Hypertension epidemiology in India: emerging aspects

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Hypertension is a leading noncommunicable disease risk factor in India, impacting an estimated 200 million individuals.
• Nationwide studies indicate a concerning increase in hypertension prevalence across the country.

Purpose of the Study:

• To summarize the unique epidemiological and clinical features of hypertension in the Indian population.
• To highlight recent findings on hypertension prevalence, awareness, treatment, and control in India.

Main Methods:

• Analysis of data from two recent nationwide studies: the Fourth National Family Health Survey and the Fourth District Level Health Survey/Annual Health Survey.
• Review of pharmacoepidemiology studies on antihypertensive drug use and genetic epidemiology research.

Main Results:

• Age-adjusted hypertension prevalence was higher in men (24.5%) than women (20.0%).
• Hypertension is more prevalent in developed states, urban populations, and individuals with higher socioeconomic status.
• Unique findings include urban-rural convergence and higher prevalence in younger individuals. Awareness, treatment, and control rates are low.
• High prevalence of diabetes in hypertensive patients suggests insulin resistance; resistant hypertension is also frequent.
• Widespread use of various antihypertensive drug classes, including a growing trend in renin-angiotensin system blockers, is observed.

Conclusions:

• Hypertension is highly prevalent in India, exhibiting significant regional variations and a higher burden in urban areas and younger demographics.
• Despite widespread use of newer antihypertensive medications, treatment and control rates remain suboptimal.
• Diabetes is a significant comorbidity, and resistant hypertension is common, underscoring the need for improved management strategies.