Prevalence Of Hypertension In India Research Articles

PS-P12-4: AWARENESS OF HYPERTENSION AND DEMOGRAPHIC FACTORS INFLUENCING HYPERTENSION TREATMENT AMONG RURAL POPULATION OF KRISHNA DISTRICT IN SOUTH INDIA

Introduction: Being ascertained as single biggest risk factor for myocardial infarctions and stroke and cause of 10.8% of deaths in India, ICMR has already labelled HTN as silent killer. HTN is predicted to have higher prevalence than Diabetes mellitus and affect 1/3rd of our world population by year 2020. Prevalence of hypertension in India is predicted to be 200 million with only 40% being actually aware of the disease and only 20% of them being treated adequately. Thus, this study was aimed to assess awareness and demographic factors influencing treatment of HTN among rural population of Krishna district Methods: A cross sectional observational analytical study was carried out in out patient department setting of a tertiary level institute in Andhra Pradesh. Five hundred and eleven patients presenting with hypertension as per AHA guidelines were included in the study after informed written consent. Detailed clinical history was sought and thorough examination was performed. Treatment history was verified by reviewing prescriptions. Data regarding demographics, awareness of hypertension, awareness on hypertension therapy and compliance to therapy was collected using predesigned validated questionnaire. Data on compliance of treatment was also obtained. Results: Maximum subjects were noted to be in fifth and sixth decade of their age (60.4%). About a third of them were alcoholic while 3/4th were non vegetarian. Known hypertensive comprised 61.8% of these while 38.2% were diagnosed for first time. DM was observed as co-morbidity in 237 (46.4%) subjects and events of MI/CVA/CAD/AF was found in 33 (6.5%) subjects Commonest factor in undiagnosed hypertension was not visiting the clinic followed by absence of health clinic in vicinity. Significantly higher frequency of incorrect drug combinations, incorrect dosage and poor adherence to drug therapy was noted in newly diagnosed hypertensive subjects. Conclusion: Undiagnosed hypertensive comprised of 38.2% of subjects visiting our health facility. Lack of assess and visit to clinic were the most common factors in undiagnosed cases. Significant inadequacy and non-compliance to treatment was also noted in newly diagnosed case.

SIMULTANEOUS ESTIMATION OF VALSARTAN AND HYDROCHLOROTHIAZIDE IN BULK AND PHARMACEUTICAL DOSAGE FORM BY HPTLC

Objective: The prevalence of Hypertension in India is estimated to be greater than 45% in the middle age population; elevated hypertension is one of the known causes of CHD, strokes and death. The objective of this work was to develop a simple, accurate and robust HPTLC method was developed for simultaneous estimation of Valsartan and Hydrochlorothiazide in bulk and tablets. Methods: The mobile phase optimized by HPTLC method consists of Toluene: Ethyl acetate: formic acid in the ratio of (3:7:0.3, v/v/v). The solvent front was a run-up to a distance of 80 cm; which took 15 min for the development of TLC plate. Analytical Wavelength for UV detection selected was at 225 nm. Results: Retention factor was found to be 0.74±0.02 and 0.45±0.02 for VAL and HTZ, respectively. Developed chromatographic method was validated as per ICH, Q2(R1) guidelines. Linearity was found at concentration range 300-1800 ng/spot (r2 = 0.999), 50-300ng/spot (r2 = 0.9991) for VAL and HTZ respectively. LOD were found to be 23.02 ng/spot and 4.12ng/spot respectively for Valsartan and Hydrochlorothiazide. LOQ was found to be 69.76ng/spot and 12.5ng/spot for, Valsartan and Hydrochlorothiazide respectively. Conclusion: Percentage RSD was found out to less than 2, indicating the developed method was precise and can be successively applied to pharmaceutical formulation. No interferences with the excipients were reported.

Hypertension: A National Cross-Sectional Study in India.

Hypertension is a global public health problem. This article aimed to estimate the national prevalence of hypertension in India for both women and men. The study had also examined the demographic and socioeconomic status of hypertensive women and men. The study used the National Family Health Survey 4 from all over India. Hypertension of 661 771 women (15-49 years) and 104 357 men (15-54 years) and their demographic and socioeconomic variables were assessed. Crosstabulation, chi-square tests, and multivariate logistic regression were used. The prevalence of hypertension in women and men were 11.40% and 18.10%, respec- tively. State-wise, Sikkim had shown the maximum prevalence. Older women (45-49 years) and men (50-54 years) had the highest hypertension prevalence among all age groups. Urban people had shown proportionately more hypertension than rural people. Education, working status, and richer economic status emerged as significant risk factors. Women with lower edu- cational status and men with higher educational status were more likely to be hypertensive. Working people were more hypertensive than their non-working peers. Economically, sound men were more hypertensive than poor people. Hypertensive people accessed medical care more. There are various modifiable risk socioeconomic factors associated with hyperten- sion. Policymakers can consider the current findings for better preventive planning. The risk factors identified in the study should be considered with appropriate weightage.

Drug utilization study of anti-hypertensive drugs and prescription pattern adherence with joint national committee-8 guideline

Background: Hypertension is a major and serious non-communicable disease. It is also a major risk factor for cerebrovascular strokes, coronary artery thrombosis, and renal failure. The overall prevalence of hypertension in India is 29.8%. Joint national committee-8 guidelines on prevention, detection, evaluation, and treatment of high blood pressure highlight that aggressive blood pressure control is essential for the reduction of hypertension-associated morbidity and mortality.Methods: It was a cross-sectional, observational study. Prescriptions were collected from four pharmacy stores located in four different areas of Ahmedabad over a period of 2 months. These were analysed along with relevant co-morbidities and, the level of prescription pattern adherence was assessed as per JNC 8 guidelines. Appropriate statistical tests were applied for analyses of collected data.Results: A total of 321 prescriptions were collected. Out of them, 186(57.9%) were prescribed to male patients while 135 (42.1%) were for female patients. Mean systolic and diastolic blood pressure was found to be 152 mmHg and 91 mmHg respectively. The mean age of the patients was found to be 44.63 years. A total of 209 (65.1%), 91 (28.34%), 21 (6.54%) prescriptions had monotherapy, dual therapy, and polytherapy for treating hypertension respectively. Amlodipine (CCBs) was found to be the most commonly prescribed medicine as a monotherapy. The overall adherence rate was found to be 77.88%.Conclusions: The present study demonstrated that medical professionals are not completely adhering to standard guidelines while prescribing antihypertensive drugs. There is substantial scope for improvement, particularly the utilization of antihypertensive agents in patients of the pre-hypertension category, where non-pharmacological measures play an important role to treat the condition.

Alcohol and tobacco influencing prevalence of hypertension among 15–54 years old Indian men: An application of discriminant analysis using National Family Health Survey (NFHS), 2015–16

BackgroundHypertension has been described as an “iceberg disease” as those who suffer are usually unaware and hence usually seek healthcare services at a very late stage. It is estimated that more than two million Indians are suffering from hypertensive heart diseases that contributed to above 0.13 million deaths in 2016. ObjectivesThe present study aims to know the prevalence of Hypertension in India and its variation by socioeconomic backgrounds, and to find out risk factors discriminating hypertension with special emphasis on tobacco and alcohol consumption among men aged 15–54 years in India. MethodsIn this study, NFHS (2015–16) data were analyzed by applying binary logistic regression and discriminant analysis in the attempt to find significant predictors and discriminants of interest. ResultsThe prevalence of hypertension was 16.5% in the study population. The results suggested that the consumption of alcohol and tobacco are significant discriminant characteristics associated with hypertension irrespective of the socioeconomic background characteristics of the respondents. Hypertension is a chronic disease and is itself a causative factor for several other diseases like renal impairment, other cardiovascular diseases, and stroke. ConclusionsThe findings are expected to have direct implications on public health interventions and policy formulation to reduce diseases caused by tobacco and alcohol, particularly hypertension among men in the potential economically productive age group in India and similar settings.

Regional impact of updated guidelines on prevalence and distribution of blood pressure categories for hypertension in India: Results from the National Family Health Survey 4

IntroductionIn 2017, the American College of Cardiology/American Heart Association revised guidelines for diagnosis and management of hypertension in adults. The regional impact of the updated guidelines on the prevalence of hypertension in India is unknown. MethodsData from nationally representative Indian households were analyzed to estimate the regional prevalence of hypertension according to the old and the new guidelines in men (age 18–54 years) and women (age 18–49 years). The old guidelines defined hypertension as a systolic blood pressure of ≥140 mmHg or diastolic blood pressure of ≥90 mmHg or treatment. The new guidelines define hypertension as a systolic blood pressure of ≥130 mmHg or diastolic blood pressure of ≥80 mmHg or treatment. We calculated the increase in the prevalence of hypertension among the states and union territories of India (hereafter “states”). ResultsAmong 679,712 participants (85.6% women), the median age was 31 years (interquartile range 24, 40) and was comparable among men and women (33 vs. 31 years, respectively). The overall weighted prevalence according to old and new guidelines was 18.5% (95% CI 18.2, 18.7) and 43.0% (95% CI 42.8, 43.3), respectively. There was a significant increase in hypertension prevalence, both among men and women, and across all regions. The northeast region of the country had the highest prevalence. ConclusionThe overall prevalence of hypertension significantly increases with the new compared to the old guidelines, however, the regional heterogeneity of prevalence of hypertension is maintained.

May Measurement Month 2019: an analysis of blood pressure screening results from India.

AimsMay Measurement Month is a global screening campaign to raise awareness regarding elevated blood pressure (BP). With the growing burden of hypertension, it is imperative to regularly assess the disease’s prevalence, risk factors, and awareness levels in a country. The current prevalence of hypertension in India as per the National Family Health Survey Data stands at 25.3%. May Measurement Month mobilizes healthcare professionals and sensitizes them to regularly measure BP, and impart lifestyle modification advice to the community. It also complements the deficiency in screening programmes at a national and international level. Methods and resultsMay Measurement Month was carried out in May 2019 as an opportunistic screening campaign for adults (≥18 years). It was carried out by over 5000 trained volunteers across approximately 1000 screening sites (hospitals, public places, pharmacies, villages, and malls) in India. A total of 362 708 (57% males and 42.7% females) people were screened, among whom 68.1% had never measured their BP, and 29.4% (n = 106 522) were found to have hypertension. Of these, only 42.0% were on antihypertensive medication and 23.3% had controlled hypertension. ConclusionAlmost a third of the screened population had hypertension, and less than half of those with hypertension were aware of it or on treatment for it. Among those on antihypertensive drugs, BP was controlled in only half of them. These results support the need for greater impetus on BP screening initiatives to detect hypertension early in the community and prevent complications due to uncontrolled BP.

MANAGEMENT OF ESSENTIAL HYPERTENSION USING HERBAL FORMULATION WITH AND WITHOUT GOKSHURA KWATHA – A COMPARATIVE STUDY

Hypertension is one of the major causes of cardiovascular morbidity and mortality worldwide. It is a global health problem affecting the people of different ethnicity and ages around the world. An estimated 1.13 billion people worldwide have hypertension, most (two-thirds) living in low- and middle-income countries. According to WHO (2015) the overall prevalence of hypertension in India was 24.2% and 22% among the men and women respectively. Hypertension is called a silent killer, non-communicable chronic disease because it rarely exhibits symptoms before it damages vital organs like kidney, brain or heart. In Ayurveda there is not a single disease which resemble with hypertension, but physician should understand the disease through Dosha, Dushya, Samprapti and initiate the treatment. A lot of potent modern antihypertensive drugs are available but none of them are free from untoward side-effects. So, a clinical study was done using herbal formulation containing Sarpaghandha, Sankhpushpi, Arjuna, Jatamansi and Ashwagandha in the form of Ghanvati. A comparative study was done as this Ghanvati was given with and without Gokshur kwath. For clinical study 52 (Group A- 25 and Group B- 27) clinically diagnosed patients of essential hypertension who fulfil inclusion criteria were selected irrespective of their age, sex, religion, occupation etc. and simple random sampling technique was followed for grouping the patients into 2 groups. All the patients selected for the clinical trial were divided in two groups ‘A’ and ‘B’. Patients of Group A were given 250 mg of Ghanvati two times a day with water as Anupan and patients of Group B were given 250 mg of Ghanvati with water as Anupan and Gokshur kwath both two times a day. Duration of the study for each group was 30 days. The present study showed that herbal formulation is also effective in the management of essential hypertension. Keywords: Essential hypertension, Ghanvati

Impact of the 2017 ACC/AHA guidelines on the prevalence of hypertension among Indian adults: Results from a cross-sectional survey

BackgroundThe impact of the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for diagnosis and management of hypertension on the prevalence of hypertension in India is unknown. MethodsWe analyzed data from the Cardiac Prevent 2015 survey to estimate the change in the prevalence of hypertension. The JNC8 guidelines defined hypertension as a systolic blood pressure of ≥140 ​mmHg or diastolic blood pressure of ≥90 ​mmHg. The 2017 ACC/AHA guidelines define hypertension as a systolic blood pressure of ≥130 ​mmHg or diastolic blood pressure of ≥80 ​mmHg. We standardized the prevalence as per the 2011 census population of India. We also calculated the prevalence as per the World Health Organization (WHO) World Standard Population (2000–2025). ResultsAmong 180,335 participants (33.2% women), the mean age was 40.6 ​± ​14.9 years (41.1 ​± ​15.0 and 39.7 ​± ​14.7 years in men and women, respectively). Among them, 8,898 (4.9%), 99,791 (55.3%), 35,694 (11.9%), 23,084 (12.8%), 9,989 (5.5%) and 2,878 (1.6%) participants belonged to age group 18–19, 20–44, 45–54, 55–64, 65–74 and ​≥ ​75 years respectively. The prevalence of hypertension according to the JNC8 and 2017 ACC/AHA guidelines was 29.7% and 63.8%, respectively- an increase of 115%. With the 2011 census population of India, this suggests that currently, 486 million Indian adults have hypertension according to the 2017 ACC/AHA guidelines, an addition of 260 million as compared to the JNC8 guidelines. ConclusionAccording to the 2017 ACC/AHA guidelines, 3 in every 5 Indian adults have hypertension.

Inequalities and risk factors analysis in prevalence and management of hypertension in India and Nepal: a national and subnational study

BackgroundHypertension is one of the leading risk factors for cardiovascular diseases in India and Nepal. Socio-economic disparity in these two countries has created wide gap in management of hypertension. However, inequalities in prevalence and management (awareness, treatment, and control) of hypertension is poorly assessed. This study analyzes the risk factors associated with prevalence and management of hypertension in India and Nepal and assesses the wealth-and education-based inequalities in them.MethodsThis study used data from the Demographic and Health Survey; a cross-sectional survey conducted between January 2015 to December 2016 in India and June 2016 to January 2017 in Nepal. A total of 787,713 individuals in India and 14,454 individuals in Nepal aged between 15 and 49 years were included in the study. Respondents were classified as being hypertensive if their systolic blood pressure (SBP) readings were at least 140 mmHg or diastolic blood pressure (DBP) readings were at least 90 mmHg, or if they reported currently taking anti-hypertensive medication. Multilevel logistic regression models with random intercepts at household-and community-levels were used to identify the risk factors associated with prevalence and management of hypertension. For inequality assessment, slope index and relative index of inequalities in prevalence and management of hypertension were estimated.ResultsOverall prevalence of hypertension in India and Nepal were 11.4% (95% confidence interval (CI), 11.4–11.5) and 19.6% (95% CI, 18.9–20.2), respectively. Less than one-third of the hypertensive population received treatment and below 20% among them had their blood pressure controlled. In both countries, wealth-and education-based inequalities in awareness, treatment, and control of hypertension were significantly high in urban and rural areas.ConclusionWealth- and education-based inequalities in prevalence and management of hypertension were high among different socio-economic groups at national and sub-national levels. Tailored strategies are required to effectively manage hypertension in different regions by considering socio-economic and demographic factors.

Self Care Practices among Hypertensive Patients with the View to Develop Informational Pamphlet

Background: Hypertension is condition approximately 25% affecting to adult population worldwide. Hypertension is said to be most common health problem all over the world. Prevalence of hypertension in India was 29.8%. Objective: study investigated the effectiveness of Informational Pamphlet on Self Care Practices among Hypertensive Patients. Method: One group pretest posttest design was used to conduct the study among hypertensive patients totally 60 patients were selected by Purposive sampling technique. Study conducted at Krishna hospital Karad. Data was collected by using structured questionnaire. Pre-test was conducted to assess the existing knowledge of self care practices regarding hypertension. Informational pamphlet was given to the patients then posttest level of knowledge was assessed by using same questionnaire. Results: Results of the present study shows that in the pretest most of the samples were having average knowledge (70%) regarding self care practices regarding hypertension and in postest majority (99.66%) were having good knowledge. The pretets mean was 12.08 and post-test mean was 18.78 and calculated t value was 6.70 found significant at the level of p<0.0001. Conclusion: Study concluded that information pamphlet was found effective to improve the Knowledge regarding self care practices among hypertensive patients.

Patterns and determinants of healthcare-seeking behavior among hypertensive patients in a rural population of north India: A mixed-method study.

The prevalence of hypertension in india over the last 30 years is known to have increased rapidly. Hypertension is a chronic disease that needs to be managed within its sociological context as experienced by individuals. This study was conducted to identify the quantitative and qualitative determinants of healthcare-seeking behavior among hypertensive individuals in a rural population of north india.Methodology:A mixed-method study involving 100 adult hypertensive patients was employed. Data were collected on demographic characteristics, health-seeking behavior, and the reasons for choosing a particular health service using a structured questionnaire and interview guide. Descriptive statistics were used to examine the influence of determinants on health-seeking behavior and utilization of healthcare facilities and expressed as percentages. Qualitative data were thematically analyzed.Results:A total of 100 participants with hypertension between 38 and 76 years of age were included in the study. Out of the total study participants, 66.0% of the respondents were males and 34.0% were females. Participants demonstrated a generalized knowledge of hypertension and showed significant gaps and misconceptions in their understanding of the disease and the need for seeking expert care. There was also a lack of sense of trust in the healthcare system. Various demographic, sociocultural, and economic determinants of healthcare-seeking behavior in these rural patients’ services were explored. This evidence can prove helpful in streamlining interventional programs and realigning the existing interventions to prevent and control hypertension in rural settings.

Prevalence and associated risk factors of hypertension among persons aged 15–49 in India: a cross-sectional study

ObjectivesThis is the first attempt to provide estimates on the prevalence of hypertension at the national, state and district level, a prerequisite for designing effective interventions. Besides, the study aims...

Hypertension prevalence as a function of different guidelines, India.

ObjectiveTo determine the effect of different hypertension management guidelines and of basing diagnosis on a single reading of blood pressure on the hypertension prevalence in the Indian population.MethodsWe performed a secondary analysis of data acquired as part of the Fourth national family health survey, 2015 to 2016, over all districts in India. We calculated the proportion of the population within three different age groups (18 to 34, 35 to 49 and 18 to 49 years of age) with raised blood pressure according to six different guidelines, and how prevalence changed if diagnoses were based on a single blood pressure measurement.FindingsWe observed that the Government of India and the American College of Cardiology/American Heart Association guidelines consistently yielded the lowest and highest prevalence of raised blood pressure; in the combined age group, we calculated the proportion of the population categorized as having raised blood pressure as 7.5% (95% confidence interval (CI): 7.4 to 7.7) and 40.1% (95% CI: 39.7 to 40.7), respectively. When basing diagnosis on a single reading of blood pressure only, a total of 56 million individuals would be erroneously categorized as hypertensive following the Government of India guidelines. We also showed that prevalence of hypertension in India varies with guidelines adhered to; in the combined age group, the national hypertension prevalence was three times higher when following the American College of Cardiology/American Heart Association compared with the Government of India guidelines.ConclusionTo optimize current clinical practice, health-care providers need to follow universally agreed, evidence-based methods of diagnosing hypertension.

A study on prevalence of hypertension and its relationship with overweight and obesity in adolescents and young adults, Nizamabad city

Background: The overall imbalance between unhealthy diet intake and physical activity leads to obesity which contributes to high blood pressure and high cholesterol. It is multi factorial disease and changes in the levels of blood pressure and blood lipids differ by age sex and race and are influenced by body fat and dietary patterns. These risk factors need to be monitored and evaluated in childhood and adolescents. So identifying and modifying the risk factors in early age reduces the incidence in adolescents and adult. Prevalence of hypertension varies across countries and states. The prevalence of hypertension in India is reported as ranging from 10 to 30.9%. The objective of the present study is to observe the prevalence hypertension among study population and to study contributing factors for hypertension among study population.Methods: A cross sectional study done on 100 adolescents and young adults of both sexes in the age group 17 to 25 years from 2 degree colleges randomly selected in Nizamabad city, Telangana, India.Results: In the present study population 52 were males and 48 were females, 22 students belongs to rural area and 78 belongs to urban area, pre-hypertension and hypertension was found 8% in both age groups. Overweight and obesity (>25) was found 7% in 17-19 age group and 9% in 20-25 age group. Pre-hypertension and hypertension was found among 10% of alcoholics.Conclusions: The result of our study concluded that there is increasing prevalence of hypertension with increase in age and is associated with overweight and obesity.

Lifestyle, Socio-demographic and anthropometric profile of the hypertensive patients visiting urban health centre of North Delhi

Introduction: The prevalence of hypertension has been reported to be increasing in India due to changes in the lifestyle of people. The current prevalence of hypertension in India has been estimated to be 42.2% in urban areas and is supposed to increase in future requiring huge resources for management of hypertension cases and related cardiovascular co-morbidities. So in this study the lifestyle related factors causing hypertension was explored. Materials and Methods: Diagnosed hypertensive patients visiting urban health centre were included as study subjects. The participants were asked information on life style, socio-demographic characteristics and physical activities levels in 24 hours in the form of walking, sitting and sleeping. History of hypertension in family, treatment history for hypertension, stress factors, clinical signs and symptoms were recorded. Simultaneously the anthropometric measurements including height, weight and waist circumference were measured. Information on diet intake to calculate total calorie and protein intake per day was collected. Results: Total 44 patients participated in the study. The mean age of the participants was 59.77±13.3 years. Family history of hypertension was in 47.72% participants. History of stress was in 68.18% participants. Calorie intake and protein intake per day was 1109.66±33.64 Kcal and 55.73±25.29gms. Spending time for walking of < 1hr>2hrs per day was in 27.27% participants. BMI > 25 were in 65.9% participants. Waist circumference was > 95cm in 25% of males and > 85cm in 50% of females. Conclusion: Majority of participants were found to be overweight and sedentary. Participants were spending less time in walking. So the study recommends increasing physical activity, limiting calorie and protein intake and eliminating stressors will restrict progression of hypertension in hypertensive patients. Keywords: Calorie intake, Hhypertension, Life style, Physical activity, Protein intake, Stress, Waist ci

High prevalence of resistant hypertension in India: Jaipur Heart Watch

High prevalence of resistant hypertension in India: Jaipur Heart Watch

The prevalence of peripheral artery disease by using ankle brachial index in hypertensive patients

Introduction: Hypertension is one of the leading causes of global burden of disease. In a study, prevalence of hypertension in India was quoted 13.1% and only 16.7% of the person had achieved BP control of 140/90mm Hg. Peripheral vascular disease (PVD) is a slow and progressive circulation disorder which is characterized by narrowing of the vessels that carry blood to the leg and arm muscles. It is estimated that PAD affects 2 billion people worldwide. It is also estimated that of all the hypertensives at presentation, 2-5% have claudication. Similarly 50-92% of patients with PAD have hypertension. The Ankle-brachial Index (ABI) is the ratio of the systolic blood pressures between the dorsalis pedis and the posterior tibial artery to the higher of the systolic blood pressures in the two brachial arteries. The ABI’s sensitivity is 90% and its specificity is 98%. Normal ABI range of 1.00 to 1.40.The patient is diagnosed with PAD when the ABI is ? 0.90, ABI Acts as an independent predictor of coronary and cardiovascular morbidity and mortality.Materials and methods: In this study 100 patients were registered who were suffering from hypertension, which include both indoor and outdoor patients, were studied. These patients were between the age group 45-75 years. In this study 82 were males and 18 were females. .Patients with history of Diabetes, Smoking, Hyperlipidemia, and with other risk factors excluding hypertension were excluded from the study. Ankle Brachial Index (ABI) was measured for the patients. A Doppler ultrasound blood flow detector and a sphygmomanometer (blood pressure cuff) was used to measure ABI. The patient is diagnosed with PAD when the ABI is ? 0.90Observation: Total number of patients 100. Prevalence rate of peripheral arterial disease in hypertensive patients with age group (45-75) was 7%. The highest prevalence rate was seen in patients in age group 65-75 years. Males had slightly higher prevalence of peripheral arterial disease than females. Prevalence of ECG abnormalities suggesting cardiovascular disease was higher in patients with peripheral arterial disease than patients without peripheral arterial disease. Abnormal ABI (&lt;0.9) was found in significantly higher proportion of patients with clinical evidence of peripheral arterial disease (86%) than in patients without clinical evidence of peripheral arterial disease (1.1%).Conclusion: The present study shows that ABI is a valuable method for the diagnosis of peripheral arterial disease in patients of Hypertension and should be applied in routine practices which may improve cardiovascular risk predictionBangladesh Journal of Medical Science Vol.15(4) 2016 p.556-564

Assessment of Prescribing Pattern for Hypertension and Comparison with JNC-8 Guidelines-Proposed Intervention by Clinical Pharmacist

Background: Hypertension is a common disorder that if not effectively treated results in greatly increased probability of coronary thrombosis, strokes, and renal failures. It is estimated that the prevalence of hypertension in India is about 25% among urban adults and 10% in the rural areas. The lifetime risk of developing hypertension is estimated to be 90%. To assess prescribing pattern in hypertensive patients and assessing the rationality in regards to JNC-8 Guidelines in a tertiary care hospital. Methodology: It was a prospective, observational study conducted for 6 months with of 75 hypertensive prescriptions with diabetes mellitus and/ or chronic kidney disease who get admitted in the hospital were screened for the study. Result: In a total of 75 prescriptions, 14 (18.7%) prescriptions were found in the age group of less than 50 years, in which 10 (13.3%) were males and 4 (5.4%) were females and 36 (48%) prescriptions were comes under the age group between 51–65 years, in which 26 (34.7%) were males and 10 (13.3%) were females. Also 25 (33.3%) prescriptions were comes under the age group of above 65 years, in which 20 (26.7%) were males and 5 (6.7%) were females. Among mono therapy 22 (47.8%) prescriptions had diuretics as antihypertensive drug followed by CCB 11 (24%), ARBs 7 (15.1%), β blockers 3 (6.5%), ACEIs 1 (2.2%), α blockers 1 (2.2%) and α+β blockers 1 (2.2%). When compared with JNC 8 Guidelines it was observed that 28% of prescriptions were rational and 56% of prescriptions were irrational. Regarding the perception of physicians towards JNC 8 guidelines it was found that majority were not following JNC 8 guidelines. Key words: Hypertensive’s, Combination therapy, Co-morbidity, JNC 8 Guidelines.

An epidemiological study of prevalence of hypertension and its risk factors in a rural community of Nellore, Andhra Pradesh, India

Background: Hypertension [HTN] is responsible for 57% of stroke deaths and 24% of coronary heart disease [CHD] deaths in India. As per the statistics of Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, the overall prevalence of hypertension in India by 2020 will be 159.46/1000 population. Hypertension will be the major cause of death and disability by the end of 2020. The prevalence of hypertension is increasing in both rural and urban communities. The objectives of the study were to assess the prevalence of hypertension and its associate risk factors in a rural population. Methods: A cross sectional study was conducted by the Department of community medicine in the rural field practice area of a Medical college of Nellore from October 2013 to September 2015. The socio demographic variables and risk factors were obtained by interviewing the subjects in the study and collected in a predesigned questionnaire sheet. The sample size was calculated by prevalence of HTN in previous studies and 1025 subjects were included. The blood pressure was assessed and classified using recent JNC 7 and WHO criteria to grade hypertension. Results: In the study the prevalence of pre-hypertension was 42.63% (437 subjects), stage-I hypertension was 26.15% (268 subjects) and stage-II hypertension was 10.34%. The peak age of prevalence of HTN in both males and females was 60-69 years. Significant association was observed between age, low socio economic index, high salt intake (>10gms/day)) with hypertension. A linear trend of association was seen with tobacco and alcohol use, obesity (BMI>25) and waist-hip ratio more than the cut-off value (p value<0.005). Conclusions: Indian health system is challenged with increasing prevalence of non-communicable diseases and HTN being one of the major. Prioritization of population based prevention approaches requiring multi sectoral actions and evidence based clinical approaches focusing on early detection and treatment can provide benefit to population health. To increase the awareness on hypertension, information about prevention and control of hypertension can be incorporated in the information education and communication (IEC) components of all national programmes. This can complement overall efforts to increase societal awareness through other approaches.