Prevalence, awareness, and control of hypertension among Asian Indians living in urban Singapore and rural India

Abstract

Hypertension is a major modifiable risk factor associated with cardiovascular morbidity and mortality. We compared the epidemiology of hypertension in South Asian Indians living in two geographic regions with vastly different socioeconomic settings (urban Singapore and rural India). We analyzed data from two large population-based studies: the Singapore Indian Eye Study (SINDI, n = 3228, aged 40-80 years, 49.2% women) and the Central India Eye and Medical Study (CIEMS, n = 3591, aged ≥40 years, 52.6% women). Hypertension was defined as SBP at least 140 or DBP at least 90 mmHg or self-reported history/treatment for hypertension. The age-adjusted prevalence of hypertension in SINDI and CIEMS were 58.6 and 25.3%. After adjusting for potential confounders, increasing age, overweight/obese, and diabetes status showed a positive association and 'never drinking alcohol' showed a protective association with hypertension in both populations. Current smoking and being female showed a protective association and no formal education showed a positive association with hypertension in SINDI. Among those with hypertension in SINDI and CIEMS, 72.4 and 25.3% were aware of their condition of whom 85 and 31.6% were on treatment for hypertension. The blood pressure control was similar between the two populations (48.7% in SINDI and 46.9% in CIEMS). The prevalence of hypertension, the level of awareness, and treatment for hypertension was higher in Indians living in Singapore than in rural Indians. Socioeconomic and metabolic factors explain some of the observed differences between the two populations, which may provide insights to develop public health strategies.