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Hypertension is an important risk determinant for chronic kidney disease: results from a cross-sectional, observational study from a rural population in South India

Journal of Human Hypertension volume 31, pages 327–332 (2017)Cite this article

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A Corrigendum to this article was published on 05 April 2017

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Abstract

Hypertension (HTN) is an important cause for chronic kidney disease (CKD). There is a paucity of studies exploring the association of HTN with CKD from rural India. The objective of the study was to determine the prevalence and the determinants for HTN in a rural population in South India, focusing on the association with CKD. In a cross-sectional study on 2984 adults in three villages, demographic and anthropometric data were collected. Blood pressure was recorded on all individuals and prevalence was estimated. Proteinuria, microalbuminuria (MA) and estimated glomerular filtration rate (eGFR) were determined in a subgroup of 1331 subjects and the relation with HTN was analysed. Prevalence of HTN was 30.4% (95% CI 28.75–32.05%). In all, 78.08% had stage 1 HTN while 22% had stage 2 HTN. In total, 27.4% (249/908) subjects were aware of their hypertensive status. Of them, only 14.4% had adequate control of blood pressure. Age>50 years, diabetes, body mass index >25 and eGFR<60 ml min−1 were independent significant predictors of HTN (P<0.05). HTN was found to be an important risk factor for CKD even after adjusting for age, diabetes and cardiovascular risk factors (OR 2.22, 95% CI 1.46–3.36, P<0.001). The high prevalence of HTN, very low level of awareness and control, and the significant association with kidney disease indicate a need for stronger public health initiative with better penetration for awareness and screening for HTN and CKD in India’s villages.

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  • 05 April 2017

    This article has been corrected since Advance Online Publication and a corrigendum is also printed in this issue.

References

  1. WHO. A global brief on hypertension 2013. Available at: http://www.who.int/cardiovascular_diseases/publications/global_brief_hypertension/en/ (accessed on 17 April 2016).

  2. Nadar SK . Epidemiological studies in hypertension: more relevant than ever. J Hum Hypertens 2016; 30: 219–220.

    Article  CAS  PubMed  Google Scholar 

  3. Midha T, Nath B, Kumari R, Rao YK, Pandey U . Prevalence of hypertension in India: a meta-analysis. World J Meta-Anal 2013; 1 (2): 83–89.

    Article  Google Scholar 

  4. Anchala R, Kannuri NK, Pant H, Khan H, Franco OH, Di Angelantonio E et al. Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hypertens 2014; 32 (6): 1170–1177.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Devi P, Rao M, Sigamani A, Faruqui A, Jose M, Gupta R et al. Prevalence, risk factors and awareness of hypertension in India: a systematic review. J Hum Hypertens 2013; 27: 281–287.

    Article  CAS  PubMed  Google Scholar 

  6. Hazarika NC, Narain K, Biswas D, Kalita HC, Mahanta J . Hypertension in the native rural population of Assam. Natl Med J India 2004; 17 (6): 300–304.

    CAS  PubMed  Google Scholar 

  7. Bhardwaj R, Kandori A, Marwah R, Vaidya P, Singh B, Dhiman P et al. Prevalence, awareness and control of hypertension in rural communities of Himachal Pradesh. J Assoc Physicians India 2010; 58: 423–425.

    PubMed  Google Scholar 

  8. Todkar SS, Gujarathi VV, Tapare VS . Period prevalence and sociodemographic factors of hypertension in rural Maharashtra: a cross-sectional study. Indian J Community Med 2009; 34: 183–187.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kaur P, Rao SR, Radhakrishnan E, Rajasekar D, Gupte MD . Prevalence, awareness, treatment, control and risk factors for hypertension in a rural population in South India. Int J Public Health 2012; 57: 87–94.

    Article  PubMed  Google Scholar 

  10. Thankappan KR, Sivasankaran S, Sarma PS, Mini G, Khader SA, Padmanabhan P et al. Prevalence-correlates-awareness-treatment and control of hypertension in Kumarakom, Kerala: baseline results of a community-based intervention program. Indian Heart J 2006; 58 (1): 28–3.

    CAS  PubMed  Google Scholar 

  11. Mohan S, Campbell N, Chockalingam A . Time to effectively address hypertension in India. Indian J Med Res 2013; 137: 627–631.

    CAS  PubMed  PubMed Central  Google Scholar 

  12. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification. Am J Kidney Dis 2002; 39: S1–S266.

    Google Scholar 

  13. Rahman M, Brown CD, Coresh J, Davis BR, Eckfeldt JH, Kopyt N et al. The prevalence of reduced glomerular filtration rate in older hypertensive patients and its association with cardiovascular disease: a report from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Arch Intern Med 2004; 164 (9): 969–976.

    Article  PubMed  Google Scholar 

  14. Klag MJ, Whelton PK, Randall BL, Neaton JD, Brancati FL, Ford CE et al. Blood pressure and end-stage renal disease in men. N Engl J Med 1996; 334: 13–18.

    Article  CAS  PubMed  Google Scholar 

  15. Reynolds K, Dongfeng GuD, Muntner P, Kusek JW, Chen J, Wu X et al. A population-based, prospective study of blood pressure and risk for end-stage renal disease in China. J Am Soc Nephrol 2007; 18: 1928–1935.

    Article  PubMed  Google Scholar 

  16. Anupama YJ, Uma G . Prevalence of chronic kidney disease among adults in a rural community in South India: results from the kidney disease screening (KIDS) project. Indian J Nephrol 2014; 24 (4): 214–221.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure: The JNC 7 report. JAMA 2003; 289: 2560–2572.

    Article  CAS  PubMed  Google Scholar 

  18. American Diabetes Association. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 1997; 20: 1183–1197.

  19. WHO. Obesity: preventing and managing the global epidemic. Report of a WHO Consultation. WHO Technical Report Series 894. Geneva: World Health Organization, 2000. Available at: http://apps.who.int/bmi/index.jsp (accessed 11 August 2016).

  20. Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, Rossert J et al. Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 2005; 67 (6): 2089–2100.

    Article  PubMed  Google Scholar 

  21. Vassalotti JA, Stevens LA, Levey AS . Testing for chronic kidney disease: a position statement from the National Kidney Foundation. Am J Kidney Dis 2007; 50: 169–180.

    Article  CAS  PubMed  Google Scholar 

  22. Yuvaraj BY, Nagendra Gowda MR, Umakantha AG . Prevalence, awareness, treatment, and control of hypertension in rural areas of Davanagere. Indian J Community Med 2010; 35 (1): 138–141.

    Article  Google Scholar 

  23. Gupta R . Trends in hypertension epidemiology in India. J Hum Hypertens 2004; 18: 73–78.

    Article  CAS  PubMed  Google Scholar 

  24. Gupta R . Convergence in urban–rural prevalence of hypertension in India. J Hum Hypertens 2016; 30: 79–82.

    Article  CAS  PubMed  Google Scholar 

  25. Bhansali A, Dhandania VK, Deepa M, Anjana RM, Joshi SR, Madhu SV et al. Prevalence of and risk factors for hypertension in urban and rural India: the ICMR–INDIAB study. J Hum Hypertens 2015; 29: 204–209.

    Article  CAS  PubMed  Google Scholar 

  26. Chowdhury MAB, Jamal Uddin M, Rabiul Haque M, Ibrahimou B . Hypertension among adults in Bangladesh: evidence from a national cross-sectional survey. BMC Cardiovasc Disord 2016; 16: 22.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Wang J, Zhang L, Wang F, Liu L, Wang H . China National Survey of Chronic Kidney Disease Working Group. Prevalence, awareness, treatment, and control of hypertension in China: results from a national survey. Am J Hypertens 2014; 27 (11):1355–1361.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Musinguzi G, Nuwaha F . Prevalence, awareness and control of hypertension in Uganda. PLoS ONE 2013; 8 (4): e62236.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Camara A, Baldé NM, Diakité M, Sylla D, Baldé E, Kengne AP et al. High prevalence, low awareness, treatment and control rates of hypertension in Guinea: results from a population-based STEPS survey. J Hum Hypertens 2016; 30 (4): 237–244.

    Article  CAS  PubMed  Google Scholar 

  30. Mente A, O'Donnell MJ, Rangarajan S, McQueen MJ, Poirier P, Wielgosz A et al. Association of urinary sodium and potassium excretion with blood pressure. N Engl J Med 2014; 371: 601–611.

    Article  PubMed  Google Scholar 

  31. Radhika G, Sathya RM, Sudha V, Ganesan A, Mohan V . Dietary salt intake and hypertension in an urban South Indian population – [CURES-53]. J Assoc Physicians India 2007; 55 (6): 405–411.

    CAS  PubMed  Google Scholar 

  32. Singh NP, Ingle GK, Saini VK, Jami A, Beniwal P, Lal M et al. Prevalence of low glomerular filtration rate, proteinuria and associated risk factors in North India using Cockcroft-Gault and Modification of Diet in Renal Disease equation: an observational, cross-sectional study. BMC Nephrol 2009; 10: 4.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Mohan V, Meera R, Premalatha G, Deepa R, Miranda P, Rema M . Frequency of proteinuria in type 2 diabetes mellitus seen at a diabetes centre in southern India. Postgrad Med J 2000; 76 (899): 569–573.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Farag Youssef MK, Mittal BV, Keithi-Reddy S, Acharya VN, Almeida AF, Anil C et al. Burden and predictors of hypertension in India: results of SEEK (Screening and Early Evaluation of Kidney Disease) study. BMC Nephrol 2014; 15: 42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

Association of Physicians of India, Karnataka Chapter for the funding of this study. Nanjappa Hospital, Shivamogga; Faculty and staff Nanjappa Institute of Nursing, College of Nursing for logistic support. Ms Revathy Arunkumar, Biostatistician, Shivamogga.

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Authors and Affiliations

  1. Department of Nephrology, Nanjappa Hospital, Shivamogga, Karnataka, India

    Y J Anupama

  2. Anushri Medical Center, Shivamogga, Karnataka, India

    S N Hegde

  3. Department of Nursing, Nanjappa Institute of Nursing Sciences, College of Nursing, Shivamogga, Karnataka, India

    G Uma & M Patil

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Correspondence to Y J Anupama.

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Anupama, Y., Hegde, S., Uma, G. et al. Hypertension is an important risk determinant for chronic kidney disease: results from a cross-sectional, observational study from a rural population in South India. J Hum Hypertens 31, 327–332 (2017). https://doi.org/10.1038/jhh.2016.81

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