- Email: [email protected]
High prevalence of hypertension in rural and urban Indian populations
High Prevalence of Hypertension in Rural and Urban Indian Populations R. Gupta, A.K. Sharma, and H. Prakash
H
YPERTENSION is a major cardiovascular and renal risk factor. In contrast to developed countries, where hypertension prevalence is falling, its prevalence is increasing in developing countries.1,2 In addition, there is a low awareness and treatment status of hypertension in these countries.3 Prevalence of hypertension using recent guidelines has not been determined in India. To determine age-specific blood pressure (BP) levels and prevalence of hypertension according to JNC-V criteria4 we performed surveys in rural and urban populations in Rajasthan, India. METHODS Randomly selected 3148 rural (1982 men, 1166 women) and 2122 urban (1415 men, 797 women) subjects, aged over 20 years, were studied using WHO guidelines. Detailed methodology has been reported previously.5 Hypertension was diagnosed when systolic BP ⱖ 140 or diastolic BP ⱖ90 mm Hg, or known hypertensives on treatment was present. Hypertension risk factors (diet, physical inactivity, smoking, body-mass index and truncal obesity) were also evaluated.
RESULTS
Mean BP levels were: systolic (men: rural 127 ⫾ 14, urban 125 ⫾ 17; women: rural 124 ⫾ 13, urban 126 ⫾ 18); diastolic (men: rural 81 ⫾ 8, urban 81 ⫾ 9; women: rural 80 ⫾ 8, urban 81 ⫾ 12). In the rural population hypertension was present in 470 men (23.7%) and 197 women (16.9%) while in the urban group it was in 417 men (29.5%) and 267 women (33.5%). Prevalence of hypertension was significantly greater in urban subjects (P ⬍ .05). There was significant correlation of hypertension prevalence with age, smoking, physical inactivity, body-mass index, and truncal
0041-1345/00/$–see front matter PII S0041-1345(00)01456-1 1840
obesity (P ⬍ .05). Low awareness of hypertension was seen in rural (7% men, 8% women) and urban areas (11% men, 16% women). Seventy-three percent of diagnosed hypertensives in rural and 61% in urban areas were on some form of medication, although control of hypertension was poor. COMMENT
This study shows that hypertension is a major problem in India. These prevalence rates are lower than the United States4 but are similar to many developing countries of Asia and South America.3 Greater prevalence of hypertension in urban subjects indicates that stresses of urbanisation are important in its genesis as ethnically both urban and rural groups are similar. Public awareness regarding diagnosis and control of hypertension is urgently needed in developing countries to prevent its renal and cardiovascular complications. REFERENCES 1. Whelton PK: Lancet 344:101, 1994 2. Gupta R, Al-Odat NA, Gupta VP: J Hum Hypertens 10:465, 1996 3. INCLEN Multicentre Collaborative Group: J Clin Epidemol 45:841, 1992 4. The Expert Panel: Arch Intern Med 153:154, 1993 5. Gupta R: Nat Med J Ind 10:139, 1997 From the Departments of Medicine (R.G., H.P.) and Nephrology (A.K.S.), Monilek Hospital and Research Centre, Jaipur, India. Address reprint requests to Dr R. Gupta, Monilek Hospital, Jawahar Nagar, Jaipur, India 302004.
© 2000 by Elsevier Science Inc. 655 Avenue of the Americas, New York, NY 10010 Transplantation Proceedings, 32, 1840 (2000)
H
YPERTENSION is a major cardiovascular and renal risk factor. In contrast to developed countries, where hypertension prevalence is falling, its prevalence is increasing in developing countries.1,2 In addition, there is a low awareness and treatment status of hypertension in these countries.3 Prevalence of hypertension using recent guidelines has not been determined in India. To determine age-specific blood pressure (BP) levels and prevalence of hypertension according to JNC-V criteria4 we performed surveys in rural and urban populations in Rajasthan, India. METHODS Randomly selected 3148 rural (1982 men, 1166 women) and 2122 urban (1415 men, 797 women) subjects, aged over 20 years, were studied using WHO guidelines. Detailed methodology has been reported previously.5 Hypertension was diagnosed when systolic BP ⱖ 140 or diastolic BP ⱖ90 mm Hg, or known hypertensives on treatment was present. Hypertension risk factors (diet, physical inactivity, smoking, body-mass index and truncal obesity) were also evaluated.
RESULTS
Mean BP levels were: systolic (men: rural 127 ⫾ 14, urban 125 ⫾ 17; women: rural 124 ⫾ 13, urban 126 ⫾ 18); diastolic (men: rural 81 ⫾ 8, urban 81 ⫾ 9; women: rural 80 ⫾ 8, urban 81 ⫾ 12). In the rural population hypertension was present in 470 men (23.7%) and 197 women (16.9%) while in the urban group it was in 417 men (29.5%) and 267 women (33.5%). Prevalence of hypertension was significantly greater in urban subjects (P ⬍ .05). There was significant correlation of hypertension prevalence with age, smoking, physical inactivity, body-mass index, and truncal
0041-1345/00/$–see front matter PII S0041-1345(00)01456-1 1840
obesity (P ⬍ .05). Low awareness of hypertension was seen in rural (7% men, 8% women) and urban areas (11% men, 16% women). Seventy-three percent of diagnosed hypertensives in rural and 61% in urban areas were on some form of medication, although control of hypertension was poor. COMMENT
This study shows that hypertension is a major problem in India. These prevalence rates are lower than the United States4 but are similar to many developing countries of Asia and South America.3 Greater prevalence of hypertension in urban subjects indicates that stresses of urbanisation are important in its genesis as ethnically both urban and rural groups are similar. Public awareness regarding diagnosis and control of hypertension is urgently needed in developing countries to prevent its renal and cardiovascular complications. REFERENCES 1. Whelton PK: Lancet 344:101, 1994 2. Gupta R, Al-Odat NA, Gupta VP: J Hum Hypertens 10:465, 1996 3. INCLEN Multicentre Collaborative Group: J Clin Epidemol 45:841, 1992 4. The Expert Panel: Arch Intern Med 153:154, 1993 5. Gupta R: Nat Med J Ind 10:139, 1997 From the Departments of Medicine (R.G., H.P.) and Nephrology (A.K.S.), Monilek Hospital and Research Centre, Jaipur, India. Address reprint requests to Dr R. Gupta, Monilek Hospital, Jawahar Nagar, Jaipur, India 302004.
© 2000 by Elsevier Science Inc. 655 Avenue of the Americas, New York, NY 10010 Transplantation Proceedings, 32, 1840 (2000)