Hypertension: prevalence, awareness, treatment and control in a rural area of North Kerala, India

Abstract

Background: High blood pressure is prevalent all over the world and is one of the major causes of cardiovascular morbidity and mortality. In considerable proportion of cases the disease tends to be asymptomatic for prolonged time, hence also labelled as “silent killer”. Awareness, treatment, and control of hypertension remain major challenges worldwide. The objective of this study was to determine the prevalence, awareness, treatment and control of hypertension in Northern Kerala. Methods: A community-based cross-sectional study among 687 subjects aged ≥20 years was conducted from March 2017 to July 2017. Data was collected by personal interviews, followed by anthropometric and blood pressure measurements. Diagnosis of hypertension was based on Joint National Committee (JNC) VIII guidelines. Results: The prevalence of hypertension (JNC VIII) was 48.2% with a 95% confidence interval ranging from 44.46% to 51.94%. Prevalence among males: 58.1% and females: 44.5%. Among the total hypertensives, 38.7% were aware. Of these, 94.5% taking treatment, 47.1% achieved adequate blood pressure control. Advancing age, current diabetic status, body mass index, and family history of hypertension were identified as risk factors for hypertension by multivariate logistic regression. Conclusions: High prevalence of hypertension was observed in the population. The low levels of awareness and control underscores the large gap between evidence and practice that needs to be bridged, for effective control of hypertension. This calls for plan to adopt preventive and control strategies and promote the health of the population.

Factors Associated With Hypertension Awareness, Treatment, and Control Among Adults in Kerala, India

“…Compared with previous systematic reviews on the region-specific prevalence of hypertension which found about 25% of rural population and 21% of the South India population had hypertension ( 33 ), about 27% of participants in our study (mostly rural residents) were found to have hypertension. The level of hypertension awareness, treatment, and control in previous studies conducted in Kerala varies across districts and age groups, with lower awareness found in Trivandrum (16.8%) ( 34 ), Kannur district (38.7%) ( 14 ), and higher in Ernakulam district with older age groups (78%) ( 15 ), comparing to 54% found in our study in rural Kerala. Compared with one of the earliest cohorts in Kerala to study the incidence of hypertension ( 35 ), we found slightly higher rates of awareness (54.4 vs. 42.9%) and treatment (25.5 vs. 22.9%).…”

“…In India, several studies have investigated the prevalence of hypertension awareness, treatment, and control ( 14 – 16 ). Factors associated with these rates were only explored in cross-sectional studies and also, only a limited number of potential factors were investigated ( 9 ).…”

Rationale, design, and baseline characteristics of the Salt Substitute in India Study (SSiIS): The protocol for a double‐blinded, randomized‐controlled trial

“…Hypertension is one of the leading causes of disease in India and causes huge health and economic burdens 1‐3 . While blood pressure (BP) control has improved substantially in many high‐income countries, effective management of hypertension in low‐ and middle‐income settings remains challenging 4,5 . Joint interventions that utilize drug‐based strategies, dietary interventions, and other behavioral approaches are advocated by most national and international hypertension societies, including in India 6 .…”