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Convergence in urban–rural prevalence of hypertension in India

Journal of Human Hypertension volume 30, pages 79–82 (2016)Cite this article

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Abstract

Hypertension has emerged as important public health problem in India. During the later half of the last century, epidemiological studies in India reported that hypertension (diagnosed by systolic blood pressure (BP) ⩾160 and/or diastolic BP ⩾95 mm Hg) increased from about 1% in 1950’s to 15% in 1990’s in urban (R2=0.47) and from 0.5 to 7% in rural (R2=0.21) populations. Hypertension epidemiological studies from India in the last twenty years have shown that prevalence of hypertension (diagnosed by systolic BP ⩾140 mm Hg and/or diastolic BP ⩾90 mm Hg) in urban locations has stabilized to about 25–30% (R2=0.08) but it has increased in rural populations from 15 to 25% (R2=0.04). This urban–rural convergence of hypertension in India is due to rapid urbanization of rural populations with consequent changes in lifestyles (sedentariness, high dietary salt, sugar and fat intake) and increase in overweight and obesity. Hypertension prevention, screening and control, policies and programs, need to be widely implemented in India, especially in rural populations.

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References

  1. Patel V, Chatterji S, Chisholm D, Ebrahim S, Gopalakrishna G, Mathers C et al. Chronic diseases and injuries in India. Lancet 2011; 377: 413–428.

    Article  PubMed  Google Scholar 

  2. Gupta R, Al-Odat NA, Gupta VP . Hypertension epidemiology in India: Meta-analysis of fifty-year prevalence rates and blood pressure trends. J Hum Hypertens 1996; 10: 465–472.

    CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  4. Gupta R, Gupta N . Hypertension epidemiology in the 21st century India. J Prev Cardiol 2013; 2: 350–355.

    Google Scholar 

  5. Anchala R, Kannuri S, 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: 1170–1177.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Gupta R, Kaul V, Bhagat N, Agrawal M, Gupta VP, Misra A et al. Trends in prevalence of coronary risk factors in an urban Indian population: Jaipur Heart Watch-4. Indian Heart J 2007; 59: 346–353.

    PubMed  Google Scholar 

  7. Gupta R, Guptha S, Gupta VP, Agrawal A, Gaur K, Deedwania PC . Twenty year trends in cardiovascular risk factors in India and influence of educational status. Eur J Prev Cardiol 2012; 19: 1258–1271.

    Article  PubMed  Google Scholar 

  8. McKinsey Global Institute India’s Urban Awakening: Building Inclusive Cities, Sustaining Economic Growth. McKinsey and Company: NY, USA, 2010.

  9. Mishra N . The village that could be a town. Indian Express 2015; 83 (49): 11.

    Google Scholar 

  10. Chow CK, Lock K, Teo K, Subramanian SV, McKee M, Yusuf S . Environmental and societal influences acting on cardiovascular risk factors and disease at a population level: a review. Int J Epidemiol 2009; 38: 1580–1594.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Gupta R, Sharma AK . Prevalence of hypertension and subtypes in an Indian rural population: clinical and electrocardiographic correlates. J Human Hypertens 1994; 8: 823–829.

    CAS  Google Scholar 

  12. Gupta R, Guptha S, Gupta VP, Prakash H . Prevalence and determinants of hypertension in the urban population of Jaipur in Western India. J Hypertens 1995; 13: 1193–1200.

    Article  CAS  PubMed  Google Scholar 

  13. Anand MP . Prevalence of hypertension amongst Mumbai executives. J Assoc Physicians Ind 2000; 48: 1200–1201.

    CAS  Google Scholar 

  14. Gupta R, Gupta VP, Sarna M, Bhatnagar S, Thanvi J, Sharma V et al. Prevalence of coronary heart disease and risk factors in an urban Indian population: Jaipur Heart Watch-2. Indian Heart J 2002; 54: 59–66.

    PubMed  Google Scholar 

  15. Shanthirani CS, Pradeepa R, Deepa R, Premalatha G, Saroja R, Mohan V . Prevalence and risk factors of hypertension in a selected South Indian population: the Chennai Urban Population Study. J Assoc Physicians India 2003; 51: 20–27.

    CAS  PubMed  Google Scholar 

  16. Prabhakaran D, Shah P, Chaturvedi V, Ramakrishnan L, Manhapra A, Reddy KS . Cardiovascular risk factor prevalence among men in a large industry of northern India. Natl Med J India 2005; 18: 59–65.

    CAS  PubMed  Google Scholar 

  17. Reddy KS, Prabhakaran D, Chaturvedi V, Jeemon P, Thankappan KR, Ramakrishnan L et al. Methods for establishing a surveillance system for cardiovascular diseases in Indian industrial populations. Bull WHO 2006; 84: 461–469.

    CAS  PubMed  PubMed Central  Google Scholar 

  18. Mohan V, Deepa M, Farooq S, Dutta M, Deepa R . Prevalence, awareness and control of hypertension in Chennai: The Chennai Urban Rural Epidemiology Study. J Assoc Physicians India 2007; 55: 326–332.

    CAS  PubMed  Google Scholar 

  19. Kaur P, Rao TV, Sankarasubbaiyan S, Narayanan AM, Ezhil R, Rao SR et al. Prevalence and distribution of cardiovascular risk factors in an urban industrial population in south India: a cross sectional study. J Assoc Physicians India 2007; 55: 771–776.

    CAS  PubMed  Google Scholar 

  20. National Institute of Medical Statistics Integrated Disease Surveillance Project: Non-Communicable Disease Risk Factors Survey. Indian Council of Medical Research: New Delhi, India, 2009.

  21. Shah B, Mathur P . Surveillance of cardiovascular risk factors in India: the need and the scope. Indian J Med Res 2010; 132: 634–642.

    PubMed  PubMed Central  Google Scholar 

  22. Gupta R, Sharma KK, Gupta A, Agrawal A, Mohan I, Gupta VP et al. Persistent high prevalence of cardiovascular risk factors in the urban middle-class in India: Jaipur Heart Watch-5. J Assoc Physicians India 2012; 60: 11–16.

    PubMed  Google Scholar 

  23. Gupta R, Deedwania PC, Achari V, Bhansali A, Gupta BK, Gupta A et al. Normotension, prehypertension and hypertension in Asian Indians: prevalence, determinants, awareness, treatment and control. Am J Hypertens 2013; 26: 83–94.

    Article  CAS  PubMed  Google Scholar 

  24. Bhagyalaxmi A, Atul T, Shikha J . Prevalence of risk factors of non-communicable diseases in a district of Gujarat, India. J Health Popul Nutr 2013; 31: 78–85.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Bhansali A, Dhandhania VK, Mohan D, Anjana RM, Joshi SR, Joshi PP et al. Prevalence of and risk factors for hypertension in urban and rural India: the ICMR INDIAB study. J Hum Hypertens 2014; 29: 204–209.

    Article  PubMed  Google Scholar 

  26. Kusuma YS, Babu BV, Naidu JM . Prevalence of hypertension in some cross cultural populations of Vishakhapatnam district, South India. Ethn Dis 2004; 14: 250–259.

    PubMed  Google Scholar 

  27. Krishnan A, Shah B, Lal V, Shukla DK, Paul E, Kapoor SK . Prevalence of risk factors for non-communicable disease on a rural area of Faridabad district of Haryana. Indian J Pubic Health 2008; 52: 117–124.

    CAS  Google Scholar 

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

    Article  Google Scholar 

  29. 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: 423–424.

    PubMed  Google Scholar 

  30. By Y, Mr NG, Ag U . Prevalence, awareness, treatment and control of hypertension in rural areas of Davengere. Indian J Comm Med 2010; 35: 138–141.

    Article  Google Scholar 

  31. Kinra S, Bowen LJ, Lyngdoh T, Prabhakaran D, Reddy KS, Ramakrishnan L et al. Sociodemographic patterning of non-communicable disease risk factors in rural India: a cross sectional study. BMJ 2010; 341: c4974.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Kaur P, Rao SRT, Radhakrishnan E, Rajasekar E, Gupte MD . Prevalence, awareness, treatment and 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 

  33. Dutta A, Ray MR . Prevalence of hypertension and prehypertension in rural women: a report from the villages of West Bengal. A state in eastern part of India. Aust J Rural Health 2012; 20: 219–225.

    Article  PubMed  Google Scholar 

  34. Haddad S, Mohindra KS, Siekmans K, Mak G, Narayana D . Health divide between indigenous and non-indigenous populations in Kerala, India: population based study. BMC Public Health 2012; 12: 390.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Bansal SK, Saxena V, Kandpal SD, Gray WK, Walker RW, Goel D . The prevalence of hypertension and hypertension risk factors in a rural Indian community: a prospective door-to-door study. J Cardiovasc Dis Res 2012; 3: 117–123.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Meshram II, Arlappa N, Balkrishnan N, Rao KM, Laxmaiah A, Brahmam GN . Prevalence of hypertension, its correlates and awareness among adult tribal population of Kerala state, India. J Postgrad Med 2012; 58: 255–261.

    Article  CAS  PubMed  Google Scholar 

  37. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J . Global burden of hypertension: Analysis of worldwide data. Lancet 2005; 365: 217–223.

    Article  PubMed  Google Scholar 

  38. World Health Organization Global Status Report of Noncommunicable Diseases 2014. World Health Organization: Geneva, Switzerland, 2014.

  39. Danaei G, Finucane MM, Lin JK, Singh GM, Paciorek CJ, Cowan MJ et alGlobal Burden of Metabolic Risk Factors for Chronic Diseases Collaborating Group (Blood Pressure). National, regional and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and 5.4 million participants. Lancet 2011; 377: 568–577.

    Article  PubMed  Google Scholar 

  40. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL et alJoint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003; 42: 1206–1252.

    Article  CAS  PubMed  Google Scholar 

  41. Kuate-Defo B . Beyond the transition frameworks: the cross-continuum of health, disease and mortality framework. Glob Health Action 2014; 7: 1–16.

    Google Scholar 

  42. Arora NK, Pillai R, Dasgupta R, Garg PR . Whole-of-society monitoring framework for sugar, salt and fat consumption and noncommunicable diseases in India. Ann NY Acad Sci 2014; 1331: 157–173.

    Article  PubMed  Google Scholar 

  43. Gupta R, Singhal S . Coronary heart disease in India. Circulation 1997; 96: 3785.

    Article  CAS  PubMed  Google Scholar 

  44. Mukherjee S, Chakraborty D, Sikdar S Three decades of human development across Indian states: Inclusive growth or perpetual disparity? Working Paper No. 2014-139. New Delhi. National Institute of Public Finance and Policy. Available at http://www.nipfp.org.in/media/medialibrary/2014/06/WP_2014_139.pdf. Accessed on 14 January 2015.

  45. Misra A, Singhal N, Sivakumar B, Bhagat N, Jaiswal A, Khurana L . Nutrition transition in India: secular trends in dietary intake and their relationship to diet-related non-communicable diseases. J Diabetes 2011; 3: 278–292.

    Article  PubMed  Google Scholar 

  46. Gupta R, Gupta VP, Bhagat N, Rastogi P, Sarna M, Prakash H et al. Obesity is a major determinant of coronary risk factors in India: Jaipur Heart Watch Studies. Indian Heart J 2008; 60: 26–33.

    PubMed  Google Scholar 

  47. Wang Y, Chen HJ, Shaikh S, Mathur P . Is obesity becoming a public health problem in India? Examine the shift from under- to overnutrition problems over time. Obes Rev 2009; 10: 456–474.

    Article  CAS  PubMed  Google Scholar 

  48. Jamison DT, Summers LH, Alleyne G, Arrow KJ, Berkley S, Binagwaho A et al. Global Health 2035: a world converging within a generation. Lancet 2013; 382: 1898–1955.

    Article  PubMed  Google Scholar 

  49. Sridharan SE, Unnikrishnan JP, Sukumaran S, Sylaja PN, Nayak SD, Sarma PS et al. Incidence, types, risk factors and outcome of stroke in a developing country: the Trivandrum Stroke Registry. Stroke 2009; 40: 1212–1218.

    Article  PubMed  Google Scholar 

  50. O’Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, A-Melacini P et alINTERSTROKE Investigators. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet 2010; 376: 112–123.

    Article  PubMed  Google Scholar 

  51. Yusuf S, Rangarajan S, Teo K, Islam S, Wei L, Lisheng L et al. Cardiovascular risk and events in 17 low-, middle- and high-income countries. N Engl J Med 2014; 371: 818–827.

    Article  CAS  PubMed  Google Scholar 

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  1. Department of Medicine, Fortis Escorts Hospital, Jaipur, India

    R Gupta

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Gupta, R. Convergence in urban–rural prevalence of hypertension in India. J Hum Hypertens 30, 79–82 (2016). https://doi.org/10.1038/jhh.2015.48

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