-sectional studies undertaken among three tribal, Liangmai (n = 339), Mizo (n = 269) and Bhil (n = 407), and two non-tribal, Jat (n = 1447) and Meitei (n = 1142), populations of India (total sample size = 3604). Recruited participants were adults (age range 18-86 years; mean age = 47.3±11.0 years) of both sexes (55.5% females). Socio-demographic data was collected using a pretested and modified interview schedule. Height, weight, waist and hip circumference, and hypertension were measured using standard techniques. Hypertension was defined as per ACC/AHA High Blood Pressure Guidelines. Values of TC, TG, and HDL levels were obtained using commercial kits (Randox, USA) through spectrophotometry. Values of LDL, VLDL, and Apo B were calculated. Statistical analysis was performed using SPSS version 22. Results: The overall prevalence of hypertension stage-1 and stage-2 was found to be 37.9% and 34.0%, respectively. The highest prevalence of hypertension (stage-1+sage-2) was found in Meitei community and the lowest in the Bhil community. Studied physical and biochemical risk factors showed variations in the degree of association with hypertension in different populations. Of the studied risk factors, BMI and WC showed most consistent and statistically significant positive association with systolic and diastolic blood pressure. Though hypertension was found to be associated with some of the lipid variables in some populations, the pattern was not consistent across populations. Conclusions: The study suggests that physical variables (BMI and WC) may be better markers of hypertension than biochemical variables.