Hypertension and its risk factors in tea garden workers of Assam

Hypertension is emerging as a major public health problem in India. The diversity and heterogeneity of distribution of the population makes it difficult to arrive at the precise prevalence. In Assam, reports from hospitals in tea gardens reveal a high prevalence of hypertension among workers in tea gardens. However, no systematic study has been carried out in this population.

We selected, by systematic sampling, 1015 individuals (512 men and 503 women) 30 years or more in age, who were interviewed and clinically examined for hypertension. Blood pressure of all the study participants was measured using a standardized technique. Crude and adjusted odds ratios were estimated by unconditional simple and multiple logistic regression analyses. Mantel-Haenszel chi2 analysis was also used to test for the association of potential risk factors with hypertension after controlling for co-variables in a stratified analysis. Risk factors considered for hypertension included age, gender, marital status, occupation, alcohol consumption (locally prepared), extra salt intake, smoking history, khaini (a form of tobacco quid containing a mixture of tobacco and lime) intake, body mass index and waist-hip ratio.

The overall prevalence of hypertension was 60.8%. Increasing age, consumption of locally prepared alcohol, intake of extra salt in food and beverages and the habit of taking khaini were found to increase the risk of hypertension. Multivariate logistic regression models showed that the independent determinants of hypertension were age, gender, consumption of locally prepared alcohol and intake of extra salt. Gender-specific and age-stratified analyses showed the association of increased risk with intake of khaini in women only, while consumption of locally prepared alcohol was an important risk factor for hypertension in both men and women.

The disease burden of hypertension among workers in tea gardens is large, despite the community not being obese. Interventions directed at these workers as well as studies to determine the reasons for the high prevalence of hypertension are required.