Hypertension higher among educated, urban residents: Study

With hypertension a major risk factor for cardiovascular diseases, a study revealed that approximately 42% of adults aged 45 years and above, and their spouses had hypertension, and prevalence was found to be higher among richer, more educated individuals residing in urban areas across India.

Research conducted by experts of International Institute for Population Sciences, Mumbai, and others, published in ‘PLOS Medicine’ on August 24, 2021, estimated that 29.9% of the people who particiapated in the study had uncontrolled hypertension, and the prevalence was higher among richer and better educated groups.

“Awareness, treatment, and control (ATC) of hypertension in adults aged 45 years and above, and their spouses in India: A nationally representative cross-sectional study” noted that richer individuals with higher monthly per capita consumption expenditure (MPCE) were more likely to have hypertension. Prevalence was estimated to increase from 37% among the least educated to 51.2% among the most educated. Prevalence was higher in urban areas (51.8%) than in rural areas (37.8%). It was also higher among those not working.

64,427 participants

The study, which is based on a sample of 64,427 participants (58% female and 70% rural dwellers), conducted by Sanjay K. Mohanty, Sarang P. Pedgaonkar, Ashish Kumar Upadhyay, Fabrice Kampfen, Prashant Shekhar, Radhe Shyam Mishra , Jurgen Maurer and Owen O’DonnellI noted that prevalence increased strongly with age, and this was higher for females (43.7%) than for males (39.6%).

Prevalence of hypertension exceeded the national average of 42% in 28 of the 35 States, and varied from 31.3% in Uttar Pradesh to 66% in Lakshadweep. Awareness among those with hypertension varies from 27.5% in Nagaland to 75.9% in Jammu and Kashmir. Treatment among those with hypertension varies from 23.8% in Nagaland to 74.9% in Jammu and Kashmir.

States with the highest prevalence include those most advanced in the demographic transition, such as Kerala, and high-income States, such as Goa and Delhi. While prevalence tends to be lower in the low or middle-income States, it was relatively low in all four States with the highest rates of poverty – Bihar, Jharkhand, Madhya Pradesh and Uttar Pradesh.

“Those living in poorer States were at lower risk of hypertension. If they were hypertensive, however, they were also more vulnerable to diseases associated with the risk factor because they were less likely to have been diagnosed, treated, and controlled,” according to the study.

It is estimated that 54.4% of adults aged 45 years and above, and their spouses with hypertension were aware of their condition; 50.8% were treated while 28.8% had achieved control.

Major risk factor

Hypertension is a major risk factor for cardiovascular diseases (CVDs) that accounted for 44% of the 42 million deaths related to non-communicable diseases globally in 2019.

“The fact that older adults with chronic conditions, such as hypertension, are most likely to succumb to this illness and need high-cost medical care emphasises that investment in hypertension screening and management can potentially pay off in the long term through reduced demands on the health system,” the study said.