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Gender and rural-urban differences in hypertension among youth in India: Insights from a large scale survey, 2015-16. J Biosoc Sci 2022; 55:523-537. [PMID: 35343405 DOI: 10.1017/s0021932022000141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Hypertension is considered one of the most persistent public health issues and the single largest contributor to avoidable morbidity and mortality in India. This study aims to investigate the prevalence and risk factors of hypertension in youths (15-29 years) by gender and rural-urban place of residence. Data from the fourth round of the National Family and Health Survey - 2015-16 (n = 395,207) was utilised for the study. After estimation of the stratified prevalence of hypertension by various characteristics, multivariable logistic regression analysis was conducted to assess the correlates of hypertension. The results revealed that the prevalence of hypertension in youths at the national level varied from 9.16% (Meghalaya) to 3.34% (Delhi). The stratified analysis suggests pronounced gender differences in the prevalence of hypertension among youth with insignificant rural-urban differences, although the prevalence was higher in urban areas. Overall, the prevalence of hypertension was found higher for male youths living in urban areas (7.82%) and females in rural areas (5.08%). Concurrently, results from regression analysis also suggest higher odds of hypertension for males residing in urban areas for a variety of demographic, socioeconomic, and health-risk factors. Advancing age, having no education, living in the northeast region, being overweight/obese and high blood glucose level was significantly associated with a greater likelihood of hypertension for both the gender and place of residence. Public health awareness regarding blood pressure needs to be tailored differently for both males and females considering the place of residence. The study suggests that more research should focus on blood pressure/hypertension among children, adolescents and youth since they point towards adult blood pressure patterns.
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Abstract
OBJECTIVES This 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 to identify the risk factors of hypertension. DESIGN We analysed cross-sectional survey data from the fourth round (2015-2016) of National Family Health Survey (NFHS). NFHS was conducted between January 2015 and December 2016, gathering information on a range of indicators including blood pressure. The age adjusted prevalence of hypertension was calculated for state comparison, while multilevel logistic regression analysis was done to assess the correlates of hypertension. SETTING AND PARTICIPANTS India (2015-2016; n=811 917) aged 15-49. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome is hypertension, which has been defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg. RESULTS The age-adjusted prevalence of hypertension in India was 11.3% (95% CI 11.16% to 11.43%) among persons aged between 15 and 49 and was four percentage points higher among males 13.8% (95% CI 13.46% to 14.19%) than among females 10.9% (95% CI 10.79% to 11.06%). Persons in the urban location (12.5%, 95% CI 12.25% to 12.80%) had a marginally higher prevalence than persons in rural location (10.6%, 95% CI 10.50% to 10.78%). The proportion of population suffering from hypertension varied greatly between states, with a prevalence of 8.2% (95% CI 7.58% to 8.85%) in Kerala to 20.3% (95% CI 18.81% to 21.77%) in Sikkim. Advancing age, obesity/overweight, male sex, socioeconomic status and consumption of alcohol were found to be the major predictors of hypertension. CONCLUSIONS Hypertension prevalence is now becoming more concentrated among the poor. Policy measures should be taken to improve the hazardous working conditions and growing social pressures of survival responsible for 'life-style' changes such as consumption of high calorie food and alcohol.
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Affiliation(s)
- Soumitra Ghosh
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India
| | - Manish Kumar
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India
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Priyadharsini Jayaseelan V, Muthusamy K, Venkatramani S, Arumugam P, Gopalswamy J, Thiagarajan SS. Gender-specific Association of ATP2B1 (rs2681472) Gene Polymorphism with Essential Hypertension in South Indian Population. INT J HUM GENET 2018. [DOI: 10.1080/09723757.2017.1421431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Karthikeyan Muthusamy
- Department of Bioinformatics, Alagappa University, Karaikudi 630 004, Tamil Nadu, India
| | | | | | - Jayaraman Gopalswamy
- Department of Genetics, Dr. ALM PGIBMS, University of Madras, Taramani, Chennai, Tamil Nadu, India
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Tripathy JP, Thakur JS, Jeet G, Chawla S, Jain S. Alarmingly high prevalence of hypertension and pre-hypertension in North India-results from a large cross-sectional STEPS survey. PLoS One 2017; 12:e0188619. [PMID: 29267338 PMCID: PMC5739392 DOI: 10.1371/journal.pone.0188619] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 11/10/2017] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES The study was primarily aimed at estimating the prevalence of hypertension and pre-hypertension and the risk factors of hypertension in the North Indian state of Punjab. It also aimed at assessing the magnitude of undiagnosed cases of hypertension in the community and ascertaining the blood pressure control status of those on treatment. METHODS A non-communicable disease risk factor survey (based on WHO-STEPS approach) was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals. The study subjects were administered the WHO STEPS-questionnaire and also underwent anthropometric and blood pressure measurements. RESULTS Overall prevalence of HTN among the study participants was found out to be 40.1% (95% CI: 38.8-41.5%) whereas prevalence of pre-hypertension, isolated diastolic and isolated systolic hypertension were 40.8% (39.5-42.2%), 9.2% (8.4-10.0%) and 6.5% (5.9-7.2%) respectively. Age group (45-69 years), male gender, social group, marital status, alcohol use, obesity and salt intake (> = 5 gms/day) were the risk factors significantly associated with HTN. Among all persons with HTN, only 30.1% were known case of HTN or on treatment, among whom nearly 61% had controlled blood pressure. Patients with uncontrolled BP were more frequently male, obese patients, with sedentary lifestyle and patients with diabetes. CONCLUSIONS The study reported alarmingly high prevalence of hypertension, especially of undiagnosed or untreated cases amongst the adult population, a significant proportion of whom have uncontrolled blood pressure levels. This indicates the need for systematic screening and awareness program to identify the undiagnosed cases in the community and offer early treatment and regular follow up.
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Affiliation(s)
- Jaya Prasad Tripathy
- International Union Against Tuberculosis and Lung Disease, The Union South East Asia Office, New Delhi, India
| | - Jarnail Singh Thakur
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Gursimer Jeet
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sohan Chawla
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjay Jain
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Zeng J, Zhang X, Yang J, Bao J, Xiang H, Dear K, Liu Q, Lin S, Lawrence WR, Lin A, Huang C. Humidity May Modify the Relationship between Temperature and Cardiovascular Mortality in Zhejiang Province, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111383. [PMID: 29135955 PMCID: PMC5708022 DOI: 10.3390/ijerph14111383] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 11/09/2017] [Accepted: 11/11/2017] [Indexed: 11/30/2022]
Abstract
Background: The evidence of increased mortality attributable to extreme temperatures is widely characterized in climate-health studies. However, few of these studies have examined the role of humidity on temperature-mortality association. We investigated the joint effect between temperature and humidity on cardiovascular disease (CVD) mortality in Zhejiang Province, China. Methods: We collected data on daily meteorological and CVD mortality from 11 cities in Zhejiang Province during 2010–2013. We first applied time-series Poisson regression analysis within the framework of distributed lag non-linear models to estimate the city-specific effect of temperature and humidity on CVD mortality, after controlling for temporal trends and potential confounding variables. We then applied a multivariate meta-analytical model to pool the effect estimates in the 11 cities to generate an overall provincial estimate. The joint effects between them were calculated by the attributable fraction (AF). The analyses were further stratified by gender, age group, education level, and location of cities. Results: In total, 120,544 CVD deaths were recorded in this study. The mean values of temperature and humidity were 17.6 °C and 72.3%. The joint effect between low temperature and high humidity had the greatest impact on the CVD death burden over a lag of 0–21 days with a significant AF of 31.36% (95% eCI: 14.79–38.41%), while in a condition of low temperature and low humidity with a significant AF of 16.74% (95% eCI: 0.89, 24.44). The AFs were higher at low temperature and high humidity in different subgroups. When considering the levels of humidity, the AFs were significant at low temperature and high humidity for males, youth, those with a low level of education, and coastal area people. Conclusions: The combination of low temperature and high humidity had the greatest impact on the CVD death burden in Zhejiang Province. This evidence has important implications for developing CVD interventions.
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Affiliation(s)
- Jie Zeng
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Xuehai Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 510632, China.
| | - Junzhe Bao
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Hao Xiang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan 430072, China.
| | - Keith Dear
- School of Public Health, University of Adelaide, Adelaide 5005, Australia.
| | - Qiyong Liu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - Shao Lin
- School of Public Health, University at Albany, State University of New York, Albany, NY 12222, USA.
| | - Wayne R Lawrence
- School of Public Health, University at Albany, State University of New York, Albany, NY 12222, USA.
| | - Aihua Lin
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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Huang XB, Chen F, Dai W, Song L, Tu J, Xu JB, Liu JX, Yi YJ, Liu Y, Chen Y, Wang TD, Zhao SP. Prevalence and risk factors associated with hypertension in the Chinese Qiang population. Clin Exp Hypertens 2017; 40:427-433. [PMID: 29106313 DOI: 10.1080/10641963.2017.1392553] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Our aim is to investigate the prevalence and risk factors associated with hypertension among the Chinese Qiang population. From September 2012 to March 2013, a cross-sectional study was conducted in urban and rural communities of the Qiang population using multistage cluster sampling. A total of 2676 people aged above 20 years were enrolled in the analysis. Standardized mercury sphygmomanometer was used to measure the blood pressure twice after a 10-minute seated rest, and the average blood pressure was obtained. The hypertension prevalence among the population aged above 20 years was 13.9%, and age-standardized prevalence was 12.3%. Male and female prevalence of hypertension, as well as the prevalence in urban and rural areas, all increased with age. There were no significant differences between males and females and between urban and rural residents. Among hypertensive patients, 44.2% were aware of their hypertension, 38.0% were undergoing antihypertensive treatment, but only 10.5% achieved blood pressure control. Multivariate logistic regression analysis showed that the risk factors of hypertension included age, low income, overweight and obesity, family history of hypertension. The prevalence of hypertension in Chinese Qiang adults is significantly lower than the national level. Awareness, treatment, and control rates of hypertension were low in the Qiang population. Thus, hypertension-related health knowledge should be more aggressively delivered to improve public awareness and the capacity of community health services should be strengthened.
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Affiliation(s)
- Xiao-Bo Huang
- a Department of Cardiology , the second people's hospital of Chengdu , Chengdu Sichuan Province , China.,c Department of Cardiology , Cent S Univ, Xiangya Hosp 2 , Changsha Hunan , China
| | - Fei Chen
- b Department of Epidemiology and Health Statistics , West China School of Public Health, Sichuan University , Chengdu Sichuan , China
| | - Wen Dai
- c Department of Cardiology , Cent S Univ, Xiangya Hosp 2 , Changsha Hunan , China
| | - Lei Song
- d Department of Cardiology , Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing China
| | - Jiao Tu
- e Department of Epidemiology &health statistics , School of Public Health, Xiangya Medical College, Central South University , Changsha Hunan , China
| | - Jun-Bo Xu
- a Department of Cardiology , the second people's hospital of Chengdu , Chengdu Sichuan Province , China
| | - Jian-Xiong Liu
- a Department of Cardiology , the second people's hospital of Chengdu , Chengdu Sichuan Province , China
| | - Yan-Jing Yi
- a Department of Cardiology , the second people's hospital of Chengdu , Chengdu Sichuan Province , China
| | - Ya Liu
- a Department of Cardiology , the second people's hospital of Chengdu , Chengdu Sichuan Province , China
| | - Yong Chen
- f Department of Cardiology , Sichuan Provincal Pepole's hospital , Chengdu Sichuan Province , China
| | - Tzung-Dau Wang
- g Cardiovascular Center and Division of Cardiology, Department of Internal Medicine , National Taiwan University Hospital , Taipei City , Taiwan
| | - Shui-Ping Zhao
- c Department of Cardiology , Cent S Univ, Xiangya Hosp 2 , Changsha Hunan , China
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Karmacharya BM, Koju RP, LoGerfo JP, Chan KCG, Mokdad AH, Shrestha A, Sotoodehnia N, Fitzpatrick AL. Awareness, treatment and control of hypertension in Nepal: findings from the Dhulikhel Heart Study. HEART ASIA 2017; 9:1-8. [PMID: 28123454 DOI: 10.1136/heartasia-2016-010766] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Revised: 11/16/2016] [Accepted: 11/25/2016] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Although previous studies have suggested alarming rise in the prevalence of hypertension in Nepal, there is dearth of information on its awareness, treatment and control. In this cross-sectional study, we assessed awareness, treatment and control of hypertension among 298 hypertensive adults from the suburban town of Dhulikhel, Nepal. METHODS This cross-sectional study is based on Dhulikhel Heart Study, which included 1073 adults, aged ≥18 years, recruited from randomly selected households. Comprehensive health interviews and blood pressure measurements were completed during home interviews. Hypertensives (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or receiving antihypertensive medication) were further evaluated for awareness, treatment and control of hypertension. Multivariate regression model quantified the association of the sociodemographic characteristics and the cardiovascular disease (CVD) risk factors with hypertension awareness. Differences between sociodemographic characteristics and CVD risk factors with treatment and control of hypertension were tested using χ2 tests. RESULTS A total of 43.6% of all hypertensives (n=298) were aware of their hypertension status. In multivariate analyses, hypertension awareness was associated with increasing age (p<0.001). More than three-fourth (76.1%) of those who were aware of their hypertension status (n=130) were currently on treatment. There were significant differences in treatment status by sex, occupation, age, income quartiles and body mass index. Only 35.3% of those on treatment (n=99) had blood pressure control. CONCLUSIONS The levels of awareness, treatment and control of hypertension in this sample of Nepalese adults were low.
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Affiliation(s)
- Biraj M Karmacharya
- Department of Epidemiology, University of Washington, Seattle, WA, USA; Division of Cardiology, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA; Department of Community Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal; Department of Community Programs, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Rajendra P Koju
- Department of Global Health, University of Washington, Seattle, WA, USA; Department of Community Programs, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - James P LoGerfo
- Department of Global Health, University of Washington, Seattle, WA, USA; Department of Medicine, University of Washington, Seattle, WA, USA
| | - Kwun Chuen Gary Chan
- Department of Biostatistics, University of Washington, Seattle, WA, USA; Department of Health Services, University of Washington, Seattle, WA, USA
| | - Ali H Mokdad
- Department of Epidemiology, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA; Department of Health Services, University of Washington, Seattle, WA, USA; Department of Health Services, University of Washington, Seattle, WA, USA
| | - Archana Shrestha
- Department of Epidemiology, University of Washington, Seattle, WA, USA; Department of Community Programs, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal; Department of Epidemiology, Harvard T.H. Chan School of Public Health, MA, USA
| | - Nona Sotoodehnia
- Division of Cardiology, University of Washington, Seattle, WA, USA; Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
| | - Annette L Fitzpatrick
- Department of Epidemiology, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA; Department of Family Medicine, University of Washington, Seattle, WA, USA
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Dhar L, Dantas J, Ali M. A Systematic Review of Factors Influencing Medication Adherence to Hypertension Treatment in Developing Countries. ACTA ACUST UNITED AC 2017. [DOI: 10.4236/ojepi.2017.73018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Sarki AM, Nduka CU, Stranges S, Kandala NB, Uthman OA. Prevalence of Hypertension in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. Medicine (Baltimore) 2015; 94:e1959. [PMID: 26683910 PMCID: PMC5058882 DOI: 10.1097/md.0000000000001959] [Citation(s) in RCA: 206] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 10/09/2015] [Accepted: 10/13/2015] [Indexed: 11/26/2022] Open
Abstract
We aimed to obtain overall and regional estimates of hypertension prevalence, and to examine the pattern of this disease condition across different socio-demographic characteristics in low-and middle-income countries. We searched electronic databases from inception to August 2015. We included population-based studies that reported hypertension prevalence using the current definition of blood pressure ≥140/90 mm Hg or self-reported use of antihypertensive medication. We used random-effects meta-analyses to pool prevalence estimates of hypertension, overall, by World Bank region and country income group. Meta-regression analyses were performed to explore sources of heterogeneity across the included studies. A total of 242 studies, comprising data on 1,494,609 adults from 45 countries, met our inclusion criteria. The overall prevalence of hypertension was 32.3% (95% confidence interval [CI] 29.4-35.3), with the Latin America and Caribbean region reporting the highest estimates (39.1%, 95% CI 33.1-45.2). Pooled prevalence estimate was also highest across upper middle income countries (37.8%, 95% CI 35.0-40.6) and lowest across low-income countries (23.1%, 95% CI 20.1-26.2). Prevalence estimates were significantly higher in the elderly (≥65 years) compared with younger adults (<65 years) overall and across the geographical regions; however, there was no significant sex-difference in hypertension prevalence (31.9% vs 30.8%, P = 0.6). Persons without formal education (49.0% vs 24.9%, P < 0.00001), overweight/obese (46.4% vs 26.3%, P < 0.00001), and urban settlers (32.7% vs 25.2%, P = 0.0005) were also more likely to be hypertensive, compared with those who were educated, normal weight, and rural settlers respectively. This study provides contemporary and up-to-date estimates that reflect the significant burden of hypertension in low- and middle-income countries, as well as evidence that hypertension remains a major public health issue across the various socio-demographic subgroups. On average, about 1 in 3 adults in the developing world is hypertensive. The findings of this study will be useful for the design of hypertension screening and treatment programmes in low- and middle-income countries.
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Affiliation(s)
- Ahmed M Sarki
- From the Division of Health Sciences, University of Warwick Medical School, Coventry, UK (AMS, CUN); Family and Youth Health Initiative (FAYOHI), Nigeria (AMS); Department of Population Health, Luxembourg Institute of Health, Luxembourg (SS, N-BK); Warwick-Centre for Applied Health Research and Delivery (WCAHRD), Division of health Sciences, University of Warwick Medical School, Coventry, UK (OAU); and Centre for Applied Health Research and Delivery (CAHRD), Liverpool School of Tropical Medicine, International Health Group, Liverpool, UK (OAU); Department of Mathematics and Information sciences, Faculty of Engineering and Environment, Northumbria University, Newcastle upon Tyne, UK (N-BK)
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Adhikari P, Pemminati S, Pathak R, Kotian MS, Ullal S. Prevalence of Hypertension in Boloor Diabetes Study (BDS-II) and its Risk Factors. J Clin Diagn Res 2015; 9:IC01-IC04. [PMID: 26674015 DOI: 10.7860/jcdr/2015/16509.6781] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 09/19/2015] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Hypertension is a major public health problem in India and worldwide. Since hypertension is often asymptomatic, it commonly remains undetected, leading to serious complications if untreated. Hypertension is one of the leading causes of end stage renal disease. It doubles the risk of developing coronary artery disease, increases the risk of congestive heart failure by four folds and that of cerebrovascular disease and stroke by seven folds. Hypertension is directly responsible for 57% of all stroke deaths and 42% of coronary heart disease deaths in India. AIM To identify prevalence and risk factors for hypertension in a semi urban population of Mangalore, who participated in Boloor Diabetes Study (BDS-II). MATERIALS AND METHODS This cross-sectional study was conducted on 551 subjects aged ≥ 20 years who were randomly selected. Hypertension was diagnosed and classified according to Joint National Committee 7 (JNC) criteria. Blood pressure was measured by a doctor using calibrated sphygmomanometer. Anthropometric measurements, lipid and glucose estimations were done for all subjects. Statistical analysis was done using Chi-square test and student's t-test (unpaired). Multivariate logistic regression analysis was done using hypertension as dependent variable and the various risk factors as independent variables. RESULTS Overall prevalence of hypertension in the community was 41% (227/551) (40.9% in men, 41.3% in women). Prehypertension was found in 40% (223/551) (45.4% in men, 38.1% in women), and only 18.3% (101/551) had normal blood pressure. Stage I hypertension was seen in 29.7% (164/551) (28.9% in men, 30.1% in women). Stage II hypertension was seen in 11.4% (63/551) (12% in men, 11% in women). Age, obesity, diabetes, serum cholesterol and serum triglycerides were strongly associated with hypertension. Only 46% (254/551) of the hypertensive subjects were aware that they were hypertensive. CONCLUSION Prevalence of hypertension was high in this population. Nearly 54% were unaware of their hypertensive status. Prevalence increased with age, obesity, diabetic status and dyslipidemia. Nearly half of subjects were prehypertensives. This study highlights the need for regular screening coupled with educational programmes to detect, improve awareness and optimally treat hypertension in the community to reduce cardiovascular and renal complications.
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Affiliation(s)
- Prabha Adhikari
- Professor, Department of Medicine, Kasturba Medical College, Attavar Hospital, Manipal Universtiy , Mangalore, Karnataka, India
| | - Sudhakar Pemminati
- Assistant Professor, Department of Pharmacology, AUA College of Medicine, Manipal University , Antigua, India
| | - Rahul Pathak
- Post Graduate, Department of Medicine, Kasturba Medical College, Attavar Hospital , Mangalore, Karnataka, India
| | - Mangalore Shashidhar Kotian
- Selection Grade Lecturer, Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India
| | - Sheetal Ullal
- Associate Professor, Department of Pharmacology, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India
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Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hypertens 2015; 32:1170-7. [PMID: 24621804 PMCID: PMC4011565 DOI: 10.1097/hjh.0000000000000146] [Citation(s) in RCA: 423] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: A region-specific (urban and rural parts of north, east, west, and south India) systematic review and meta-analysis of the prevalence, awareness, and control of hypertension among Indian patients have not been done before. Methods: Medline, Web of Science, and Scopus databases from 1950 to 30 April 2013 were searched for ‘prevalence, burden, awareness, and control of blood pressure (BP) or hypertension (≥140 SBP and or ≥90 DBP) among Indian adults’ (≥18 years). Of the total 3047 articles, 142 were included. Results: Overall prevalence for hypertension in India was 29.8% (95% confidence interval: 26.7–33.0). Significant differences in hypertension prevalence were noted between rural and urban parts [27.6% (23.2–32.0) and 33.8% (29.7–37.8); P = 0.05]. Regional estimates for the prevalence of hypertension were as follows: 14.5% (13.3–15.7), 31.7% (30.2–33.3), 18.1% (16.9–19.2), and 21.1% (20.1–22.0) for rural north, east, west, and south India; and 28.8% (26.9–30.8), 34.5% (32.6–36.5), 35.8% (35.2–36.5), and 31.8% (30.4–33.1) for urban north, east, west, and south India, respectively. Overall estimates for the prevalence of awareness, treatment, and control of BP were 25.3% (21.4–29.3), 25.1% (17.0–33.1), and 10.7% (6.5–15.0) for rural Indians; and 42.0% (35.2–48.9), 37.6% (24.0–51.2), and 20.2% (11.6–28.7) for urban Indians. Conclusion: About 33% urban and 25% rural Indians are hypertensive. Of these, 25% rural and 42% urban Indians are aware of their hypertensive status. Only 25% rural and 38% of urban Indians are being treated for hypertension. One-tenth of rural and one-fifth of urban Indian hypertensive population have their BP under control.
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Ram CVS. "Hypertension guidelines: good-bye to confusion and welcome to clarity". Indian Heart J 2015; 67:18-22. [PMID: 25820045 PMCID: PMC4382548 DOI: 10.1016/j.ihj.2015.02.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 02/16/2015] [Indexed: 01/13/2023] Open
Affiliation(s)
- C Venkata S Ram
- Apollo Institute for Blood Pressure Management, Apollo Blood Pressure Clinics, Apollo Hospitals, Hyderabad, India; Texas Blood Pressure Institute, Dallas Nephrology Associates, University of Texas Southwestern Medical School, Dallas, TX, USA.
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Neupane D, McLachlan CS, Sharma R, Gyawali B, Khanal V, Mishra SR, Christensen B, Kallestrup P. Prevalence of hypertension in member countries of South Asian Association for Regional Cooperation (SAARC): systematic review and meta-analysis. Medicine (Baltimore) 2014; 93:e74. [PMID: 25233326 PMCID: PMC4616265 DOI: 10.1097/md.0000000000000074] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 07/07/2014] [Accepted: 07/08/2014] [Indexed: 02/01/2023] Open
Abstract
Hypertension is a leading attributable risk factor for mortality in South Asia. However, a systematic review on prevalence and risk factors for hypertension in the region of the South Asian Association for Regional Cooperation (SAARC) has not carried out before.The study was conducted according to the Meta-Analysis of Observational Studies in Epidemiology Guideline. A literature search was performed with a combination of medical subject headings terms, "hypertension" and "Epidemiology/EP". The search was supplemented by cross-references. Thirty-three publications that met the inclusion criteria were included in the synthesis and meta-analyses. Hypertension is defined when an individual had a systolic blood pressure (SBP) ≥140 mm Hg and/or diastolic blood pressure (DBP) ≥90 mm Hg, was taking antihypertensive drugs, or had previously been diagnosed as hypertensive by health care professionals. Prehypertension is defined as SBP 120-139 mm Hg and DBP 80-89 mm Hg.The overall prevalence of hypertension and prehypertension from the studies was found to be 27% and 29.6%, respectively. Hypertension varied between the studies, which ranged from 13.6% to 47.9% and was found to be higher in the studies conducted in urban areas than in rural areas. The prevalence of hypertension from the latest studies was: Bangladesh: 17.9%; Bhutan: 23.9%; India: 31.4%; Maldives: 31.5%; Nepal: 33.8%; Pakistan: 25%; and Sri Lanka: 20.9%. Eight out of 19 studies with information about prevalence of hypertension in both sexes showed that the prevalence was higher among women than men. Meta-analyses showed that sex (men: odds ratio [OR] 1.19; 95% confidence interval [CI]: 1.02, 1.37), obesity (OR 2.33; 95% CI: 1.87, 2.78), and central obesity (OR 2.16; 95% CI: 1.37, 2.95) were associated with hypertension.Our study found a variable prevalence of hypertension across SAARC countries, with a number of countries with blood pressure above the global average. We also noted that studies are not consistent in their data collection about hypertension and related modifiable risk factors.
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Affiliation(s)
- Dinesh Neupane
- Department of Public Health (DN, PK), Center for Global Health, Aarhus University, Aarhus, Denmark; Rural Clinical School (CSM), University of New South Wales, Sydney, Australia; Unit of Health Promotion (RS, BG), University of Southern Denmark, Esbjerg, Denmark; School of Public Health (VK), Curtin University, Perth, Australia; Nepal Development Society (SRM), Kathmandu, Nepal; and Department of Public Health (BC), Institute of General Medical Practice, Aarhus University, Aarhus, Denmark
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Midha T, Nath B, Kumari R, Rao YK, Pandey U. Prevalence of hypertension in India: A meta-analysis. World J Meta-Anal 2013; 1:83-89. [DOI: 10.13105/wjma.v1.i2.83] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 04/26/2013] [Accepted: 06/04/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To determine the prevalence of hypertension in the urban and rural population of India.
METHODS: Relevant studies were identified through computer based and manual searches using MEDLINE/ PubMed, Google scholar, EMBASE, Cochrane Library and reference lists of prevalence studies from January 2000 to June 2012. A total of 12 studies were included in the meta-analysis of hypertension in urban India and 10 studies in the analysis of hypertension in rural India after applying the inclusion and exclusion criteria. Estimates of prevalence were calculated using the random effect model for meta-analysis.
RESULTS: The electronic search using appropriate keywords identified 177 titles for prevalence of hypertension in urban India, of which 165 were excluded, and 133 titles for prevalence in rural India, of which 123 were excluded after applying the inclusion criteria. Twelve studies including 125333 subjects were analyzed to assess the prevalence of hypertension in the urban Indian population, whereas ten studies including 24800 subjects were analyzed to determine the prevalence of hypertension in the rural Indian population. The prevalence of hypertension in the urban population was estimated to be 40.8% (95%CI: 40.5%-41.0%) and that of hypertension in the rural population was 17.9% (95%CI: 17.5%-18.3%). It is evident that the prevalence of hypertension is significantly higher in the urban population of India compared to the rural.
CONCLUSION: Current evidence suggests that policies and interventions should be prioritized for reduction of hypertension in the adult Indian population, especially the urban population.
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Wu X, Pan B, Chen X, Zhuang X, Zhu K, Zeng L, Dai L, Dong X. Useful information for hypertension management reform in community health care: prevalence, awareness, treatment and control among Guangzhou adults. Clin Exp Hypertens 2013; 36:227-35. [DOI: 10.3109/10641963.2013.810225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Prevalence, awareness, treatment and control of hypertension in the Palestinian population. J Hum Hypertens 2013; 27:623-8. [PMID: 23575447 DOI: 10.1038/jhh.2013.26] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 02/05/2013] [Accepted: 02/22/2013] [Indexed: 01/13/2023]
Abstract
We determined the prevalence of hypertension and the level of awareness, treatment and control of hypertension among Palestinian adults in a population-based cross-sectional survey. Two-stage stratified sampling method was used to select 2077 participants from the general population aged 25 years and over. Trained observers obtained two blood pressure (BP) measurements from each individual by the use of a standardized mercury sphygmomanometer after a 5-min sitting rest. Information on sociogeographical factors and antihypertensive medications was obtained using a standard questionnaire. Hypertension was defined as a mean systolic BP (SBP) 140 mm Hg, diastolic BP (DBP) 90 mm Hg, and/or use of antihypertensive medications. The overall prevalence of hypertension was 27.6%, with a higher percentage among men (29.2 vs 26.4%; P=0.04). Hypertension increased with age in both men and women. Among hypertensive patients, 51.0% were aware of their elevated BP, 40.2% had treatment and only 9.5% achieved targeted BP control (<140/90 mm Hg). Patients under antihypertensive treatment showed SBP and DBP that were only 3.1 mm Hg and 2.5 mm Hg lower than individuals without antihypertensive treatment, respectively. The data show that hypertension prevalence among Palestinian adults is high, whereas the proportions of awareness treatment and control of hypertension were low. Concerted public health effort is urgently required to improve the detection, treatment and control of hypertension in Palestine.
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Mahmood SE, Prakash D, Srivastava J, Zaidi Z, Bhardwaj P. Prevalence of Hypertension Amongst Adult Patients Attending Out Patient Department of Urban Health Training Centre, Department of Community Medicine, Era's Lucknow Medical College and Hospital, Lucknow. J Clin Diagn Res 2013; 7:652-6. [PMID: 23730639 PMCID: PMC3644437 DOI: 10.7860/jcdr/2013/4707.2874] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Accepted: 02/05/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Hypertension is the most common disorder which is encountered in outdoor patients. The existing data suggests that there is an increase in the prevalence of pre-hypertension and hypertension in India. The prevalence of hypertension will increase even further, unless broad and effective preventive measures are implemented. The main objective of this study was to find out the prevalence of hypertension amongst the adult outdoor patients of an urban health centre of Lucknow district. MATERIALS AND METHODS This observational, Out Patients Department based study involved a survey on 306 male and 1203 female respondents who were aged 18 years, who attended the Urban Health Training Centre of the Department of Community Medicine, Era's Lucknow Medical College and Hospital, Lucknow, India. A structured, pretested schedule was used to collect the data with regards to the demographic characteristics and the blood pressure pattern. The Chi- square test and ANOVA were used to analyze the data. RESULTS The prevalence of hypertension was found to be 44.46%. The proportion of hypertension showed an increasing trend with age. The mean systolic as well as diastolic blood pressure patterns were found to be higher, with an increase in age. CONCLUSION Hypertension was found to be highly prevalent among the outdoor patients of an urban health centre of Lucknow. An early detection of hypertension can be facilitated by periodically screening people regularly.
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Affiliation(s)
- Syed Esam Mahmood
- Assistant Professor, Department of Community Medicine, Rohilkhand Medical College and Hospital, Bareilly U.P. – 243006, India
| | - Daya Prakash
- Associate Professor, Department of Community Medicine, Era’s Lucknow Medical College and Hospital, Lucknow U.P. – 246003, India
| | - J.P. Srivastava
- Professor & Head, Department of Community Medicine, Era’s Lucknow Medical College and Hospital, Lucknow U.P. – 246003, India
| | - Z.H. Zaidi
- Lecturer/Statistician, Department of Community Medicine, Era’s Lucknow Medical College and Hospital, Lucknow U.P. – 246003, India
| | - Pankaj Bhardwaj
- Assistant Professor, Department of Community Medicine, Era’s Lucknow Medical College and Hospital, Lucknow U.P. - 246003, India
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Bhupatiraju C, Saini D, Patkar S, Deepak P, Das B, Padma T. Association of shorter telomere length with essential hypertension in Indian population. Am J Hum Biol 2012; 24:573-8. [PMID: 22431479 DOI: 10.1002/ajhb.22264] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Revised: 01/26/2012] [Accepted: 02/08/2012] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Essential hypertension is known to be associated with growth, development, and aging of humans. Telomeres are specialized nucleoprotein complexes consisting of tandem repeats of DNA sequences (TTAGGG)n that serve as protective caps of human chromosomes. Telomere length is considered as a biomarker of aging in somatic cells. In the present investigation, leukocyte telomere length was determined among hypertensive and normal individuals to find out the association, if any, with hypertension. MATERIALS AND METHODS Venous blood samples were collected from normal and hypertensive individuals with written informed consent approved by ethic committee of Department of Genetics, Osmania University Hyderabad, India. Genomic DNA was isolated from blood samples of 98 normal (age range: 30-70 years, mean age: 51.01 ± 10.12 years) and 96 hypertensive individuals (age range: 35-75 years, mean age: 49.18 ± 6.46 years). Using a SYBR green-based real time quantitative PCR relative telomere length was determined among these individuals. RESULTS The relative telomere length (T/S ratio) in hypertensive individuals was observed to be 0.91 ± 0.16 which was significantly different (P < 0.001) from normal individuals where the relative telomere length was 0.99 ± 0.13. No significant difference was observed between relative telomere length of male and female individuals, although there is negative correlation between age and telomere length was observed in both normal and hypertensive individuals. The systolic and diastolic blood pressure was negatively correlated with relative telomere length, though not significant. CONCLUSION Shorter telomere length is associated with hypertensive individuals in Indian population.
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Affiliation(s)
- Charita Bhupatiraju
- Department of Genetics, Osmania University, Hyderabad 500 007, Andhra Pradesh, India
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Prasad DS, Kabir Z, Dash AK, Das BC. Prevalence and predictors of adult hypertension in an urban eastern Indian population. HEART ASIA 2012; 4:49-52. [PMID: 27326028 DOI: 10.1136/heartasia-2011-010071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/16/2012] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To determine the prevalence of hypertension and to identify predictors of adult hypertension specifically in an underdeveloped urban region of eastern India. STUDY DESIGN Population-based cross-sectional study, with multi-stage random sampling technique. SETTINGS A main urban city located in South Orissa in eastern India. PARTICIPANTS 1178 adults 20-80 years of age randomly selected from 37 electoral wards of an urban locale. STATISTICAL METHODS Descriptive and multivariable logistic regression analyses. RESULTS The prevalence of hypertension was 36%. Significant predictors of hypertension were age, central obesity, inadequate fruit intake, diabetes, low high-density lipoprotein level and physical inactivity. CONCLUSIONS One-third of the adults in this urban population of eastern India are reported to be hypertensive and the classical risk factors have been found to contribute to the increased burden, which reinforces the importance of preventive cardiovascular interventions in tackling this burden.
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Affiliation(s)
- D S Prasad
- Sudhir Heart Centre, Berhampur, Orissa, India
| | - Zubair Kabir
- Department of Epidemiology, Research Institute for a Tobacco Free Society, Dublin, Ireland
| | - Ashok K Dash
- Department of Pathology, M.K.C.G Medical College and Hospital, Berhampur, Orissa, India
| | - B C Das
- Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneshwar, Orissa, India
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Gupta R, Pandey RM, Misra A, Agrawal A, Misra P, Dey S, Rao S, Menon VU, Kamalamma N, Vasantha Devi KP, Revathi K, Vikram NK, Sharma V, Guptha S. High prevalence and low awareness, treatment and control of hypertension in Asian Indian women. J Hum Hypertens 2011; 26:585-93. [PMID: 21881598 DOI: 10.1038/jhh.2011.79] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Hypertension is an important public health problem in India. To determine its prevalence, awareness, treatment and control among women, we performed a nationwide study. Population-based studies among women aged 35-70 years were performed in four urban and five rural locations. Stratified sampling was performed and we enrolled 4608 (rural 2604 and urban 2004) of the targeted 8000 (57%). Demographic details, medical history, diet, physical activity, anthropometry and blood pressure (BP) were recorded. Descriptive statistics are reported. Logistic regression was performed to determine the association of hypertension and its awareness, treatment and control with socioeconomic factors. Age-adjusted prevalence of hypertension (known or BP≥140/≥90 mm Hg) was observed in 1672 women (39.2%) (rural 746, 31.5%; urban 926, 48.2%). Significant determinants of hypertension were urban location, greater literacy, high dietary fat, low fibre intake, obesity and truncal obesity (P<0.01). Hypertension awareness was noted in 727 women (42.8%), more in urban (529, 56.8%) than in rural (198, 24.6%). Of these, 38.6% of the women were on treatment (urban 35.7, rural 46.5) and of those treated, controlled blood pressure (<140 and <90 mm Hg) was observed in 21.5% (urban 28.3 vs 10.2). Among hypertensive subjects, treatment was noted in 18.3% (rural 13.1, urban 22.5) and control in 3.9% (rural 1.3, urban 5.9). A significant determinant of low awareness, treatment and control was rural location (multivariate-adjusted P<0.05). There is a high prevalence of hypertension in middle-aged Asian Indian women. Very low awareness, treatment and control status are observed.
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Affiliation(s)
- R Gupta
- Department of Medicine, Fortis Escorts Hospital, Jaipur, India.
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Pednekar MS, Gupta R, Gupta PC. Illiteracy, low educational status, and cardiovascular mortality in India. BMC Public Health 2011; 11:567. [PMID: 21756367 PMCID: PMC3160988 DOI: 10.1186/1471-2458-11-567] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Accepted: 07/15/2011] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Influence of education, a marker of SES, on cardiovascular disease (CVD) mortality has not been evaluated in low-income countries. To determine influence of education on CVD mortality a cohort study was performed in India. METHODS 148,173 individuals aged ≥ 35 years were recruited in Mumbai during 1991-1997 and followed to ascertain vital status during 1997-2003. Subjects were divided according to educational status into one of the five groups: illiterate, primary school (≦ 5 years of formal education), middle school (6-8 years), secondary school (9-10 years) and college (> 10 years). Multivariate analyses using Cox proportional hazard model was performed and hazard ratios (HRs) and 95% confidence intervals (CIs) determined. RESULTS At average follow-up of 5.5 years (774,129 person-years) 13,261 deaths were observed. CVD was the major cause of death in all the five educational groups. Age adjusted all-cause mortality per 100,000 in illiterate to college going men respectively was 2154, 2149, 1793, 1543 and 1187 and CVD mortality was 471, 654, 618, 518 and 450; and in women all-cause mortality was 1444, 949, 896, 981 and 962 and CVD mortality was 429, 301, 267, 426 and 317 (ptrend < 0.01). Compared with illiterate, age-adjusted HRs for CVD mortality in primary school to college going men were 1.36, 1.27, 1.01 and 0.88 (ptrend < 0.05) and in women 0.69, 0.55, 1.04 and 0.74, respectively (ptrend > 0.05). CONCLUSIONS Inverse association of literacy status with all-cause mortality was observed in Indian men and women, while, for CVD mortality it was observed only in men.
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Affiliation(s)
- Mangesh S Pednekar
- Healis Sekhsaria Institute for Public Health, CBD Belapur, Navi Mumbai, Maharashtra-400614, India
| | - Rajeev Gupta
- Department of Medicine, Fortis Escorts Hospital, Malviya Nagar, Jaipur-302017, India
| | - Prakash C Gupta
- Healis Sekhsaria Institute for Public Health, CBD Belapur, Navi Mumbai, Maharashtra-400614, India
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Son PT, Quang NN, Viet NL, Khai PG, Wall S, Weinehall L, Bonita R, Byass P. Prevalence, awareness, treatment and control of hypertension in Vietnam-results from a national survey. J Hum Hypertens 2011; 26:268-80. [PMID: 21368775 DOI: 10.1038/jhh.2011.18] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The objective of this study was to estimate mean blood pressure (BP), prevalence of hypertension (defined as BP ≥140/90 mm Hg) and its awareness, treatment and control in the Vietnamese adult population. This cross-sectional survey took place in eight Vietnamese provinces and cities. Multi-stage stratified sampling was used to select 9832 participants from the general population aged 25 years and over. Trained observers obtained two or three BP measurements from each person, using an automatic sphygmomanometer. Information on socio-geographical factors and anti-hypertensive medications was obtained using a standard questionnaire. The overall prevalence of hypertension was 25.1%, 28.3% in men and 23.1% in women. Among hypertensives, 48.4% were aware of their elevated BP, 29.6% had treatment and 10.7% achieved targeted BP control (<140/90 mm Hg). Among hypertensive aware, 61.1% had treatment, and among hypertensive treated, 36.3% had well control. Hypertension increased with age in both men and women. The hypertension was significantly higher in urban than in rural areas (32.7 vs 17.3%, P<0.001). Hypertension is a major and increasing public health problem in Vietnam. Prevalence among adults is high, whereas the proportions of hypertensives aware, treated and controlled were unacceptably low. These results imply an urgent need to develop national strategies to improve prevention and control of hypertension in Vietnam.
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Affiliation(s)
- P T Son
- Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam.
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Association of blood pressure and cardiovascular mortality in India: Mumbai cohort study. Am J Hypertens 2009; 22:1076-84. [PMID: 19629050 DOI: 10.1038/ajh.2009.131] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND To determine all-cause and circulatory system (cardiovascular)-related mortality in subjects with different grades of hypertension, we performed a prospective study. METHODS A total of 148,173 individuals aged > or =35 years were recruited in Mumbai, India in years 1991-1997. Clinical history and anthropometric data were obtained and hypertension-categorized using US 7th Joint National Committee guidelines into normal, prehypertension, stage-I, and stage-II. These subjects were followed to ascertain vital status from 1997 to 2003. Multivariate analysis was performed using Cox proportional analyses and adjusted hazard ratios (HRs), 95% confidence intervals (CIs) determined for mortality in various hypertension grades. RESULTS At baseline, hypertension was in 47.3% men and 45.7% women, while prehypertension in 40.8% men and 35.9% women. In total, 13,261 persons died during average 5.5 years follow-up of whom 9,259 deaths were matched and coded using International Classification of Diseases-10. Compared to those with normal blood pressure (BP), all cause mortality (HR, 95% CI) was significantly greater in stage-II (men 1.41, 1.31-1.52; women 1.46, 1.30-1.64). Circulatory system deaths were significantly more in stage-II (men 2.05, 1.77-2.39; women 2.06, 1.62-2.61) as well as stage-I (men 1.31, 1.14-1.52; women 1.39, 1.10-1.77). Subjects with stage-II hypertension had greater risk of death from hypertensive heart disease (men 2.77, 1.75-4.40; women 3.04, 1.73-5.35), ischemic heart disease (men 1.87, 1.54-2.28; women 1.85, 1.29-2.65), and cerebrovascular diseases (men 3.50, 2.42-5.05; women 3.09, 1.77-5.39). CONCLUSIONS In urban Indian subjects, compared to normal BP stage-II hypertension is associated with increased risk of all-cause mortality, while both stage-II and stage-I hypertension with circulatory system-related mortality.
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Prevalence of prehypertension, hypertension and, associated risk factors in Mongolian and Han Chinese populations in Northeast China. Int J Cardiol 2008; 128:250-4. [DOI: 10.1016/j.ijcard.2007.08.127] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2007] [Revised: 08/15/2007] [Accepted: 08/18/2007] [Indexed: 12/26/2022]
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Prevalence and management of prehypertension and hypertension by geographic regions of Thailand: the Third National Health Examination Survey, 2004. J Hypertens 2008; 26:191-8. [PMID: 18192831 DOI: 10.1097/hjh.0b013e3282f09f57] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To determine the prevalence of prehypertension and hypertension, and management of hypertension, by geographic regions of Thailand. METHODS Using a stratified, multistage sampling design, data from a nationally representative sample of 39 290 individuals aged > or = 15 years were collected by interview, physical examination and blood sample. RESULTS The prevalence of hypertension and prehypertension weighted to the national 2004 population was 22.0% [95% confidence interval (CI) = 20.5-23.6] and 32.8% (95% CI = 31.5-34.1), respectively, with a higher prevalence in men compared to women. Hypertension was more common in urban compared to rural men, but similar between urban and rural women. Despite some variation, the prevalence of hypertension and prehypertension was relatively uniform across geographical regions. Of those identified as having hypertension in the survey, 69.8% (95% CI = 67.8-71.7) were unaware that they had hypertension. Although the majority of those who were aware (78.2%; 95% CI = 75.8-80.5) had taken blood pressure-lowering drugs in the last 2 weeks, of these only 36.6% (95% CI = 33.3-40.0) had blood pressure < 140/90 mmHg. Rural populations and those from the economically poorer Northeast region were more likely to be unaware that they had hypertension. CONCLUSION Compared to previous surveys, the prevalence of hypertension and prehypertension is rising rapidly, and is spread relatively evenly across regions of Thailand. Levels of awareness of hypertension were low across the country. A challenging task remains in improving screening, treatment and control of hypertension at the same time as promoting healthier lifestyles.
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Choi KM, Park HS, Han JH, Lee JS, Lee J, Ryu OH, Lee KW, Cho KH, Yoon D, Baik SH, Choi DS, Kim SM. Prevalence of prehypertension and hypertension in a Korean population: Korean National Health and Nutrition Survey 2001. J Hypertens 2006; 24:1515-21. [PMID: 16877953 DOI: 10.1097/01.hjh.0000239286.02389.0f] [Citation(s) in RCA: 123] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The present study aimed to determine the prevalence of prehypertension and hypertension, and their association with the risk factors in a Korean population. DESIGN The Korean Nation Health and Nutrition Survey 2001, a cross-sectional survey, was a nationally representative survey in which a stratified multistage sampling design was used. METHODS Data from a comprehensive questionnaire, together with a physical examination and blood sample, were obtained from 6074 Korean adults (2620 men and 3454 women) aged > or = 20 years, and analysed. RESULTS The estimated age-adjusted prevalence of hypertension and prehypertension was 22.9% (26.9% in men, 20.5% in women) and 31.6% (41.9% in men, 25.9% in women), respectively, in the Korean population according to Joint National Committee 7 criteria. Multivariate analysis revealed that age, gender, body mass index, fasting plasma glucose, total-cholesterol and alcohol consumption were significantly associated with hypertension. Overall, only 30.2% of the hypertensive individuals had been previously diagnosed. Furthermore, 22.9% of the hypertensive individuals were being treated with antihypertensive medication, but only 10.7% had their blood pressure adequately controlled. The rates of awareness, treatment and control were higher for the women than for the men, and these rates increased with age. CONCLUSION Hypertension and prehypertension are common in Korea, and more than one-half of the hypertensive patients have not been diagnosed. These results place great emphasis on the urgent need for a public health program to improve the detection, prevention and treatment of hypertension and prehypertension.
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Affiliation(s)
- Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Abstract
Hypertension is the leading cause of cardiovascular disease worldwide. Prior to 1990, population data suggest that hypertension prevalence was decreasing; however, recent data suggest that it is again on the rise. In 1999-2002, 28.6% of the U.S. population had hypertension. Hypertension prevalence has also been increasing in other countries, and an estimated 972 million people in the world are suffering from this problem. Incidence rates of hypertension range between 3% and 18%, depending on the age, gender, ethnicity, and body size of the population studied. Despite advances in hypertension treatment, control rates continue to be suboptimal. Only about one third of all hypertensives are controlled in the United States. Programs that improve hypertension control rates and prevent hypertension are urgently needed.
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Affiliation(s)
- Ihab Hajjar
- Department of Medicine, Harvard Medical School and Hebrew Senior Life, 1200 Centre St., Boston, Massachusetts 02131, USA.
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Agyemang C, Bindraban N, Mairuhu G, Montfrans GV, Koopmans R, Stronks K. Prevalence, awareness, treatment, and control of hypertension among Black Surinamese, South Asian Surinamese and White Dutch in Amsterdam, The Netherlands: the SUNSET study. J Hypertens 2006; 23:1971-7. [PMID: 16208137 DOI: 10.1097/01.hjh.0000186835.63996.d4] [Citation(s) in RCA: 120] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess ethnic differences in prevalence, levels of awareness, treatment and control of hypertension among Dutch ethnic groups and to determine whether these differences are consistent with the UK findings. DESIGN Cross-sectional survey. SETTING South-east Amsterdam, The Netherlands. PARTICIPANTS A random sample of 1383 non-institutional adults aged 35-60 years. Of these, 36.7% were White, 42% were Black and 21.3% were South Asian people. MAIN OUTCOME MEASURES Prevalence of hypertension, rates of awareness, treatment, and control of hypertension. RESULTS The Black and South Asian subjects had a higher prevalence of hypertension compared with White people. After adjustments for age, the odds ratios (95% confidence interval) for being hypertensive were 2.2 (1.4-3.4; P < 0.0001) and 3.8 (2.6-5.7; P < 0.0001) for Black men and women, respectively, and 1.7 (1.0-2.6; P = 0.039) and 2.8 (1.8-4.5; P < 0.0001) for South Asian men and women, compared with White people. There were no differences in awareness and pharmacological treatment of hypertension between the groups. However, Black hypertensive men 0.3 (0.1-0.7; P < 0.01) and women 0.5 (0.3-0.9; P < 0.05) were less likely to have their blood pressure adequately controlled compared with White people. CONCLUSION The higher prevalence of hypertension found among Black and South Asian people in The Netherlands is consistent with the UK studies. However, the lower control rates and the similar levels of awareness and treatment of hypertension in Black Surinamese contrast with the higher rates reported in African Caribbeans in the UK. The rates for the South Asians in The Netherlands were relatively favourable compared to similar South Asian groups in the UK. These findings underscore the urgent need to develop strategies aimed at improving the prevention and control of hypertension, especially among Black people, in The Netherlands.
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Affiliation(s)
- Charles Agyemang
- Department of Social Medicine, Academic Medical Centre, University of Amsterdam, Netherlands.
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