Normotension, Prehypertension, and Hypertension in Urban Middle-Class Subjects in India: Prevalence, Awareness, Treatment, and Control

• Published in: American journal of hypertension Vol. 26; no. 1; pp. 83 - 94
• Main Authors: Gupta, Rajeev, Deedwania, Prakash C., Achari, Vijay, Bhansali, Anil, Gupta, Bal Kishan, Gupta, Arvind, Mahanta, Tulika G., Asirvatham, Arthur J., Gupta, Sunil, Maheshwari, Anuj, Saboo, Banshi, Jali, Mallikarjuna V., Singh, Jitendra, Guptha, Soneil, Sharma, Krishna Kumar
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 01.01.2013
• Subjects: Adult; Age; Aged; Blood Pressure; Dietary Fats - administration & dosage; Female; Health Knowledge, Attitudes, Practice; Health risk assessment; Humans; Hypercholesterolemia - epidemiology; Hypertension; Hypertension - epidemiology; Hypertension - therapy; India - epidemiology; Male; Metabolic Syndrome - epidemiology; Middle Aged; Middle class; Prehypertension - epidemiology; Prehypertension - therapy; Prevalence; Risk Factors; Smoking - epidemiology; Social Class; Urban Population; Women; epidemiology; blood pressure; low-income countries; cardiovascular risk factors; hypertension
• ISSN: 0895-7061; 1941-7225; 1941-7225
• DOI: 10.1093/ajh/hps013

OBJECTIVE We conducted a multisite study to determine the prevalence and determinants of normotension, prehypertension, and hypertension, and awareness, treatment, and control of hypertension among urban middle-class subjects in India. METHODS We evaluated 6,106 middle-class urban subjects (men 3,371; women, 2,735; response rate, 62%) in 11 cities for sociodemographic and biological factors. The subjects were classified as having normotension (BP < 120/80), prehypertension (BP 120-139/80-89), and hypertension (documented or BP ≥ 140/90). The prevalence of other cardiovascular risk factors was determined and associations evaluated through logistic regression analysis. RESULTS The age-adjusted prevalences in men and women of normotension were 26.7% and 39.1%, of prehypertension 40.2% and 30.1%, and of hypertension 32.5% and 30.4%, respectively. The prevalence of normotension declined with age whereas that of hypertension increased (P-trend < 0.01). A significant association of normotension was found with younger age, low dietary fat intake, lower use of tobacco, and low obesity (P < 0.05). The prevalence of hypercholesterolemia, diabetes, and metabolic syndrome was higher in the groups with prehypertension and hypertension than in the group with normotension (age-adjusted odds ratios (ORs) 2.0-5.0, P < 0.001). The prevalences in men and women, respectively, of two or more risk factors were 11.1% and 6.4% in the group with normotension, 25.1% and 23.3% in the group with prehypertension, and 38.3% and 39.1% in the group with hypertension (P < 0.01). Awareness of hypertension in the study population was in 55.3%; 36.5% of the hypertensive group were receiving treatment for hypertension, and 28.2% of this group had a controlled BP (< 140/90mm Hg). CONCLUSIONS The study found a low prevalence of normotension and high prevalence of hypertension in middle-class urban Asian Indians. Significant associations of hypertension were found with age, dietary fat, consumption of fruits and vegetables, smoking, and obesity. Normotensive individuals had a lower prevalence of cardiometabolic risk factors than did members of the prehypertensive or hypertensive groups. Half of the hypertensive group were aware of having hypertension, a third were receiving treatment for it, and quarter had a controlled BP.