Convergence in urban–rural prevalence of hypertension in India

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 (R(2)=0.47) and from 0.5 to 7% in rural (R(2)=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% (R(2)=0.08) but it has increased in rural populations from 15 to 25% (R(2)=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.

Trends in Coronary Heart Disease Epidemiology in India

“…62 There is an urban-rural convergence in hypertension prevalence in India. 60 Review of hypertension epidemiology studies over the last 20 years (1995-2015) indicates that although its prevalence has stabilized at 28%-32% in urban populations, in rural populations it has increased from 10%-12% in 1990s to 22%-25% presently. Similarly, serial NFHS studies have reported a more rapid increase in obesity in Indian rural populations than in urban populations.…”

“…59,60 Smoking and nonsmoked tobacco continues to increase in rural and less literate populations, while it is declining in more educated urban populations. 59 The epidemic of sedentariness has penetrated rural households with rapidly increasing use of labor-saving technologies.…”

Hypertension and Cardiovascular Trends in India

“…Several Indian studies over the years have shown increasing prevalence of HTN in both urban and rural areas. [1,[9][10][11][12][13] In the mid-1950s, epidemiological studies had employed older World Health Organization diagnostic definitions (SBP ≥ 160 mmHg and/or diastolic BP [DBP] ≥95 mmHg) and reported an urban prevalence of 1.2-4%. The urban prevalence of HTN has been steadily rising from around 3-4% in the early 1960s to [11][12][13][14][15].5% in the mid-1900s.…”

“…[1,[9][10][11][12][13] In the mid-1950s, epidemiological studies had employed older World Health Organization diagnostic definitions (SBP ≥ 160 mmHg and/or diastolic BP [DBP] ≥95 mmHg) and reported an urban prevalence of 1.2-4%. The urban prevalence of HTN has been steadily rising from around 3-4% in the early 1960s to [11][12][13][14][15].5% in the mid-1900s. The prevalence in rural areas though low has also shown a significant rise from <1% in the early 1960s to 5-7% in the late 1990s� [11] Later studies of prevalence employed the JNC-7 diagnostic criteria (known HTN or SBP ≥140 mmHg and/or DBP ≥90 mmHg).…”

A Study of Adverse Effects Profile of Various Antihypertensive Drugs Among Hypertensive Patients in a Tertiary Care Centre

“…3 The epidemiological studies of last 20 years show that prevalence of hypertension in urban location has stabilised to about 20-30% but it has increased in rural population from 15 to 25%. 4 Residual lifetime risk for developing hypertension in middle-aged and elderly individuals is 90%, indicating a huge public health burden. 5 The aim of hypertensive therapy is to prevent morbidity and mortality associated with persistent raised BP by lowering it to an acceptable level with minimum inconvenience to the patient.…”