A study published in the Journal of Human Hypertension — a medical journal — shows that there is an urgent need to have a robust health care system to detect hypertension in the country. The study, which is phase I of the Indian Council of Medical Research–India Diabetes (ICMR–INDIAB), revealed that at every age interval the prevalence of hypertension in urban areas is higher compared to rural prevalence of hypertension in the country.
"This study is significant because it shows large increases in prevalence of hypertension not only in urban areas of India but rural too. We found that even in the age group of 20-24 years, the prevalence of hypertension ranged from 5.4-13.9% in urban and from 9-10% in rural areas. We also found that there is a rise in hypertension cases and one out of four people in these region have hypertension," said Dr Shashank Joshi, endocrinologist at Lilavati Hospital and one of the lead authors of the INDIAB study.
The study involved 16,607 people of the age 20 years and above from three states (Maharashtra, Jharkhand and Tamil Nadu) and one Union Territory (Chandigarh). The populations studied in all four regions comprised 49.7% males.
"The prevalence of hypertension was significantly higher in men than in women in all regions except Jharkhand. Hypertensive subjects were older, had a greater BMI and waist circumference, and a significantly higher prevalence of smoking, alcohol consumption, generalised obesity and diabetes than normotensive subjects in all four regions studied," said Dr V Mohan, co-author and anchor of the study.
The study underlined that those who consumed more than 6.5 g per day of salt had a significantly higher risk of developing hypertension as compared to those who consumed less than the median intake of salt in the population studied. Various risk factors including obesity, sedentary behaviour, alcohol use, higher social class, salt intake, diabetes mellitus and smoking are associated with hypertension in developing countries.
"Over the past three decades, hypertension has reached epidemic proportions in India and is now a major public health problem. This is a national study that presents the prevalence of hypertension in urban and rural areas based on the representative samples obtained from four regions representing North, South, East and West of India covering a population of 213 million,"added Dr Joshi.
Doctors say that in India, the growing number of hypertension cases is of more concern because of the epidemic of diabetes. "Having both hypertension and diabetes is a dangerous combination. The other concern in India is a sizeable number of people don't know if they are suffering from hypertension or diabetes," said Dr Joshi.
Question of a billion
Hypertension currently affects about one billion people worldwide and it is estimated that this could increase to 1.56 billion by 2025. Most of the developing countries including India report a marked increase in the prevalence of hypertension.