Prevalence and correlates of hypertension in a semi-rural population of Southern India

Mandeep Singh,Atul Kotwal,S Ram Babu,Chetan Mittal,Sahul Bharti,C Venkata S Ram

doi:10.1038/s41371-017-0010-5

Mandeep Singh, Atul Kotwal + Show 4 more

Open Access

https://doi.org/10.1038/s41371-017-0010-5

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Abstract

While elevated blood pressure is a recognized risk factor for cardiovascular disease, the prevalence of hypertension still remains unclear for most populations. A door-to-door survey was conducted using modified WHO STEPS questionnaire in a group of villages under the Thavanampalle Mandal of Chittoor District in the state of Andhra Pradesh of South India. Data were collated and analyzed for 16,636 individuals (62.3% females and 37.7% males) above 15 years of age. Overall, prevalence of hypertension (as per JNC-7 classification) was found to be 27.0% (95% CI, 26.3, 27.7) in the surveyed community with 56.7% of the total hypertensives being diagnosed for the first time during the survey. An additional 39.1% had their blood pressure readings in the prehypertensive range. Among the known Hypertensives on treatment only 46.2% had a blood pressure recording within acceptable limits, with 31.2% in the prehypertensive range and only 15.0% in the normal range. Systolic blood pressure (SBP) of the surveyed population showed a continuous linear increase with age, but diastolic blood pressure (DBP) peaked and started reducing in early fifth decade in males. Male gender, increasing age, higher body mass index (BMI), increased waist-hip ratio, increased body weight, family history of hypertension, death of spouse, and diabetes were found to be positively correlated with hypertension. Risk factors of alcohol intake, use of ground nut/palm oil, and family history of diabetes lost their independent predictive ability for hypertension on multivariate logistic regression analysis. The level of physical activity was also not found to be a significant predictor of hypertension in the study population.

Highlights

Developing countries are known to have a high prevalence of hypertension and the suffering is aggravated by resource constraints and lack of awareness leading to poor control [1]
This paper provides results on estimate of baseline prevalence and risk factors of hypertension among the study participants, with an overall aim of providing information critical for the development and implementation of interventions and control strategies specific to a population [15]
Overall prevalence of hypertension in the surveyed rural population has been found to be almost equal to what has been estimated by recent studies in developing countries like Vietnam (25.1%) [16, 17] and as per meta-analysis of Indian studies which found overall prevalence for hypertension in India as 29.8%, with a prevalence of 27.6% (23.2, 32.0) in rural areas, our study estimate was higher than that of rural south India (21.1%, 20.1, 22.0) [9]

Summary

Introduction

Developing countries are known to have a high prevalence of hypertension and the suffering is aggravated by resource constraints and lack of awareness leading to poor control [1]. These issues are important and significant in India [2] where temporal trends of rising prevalence of hypertension have been documented [3]. Even though there is a widely accepted belief that illiteracy is associated with higher prevalence of hypertension, literature from middleincome countries are not very conclusive.

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