Prevalence and determinants of comorbid diabetes and hypertension: Evidence from non communicable disease risk factor STEPS survey, India

Abstract

Problem statementComorbidity of non-communicable diseases carries a significant risk of cardiovascular events and mortality. With the rising burden of diabetes, hypertension and other risk factors, and ageing population in India, this is likely to pose a major threat to the health system. It is therefore essential to understand this high risk group. This article reports prevalence of comorbid diabetes and hypertension and its associated risk factors in the North Indian state of Punjab. MethodsA household NCD STEPS survey was done in Punjab, India in a multistage stratified sample of 5127 individuals. All the subjects were administered the WHO STEPS questionnaire, anthropometric and blood pressure measurements. Every alternate respondent in the sample (n=2499) were assayed for blood glucose and lipid parameters. ResultsThe prevalence of comorbid DM and HTN was 4.5% in the general adult population. DM, HTN and dyslipidemia co-existed in 1.8% of the population. Obesity and dyslipidemia are the most common comorbidities among persons with DM and HTN alone and comorbid DM and HTN. Factors strongly associated with comorbid DM and HTN include elderly age group, dyslipidemia, obesity and family history of DM. ConclusionsThe study reported high burden of comorbid diabetes and hypertension among the elderly, strongly associated with obesity and dyslipidemia. This emphasizes the role of nonpharmacological intervention such as weight reduction, physical activity, and dietary modification.