Background
Hypertension is the most common cause of the rising cardiovascular disease (CVD) epidemic in India. However, despite availability of proven therapies management remains sub-optimal.
Purpose
To determine the hypertension control rates and associated factors among adults with known hypertension in urban and rural India.
Methods
We conducted a representative population based cross-sectional survey among 12243 participants aged ≥30 years residing in rural and urban North and South India. Participants were selected using a multistage cluster random sampling technique. Trained personnel collected the data using an interviewer administered questionnaire, measured blood pressure, conducted anthropometry and collected bio-samples. Hypertension was defined as known hypertension (self-report of physician diagnosis) or systolic blood pressure (SBP) ≥140 mmHg or diastolic blood pressure (DBP) ≥90 mmHg. Control was defined as SBP <140 mmHg and DBP <90 mmHg among those with known hypertension. The associations were measured using logistic regression.
Results
The mean (±SD) age of participants was 47.7 (±12.5) years, women comprised 54%. The age-standardized prevalence of hypertension was 29.0% (95% CI: 28.2- 29.8) and known hypertension was 14.0% (13.4- 14.6). Among all hypertensives 38.6% (37.0–40.2) were on treatment and 26.2% (24.6–28.0) had their blood pressure controlled, while among known hypertensives 79.8% (77.8–81.7) were on treatment and 55.7% (53.3–58.1) had their blood pressure controlled. In multivariate analysis, participants from North Indian site [OR: 1.9 (1.6–2.3)], urban residents [1.3 (1.1–1.6)], younger participants [1.5 (1.2–1.8)], men [2.0 (1.5–2.6)], those with low socio-economic status [1.6 (1.1–2.3)], without comorbidities and those without a family history hypertension were more likely to be unaware about their hypertensive status and less likely to take treatment. Hypertension control was significantly higher in participants from South Indian site [1.5 (1.2–1.0)], the highly educated [1.6 (1.1–2.4)], those without heart diseases [1.8 (1.1–3.1)], those without central obesity [1.4 (1.1–1.9)], physically active individuals [1.5 (1.1–2.0)] and current non-alcohol users [1.9 (1.3–2.6)].
Conclusions
Many individuals with hypertension remain unaware and sub-optimally managed. This warrants the implementation of tailored public education to raise awareness, complemented by active screening for the early detection and effective management of hypertension, in order to stem the rising tide of preventable CVD in India.
Acknowledgement/Funding
Unrestricted educational grant from Eli Lilly under the Lilly NCD Partnership
Lifestyle disorders are becoming the major cause of ill health and disability worldwide. Hemorrhoid is one such disease which makes human life miserable. Hemorrhoids is nothing but the varicosity of blood vessels found inside or around the bottom the rectum and anus. Age group of 45-65yrs, it is estimated that 50-85% of people around the world have hemorrhoids.[1] In India 75% of the population is estimated. Clinical features of hemorrhoid resembles with Arshas. In Ayurveda classics, there are detail information about the Aharaja (Anashana, Adhyashana), Viharaja (Ativyayama, Divaswapna), Manasika (Shoka, Krodha) and Agantujanidanas (Gudakharshana, Vastivibhrama) which are responsible for the manifestation of Arsha. Common symptoms are itching, burning sensation and pain in the region of Guda and finally bleeds.[2] Maintaining the health and providing the health is the main motto of Ayurveda. This ground incorporates usage of different remedies with focusing on Nidana Parivarjana. Thus understanding the Nidana Parivarjana is the prime importance. In this study an effort is done to identify the prime causative factors in deal to Arshas.
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