Angiotensin-Converting Enzyme Gene Insertion/Deletion Polymorphism and Cardiometabolic Risk Factors: A Study Among Bhil Tribal Population from Two Environmental Settings

Prevalence of Hypertension in Indian Tribal Population: a Systematic Review and Meta-analysis

Hypertension is a serious condition that significantly increases the risks of several cardiovascular diseases. An estimated 1.28 billion adults aged 30-79 years worldwide have hypertension, and two-thirds of them live in low- and middle-income countries. Indigenous (tribal) populations are not exceptional to the threat of hypertension. Hence, there is a need to highlight the rising prevalence of hypertension among Indian tribes and to bring them under health care programmes. This paper reports the systematic review and meta-analysis of the literature on the prevalence of hypertension among Indian tribes by following the PRISMA guidelines. Three databases, viz. PubMed/Medline, Google Scholar and Scopus, were included. The gender-wise pooled prevalences were calculated, and forest plots were depicted. Other analyses were performed, including heterogeneity test, meta-regression and sub-group analysis. Of the 1010 studies obtained, 42 were included in this review. These studies covered tribal populations in different regions of India. The pooled prevalence of hypertension among men, women and combined were 23.66% (95% confidence interval (CI): 23.25 to 24.07%), 23.37% (95% CI: 22.99 to 23.75%) and 16.68% (95% CI: 16.10 to 17.28%) respectively. Considerable heterogeneity was found among these studies. The situation of increasing prevalence, as evident from this review, is worrisome as the hypertension epidemic will affect the poor tribal communities that cannot afford to pay for treatment expenses. Therefore, people's access to public health services must be improved. This review discusses the recent initiatives to reduce the burden of hypertension and other noncommunicable diseases in India and highlights the need of implementation research to strengthen these initiatives.

Prevalence, Regional Variations, and Predictors of Overweight, Obesity, and Hypertension Among Healthy Reproductive-Age Indian Women: Nationwide Cross-Sectional Polycystic Ovary Syndrome Task Force Study

BACKGROUND

A clear understanding of the anthropometric and sociodemographic risk factors related to BMI and hypertension categories is essential for more effective disease prevention, particularly in India. There is a paucity of nationally representative data on the dynamics of these risk factors, which have not been assessed among healthy reproductive-age Indian women.

OBJECTIVE

This cross-sectional polycystic ovary syndrome (PCOS) task force study aimed to assess the anthropometric and sociodemographic characteristics of healthy reproductive-age Indian women and explore the association of these characteristics with various noncommunicable diseases.

METHODS

We conducted a nationwide cross-sectional survey from 2018 to 2022 as part of the Indian Council of Medical Research-PCOS National Task Force study, with the primary aim of estimating the national prevalence of PCOS and regional phenotypic variations among women with PCOS. A multistage random sampling technique was adopted, and 7107 healthy women (aged 18-40 years) from 6 representative geographical zones of India were included in the study. The anthropometric indices and sociodemographic characteristics of these women were analyzed. Statistical analysis was performed to assess the association between exposure and outcome variables.

RESULTS

Of the 7107 study participants, 3585 (50.44%) were from rural areas and 3522 (49.56%) were from urban areas. The prevalence of obesity increased from 8.1% using World Health Organization criteria to 40% using the revised consensus guidelines for Asian Indian populations. Women from urban areas showed higher proportions of overweight (524/1908, 27.46%), obesity (775/1908, 40.62%), and prehypertension (1008/1908, 52.83%) categories. A rising trend of obesity was observed with an increase in age. Women aged 18 to 23 years were healthy (314/724, 43.4%) and overweight (140/724, 19.3%) compared with women aged 36 to 40 years with obesity (448/911, 49.2%) and overweight (216/911, 23.7%). The proportion of obesity was high among South Indian women, with 49.53% (531/1072) and 66.14% (709/1072), using both World Health Organization criteria and the revised Indian guidelines for BMI, respectively. BMI with waist circumference and waist-to-height ratio had a statistically significant linear relationship (r=0.417; P<.001 and r=0.422; P<.001, respectively). However, the magnitude, or strength, of the association was relatively weak (0.3<|r|<0.5). Statistical analysis showed that the strongest predictors of being overweight or obese were older age, level of education, wealth quintile, and area of residence.

CONCLUSIONS

Anthropometric and sociodemographic characteristics are useful predictors of overweight- and obesity-related syndromes, including prehypertension, among healthy Indian women. Increased attention to the health of Indian women from public health experts and policy makers is warranted. The findings of this study can be leveraged to offer valuable insights, informing health decision-making and targeted interventions that mitigate risk factors of overweight, obesity, and hypertension.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/23437.

Exploring the underlying mechanisms of obesity and diabetes and the potential of Traditional Chinese Medicine: an overview of the literature

Obesity and diabetes are closely related metabolic disorders that have become major public health concerns worldwide. Over the past few decades, numerous studies have explored the underlying mechanisms of these disorders and identified various risk factors, including genetics, lifestyle, and dietary habits. Traditional Chinese Medicine (TCM) has been increasingly recognized for its potential to manage obesity and diabetes. Weight loss is difficult to sustain, and several diabetic therapies, such as sulfonylureas, thiazolidinediones, and insulin, might make it harder to lose weight. While lifestyle changes should be the primary approach for people interested in lowering weight, drugs are also worth investigating. Since some of the newer glucose-lowering medications that cause weight loss, such as glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2i), are additionally utilized or are under consideration for use as anti-obesity drugs, the frontier between glucose-lowering medication and weight loss drugs appears to be shifting. This review provides an overview of the literature on the underlying mechanisms of obesity and diabetes and the prospect of TCM in their management. We discuss the various TCM interventions, including acupuncture, herbal medicine, and dietary therapy, and their effects on metabolic health. We also highlight the potential of TCM in regulating gut microbiota, reducing inflammation, and improving insulin sensitivity. The findings suggest that TCM may provide a promising approach to preventing and managing obesity and diabetes. However, further well-designed studies are needed to confirm the efficacy and safety of TCM interventions and to elucidate their underlying mechanisms of action.

The Prevalence of Overweight, Obesity, Hypertension, and Diabetes in India: Analysis of the 2015-2016 National Family Health Survey

Overweight, obesity, hypertension, and diabetes increase the risk of non-communicable diseases and all-cause mortality worldwide. Previous studies have not determined the prevalence of these conditions/diseases throughout India. Therefore, this study was aimed to address this limitation. Data on these conditions/diseases among men and women aged ≥ 18 years were obtained from the fourth National Family Health Survey conducted throughout India between January 2015 and December 2016. The prevalence and prevalence rate per 100,000 population were calculated at the national level and by age group, sex, and type of residence for each state and union territory. The national prevalence of overweight, obesity, hypertension, and diabetes were 14.6%, 3.4%, 5.2%, and 7.1%, respectively. The highest prevalence of these conditions/diseases at the national level was seen among those aged 35–49 years (54 years for men), especially women living in urban areas. In India, 1 out of every 7, 29, 19, and 14 individuals at the national level had overweight, obesity, hypertension, and diabetes, respectively—between 2015 and 2016. These results are important for the healthcare system and government policies in the future. Moreover, targeted efforts are required to establish public health strategies for the prevention, management, and treatment of these conditions/diseases throughout India.

Prevalence of cardiovascular risk factors among tribal and non-tribal populations with East Asian Ancestry from North East India

OBJECTIVES

The distribution of hypertension, type 2 diabetes, dyslipidemia, and obesity variables were studied among tribal and non-tribal populations with East Asian ancestry from northeast India.

METHODS

Data pertaining to somatometric measurements, blood pressure, lipid profile, and fasting blood glucose were collected from 1916 participants (Mizo-422, Liangmai-352, and Meitei-1142) of both sexes older than 18 years. Two-way ANOVA and chi square analysis were done to understand the inter-population prevalence differences.

RESULTS

Differential distribution of obesity variables, hypertension, type 2 diabetes, and dyslipidemia was observed among the three populations.

CONCLUSIONS

Population-specific prevalence studies need to be conducted to develop population-specific health strategies, specifically in countries like India with huge diversity.