PS-P11-5: BIOSOCIAL CORRELATES OF HYPERTENSION IN NORTHEAST INDIA INDIGENOUS POPULATION

Abstract

India is home to about 700 Indigenous and Tribal People with a population of 104.3 million. Over the years, displacement and rapid acculturation of the Tribal Peoples in India has led to dramatic changes in their social, cultural, economic and value systems. The rapid demographic, epidemiologic, nutrition and health transitions accompanied by economic development, stresses of urbanization and westernization of lifestyle predisposes the tribal population to overweight/obesity and hypertension. A cross-sectional sample of 615 Hmar adults (18–70 years) from five rural villages of the Churachandpur sub-division and 592 urban adults were collected from Imphal East and Imphal West, Manipur. Data on socio-economic, demographic, behavioural parameters, blood pressure, height, weight, sitting height, mid-upper arm, waist and hip circumferences; and three skinfold thickness, namely, biceps, triceps and subscapular were taken from each participant. JOURNAL/jhype/04.03/00004872-202301001-01269/figure1/v/2023-10-24T163949Z/r/image-jpeg The results from the present study can be presented into two broad categories: 1. Intra-variation in hypertension by independent variables within each setting. The findings of this study strengthen the case that for men, increasing age, overweight and/or obese, alcohol consumption, and household income significantly increase the odds of developing hypertension. 2. Inter-variation in terms of rural-urban differences in hypertension for each categorical independent variable The prevalence of hypertension was significantly higher in urban than in rural areas. The urban Hmars likely have a higher level of bio-behavioural and psychological stress as compared to their rural counterparts. The rural and urban differences in the risk of developing hypertension are largely due to the differences in BMI and household income. These results should, however, be interpreted with caution. Firstly, while BMI may be a contributing factor to hypertension, the relationship between socioeconomic status and hypertension is highly inconsistent. Secondly, urbanization and economic development may be associated with hypertension, but they should not be considered the causal factors of hypertension. The overall prevalence of hypertension in the present study is about 21%. Urban areas (25%) show higher risk of developing hypertension compared with their rural counterparts (17%). Obesity is the strongest predictor of hypertension in both the rural and urban Hmar adults which might require hypertension intervention at a lower BMI. The bio-behavioural and socio-economic factors taken in the present study are unevenly distributed across rural and urban settings presenting a formidable challenge to institute public health intervention strategies specific to rural and urban areas. Early diagnosis, increasing awareness and enhancing the frequency of screenings for hypertension are suggested.