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ASSESSMENT OF RISK FACTORS OF HYPERTENSION: A CROSS- SECTIONAL STUDY

Authors:
  • SGS India PvT Ltd
  • pacific medical college and hospital, udaipur india

Abstract

BACKGROUND: Context: The epidemiology of hypertension, in terms of its importance as a risk factor for cardiovascular dise ases, continues to be major area of research. Aims: The aim of this study is to assess the prevalence o f various risk factors on hypertension among adult population (20-60 years) in the rural are as. MATERIAL AND METHODOLOGY: The present study was a community based cross-sectio nal study. The study was carried out in three villages of the field-practice area of Rural H ealth Training Centre of Community Medicine Department, M. P. Shah Medical College, Jamnagar dur ing the months of September to November 2011. A total of 250 adult study subjects were included by simple sampling random technique in the present study. Pre-designed, pre-tes ted schedule was used to collect data regarding demographic characteristics and different risk factors. Percentages, chi-square test and P-value were calculated using Epi Info software. RESULTS: Out of 250 study subjects, 25.60% were male while 74.40% were females. Majorit y of the subjects belonged to 30 to 39 years of age. Overall magnitude of hypertension was found to be 15.6%. Addiction to any form of tobacco was found among 28.40% of the study parti cipants and out of those, almost 50% were hypertensives. 29.82% of the over-weight indivi duals were also found hypertensives. CONCLUSIONS: The prevalence of hypertension was found to be 15.6% in the rural areas in the present study, which needs attention because in curr ent trend of migration from rural to urban area it may cause harm as a hidden disease and may give impact on other non-communicable diseases.
ORIGINAL ARTICLE
Journal of Evolution of Medical and Dental Sciences/Volume1/ Issue4/October - 2012 Page 519
ASSESSMENT OF RISK FACTORS OF HYPERTENSION: A CROSS-
SECTIONAL STUDY
Makwana Naresh, Shah Viral, Khambhati Sudham, Choudhary Mahesh, Goswami Kalpesh,
Yadav Sudha
1. Associate Professor, Department of Community Medicine, Shri M P Shah Medical College, Jamnagar, Gujarat
2. Assistant Professor, Department of Community Medicine, Shri M P Shah Medical College, Jamnagar, Gujarat
3. Medical Officer, Department of Community Medicine, Shri M P Shah Medical College, Jamnagar, Gujarat
4. Resident, Department of Community Medicine, Shri M P Shah Medical College, Jamnagar, Gujarat
5. Resident, Department of Community Medicine, Shri M P Shah Medical College, Jamnagar, Gujarat
6. Professor & Head, Department of Community Medicine, Shri M P Shah Medical College, Jamnagar, Gujarat
CORRESPONDING AUTHOR
Dr. Mahesh Choudhary, Resident,
Department of Community Medicine,
Shri M P Shah Medical College, Jamnagar,
E-mail: drmahesh2711@gmail.com,
Ph: 0091 9016098640.
ABSTRACT: BACKGROUND: Context: The epidemiology of hypertension, in terms of its
importance as a risk factor for cardiovascular diseases, continues to be major area of research.
Aims: The aim of this study is to assess the prevalence of various risk factors on hypertension
among adult population (20-60 years) in the rural areas. MATERIAL AND METHODOLOGY:
The present study was a community based cross-sectional study. The study was carried out in
three villages of the field-practice area of Rural Health Training Centre of Community Medicine
Department, M. P. Shah Medical College, Jamnagar during the months of September to
November 2011. A total of 250 adult study subjects were included by simple sampling random
technique in the present study. Pre-designed, pre-tested schedule was used to collect data
regarding demographic characteristics and different risk factors. Percentages, chi-square test
and P-value were calculated using Epi Info software. RESULTS: Out of 250 study subjects,
25.60% were male while 74.40% were females. Majority of the subjects belonged to 30 to 39
years of age. Overall magnitude of hypertension was found to be 15.6%. Addiction to any form
of tobacco was found among 28.40% of the study participants and out of those, almost 50%
were hypertensives. 29.82% of the over-weight individuals were also found hypertensives.
CONCLUSIONS: The prevalence of hypertension was found to be 15.6% in the rural areas in the
present study, which needs attention because in current trend of migration from rural to urban
area it may cause harm as a hidden disease and may give impact on other non-communicable
diseases.
KEY-WORDS: Hypertension, risk factors, rural area
INTRODUCTION: Hypertension is reported to be the fourth contributor to premature death in
developed countries and the seventh in developing countries.
(1)
Reports indicate that nearly 1
billion adults (more than a quarter of the world’s population) had hypertension in 2000, and
this is predicted to increase to 1.56 billion by 2025.
(2)
Earlier reports also suggest that the
prevalence of hypertension is rapidly increasing in developing countries
(3, 4)
and is one of the
leading causes of death and disability in developing countries. The epidemiology of
hypertension, in terms of its importance as a risk factor for cardiovascular diseases, continues
to be major area of research. India is a vast country with a heterogeneous and young population.
ORIGINAL ARTICLE
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In the past, the control and prevention of communicable diseases were emphasized, but,
recently, attention has shifted to the control and prevention of non-communicable diseases,
including stroke, hypertension, and coronary artery disease at the national level in view of the
rising incidence of these diseases.
(5)
Blood pressure (BP) is directly associated with risks of
several types of cardiovascular disease, and the associations of BP with disease risk are
continuous, indicating that large proportions of most populations have non-optimal BP values.
Data on Hypertension in the rural areas are again limited, so that present study was conducted
to assess the prevalence of various risk factors on hypertension among adult population (20-60
years) in the rural areas.
SUBJECTS AND METHODS: The present study was a community based cross-sectional study.
The study was carried out in the field practice area of Rural Health Training Centre (RHTC) of
Community Medicine Department, M. P. Shah Medical College, Jamnagar i.e. Alia village, during
the months of September to November 2011. Total 250 study subjects in the age group of 20 –
60 years were included by simple random sampling technique in the present study. Oral
consent was obtained from the participant prior to enroll in the study. Pre-designed, pre-tested
proforma was used to collect data regarding demographic characteristics and different risk
factors i.e. smoking, alcoholism etc. through house to house visits.
Blood pressure was recorded in the sitting position in the right arm to the nearest
2mmHg using the mercury sphygmomanometer. Two readings were taken 5 minutes apart and
mean of two was taken as the blood pressure.
(6)
Hypertension was diagnosed based on drug
treatment for hypertension or if the blood pressure was greater than 140/90 mmHg – Joint
National Committee 7 (JNC VII) Criteria.
(7)
Anthropometric measurements including weight,
height, waist and hip measurements were obtained using standardized techniques as given
below. Height was measured with a tape to the nearest cm. Subjects were requested to stand
upright without shoes with their back against the wall, heels together and eyes directed
forward. Weight was measured with a traditional spring balance that was kept on a firm
horizontal surface. Subjects were asked to wear light clothing and weight was recorded to the
nearest 0.5 kg. Body mass index (BMI) was calculated using the formula: weight (Kg)/height
(m)
2
.
(6)
BMI of equal to or more than 25 was regarded as Overweight and lesser than 25 was
considered as non-overweight. Percentages, chi-square test and P-value were calculated using
Epi Info software.
RESULTS: Figure – 1 indicates that risk factors for hypertension were found in orders of
overweight (22.80%), tobacco chewing (14.80%) and smoking (8.40%) in the study subjects.
Table – 1 shows that majority (72%) of the study subjects were in the age group of 20
39 years and 6.8% were in the age group of 50 – 60 years. Sex-wise distribution of study
subjects shows over representation of females, which may be due to collection of data in day
time when majority of male members of the family were not present in their houses. More than
fifty percent were found to be illiterate. Out of the total, 66.80% of the participants were
housewives followed by farmers (11.20%). Married study subjects were 87.2%, whereas 10.8%
and 2% were unmarried and widow respectively.
Table – 2 shows association of non-modifiable risk factors with hypertension. Out of the
total 250 study subject, 39 (15.6%) were found to be hypertensive. Significant statistical
association was observed between age and hypertension. As age increases, the chance of
becoming hypertensive rises. Sex-wise distribution shows that though hypertension was found
ORIGINAL ARTICLE
Journal of Evolution of Medical and Dental Sciences/Volume1/ Issue4/October - 2012 Page 521
more among females, statistical test fails to prove this association (p>0.05). Positive family
history was strongly related with hypertension (p=0.0002).
Table – 3 shows various modifiable risk factors associated with hypertension. 28.40% of
the study subjects were addicted to tobacco in any form, whereas 71.60% subjects were non-
addicted. Almost half (49.30%) of addicted subjects were hypertensive and 2.23% of non-
addicted individuals were hypertensive, this difference is statistically significant (p<0.05). No
significant association was found among various forms of addiction (smoking, tobacco chewing,
snuffing viz.) and hypertension (p>0.05), depicts that any form of addiction is associated with
hypertension. Hypertension was found almost double among married persons (16.51%) than
unmarried and widow (9.38%), but the association was not statistically significant. 17.29%
Illiterates was found hypertensives. Hypertension was almost equally distributed among
different occupations in the range of 15 to 22%. While looking at body mass index, 17 (29.82%)
overweight individuals were found hypertensive and the association between over-weight and
hypertension was statistically significant (p=0.0016). Associated co-morbid conditions such as
diabetes mellitus and coronary heart disease were also found among hypertensives.
DISCUSSION: In the present study the overall prevalence of hypertension was found to be
15.6%. Similar findings have also been reported in other studies. Comparable prevalence (15%)
was found in the study conducted at squatter settlement of Karachi (Pakistan).
(8)
Similar
prevalence of hypertension (16.9%) has also been reported in the study conducted among
labour population of Gujarat.
(9)
A higher prevalence (20.6%) was reported in the study
conducted among adult population at rural Wardha.
(10)
Prevalence of 23% was reported by
Cielito C. in rural areas of Philippines.
(11)
The WHO estimates the prevalence of HTN at 20%
among adult populations in several countries.
(12)
However a study among tribal “Oraon”
population of Orissa revealed lower prevalence of hypertension (4.6/1000 population).
(13)
Similar finding (prevalence 5.8%) was also noted by Chadha SL et al
(14)
among Gujaratis residing
in Delhi and prevalence of 7.8% was reported in hospital patients, Mumbai.
(15)
Differential rates
are due to different cut-off points in determining the level of hypertension and also to the
differing age groups constituting the study population.
The prevalence of hypertension rises with the advancing age i.e. it was maximum
(52.94%) in the age group of 50 – 60 years (table – 2), while minimum i.e. 3.45% in the age
group of 20 – 29 years. Strong statistical association was found between the age group and
hypertension (p=0.0001). Age increase prevalence of hypertension was also reported by Todkar
SS
(16)
, Reddy SS.
(17)
Similar observations were found in other studies.
(18,19,20)
This increase in age
incidence of hypertension can be explained by changes in the lifestyle, migration, stress,
atherosclerotic changes in the blood vessels that happen with the age and certain genetic and
environmental factors.
Addiction to any form of tobacco was found to be 28.40% in the study subjects.
Prevalence of hypertension was higher among addicted in comparison with non-addicted
(49.30% vs 2.23%). This difference is statistically significant. There is a plethora of studies
suggesting the tobacco consumption as an important and independent risk factor for
hypertension and cardiovascular diseases.
(9)
A positive association was observed between body
mass index and development of hypertension. Persons having BMI more than or equal to 25
reported with higher risk of hypertension. The similar findings were reported by number of
epidemiological studies e.g. Todkar SS et al.
(16)
2009, Das et al.
(21)
2005, Reddy SS and Prabhu
GR
(17)
2005. Associated co-morbid conditions such as Diabetes and Coronary heart disease
ORIGINAL ARTICLE
Journal of Evolution of Medical and Dental Sciences/Volume1/ Issue4/October - 2012 Page 522
(CHD) were observed among hypertensives. This findings were supported by Reddy SS and
Prabhu GR
(17)
2005. Education, Occupation and Marital status has not been significantly
associated with hypertensives as observed in the current study (p>0.05).
Thus to summarize, this study reveals that the magnitude of hypertension in the rural
population is comparable to the magnitude found in the other Indian studies.
CONCLUSION: The overall prevalence of hypertension in the present study was is 15.6%.
Significant association has been noted between hypertension, age and body mass index. Other
modifiable risk factors were associated with hypertension but the statistical association was not
found.
Limitations of the study:
1. It is likely that a systematic and larger study may give better understanding of the
prevalence and the underlying risk factors among these populations.
2. Over representation of female in the current study dilutes picture of various risk
factors on hypertension.
Figure 1 Distribution of participants according to risk factors of hypertension
8.40%
14.80%
5.20%
0.80%
22.80%
4.80%
1.60% 2.80%
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
PERCENTAGE %
RISK FACTORS
ORIGINAL ARTICLE
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Table: 1 Demographic profile of study participants
Number (N=250) Percentage
AGE GROUP
20-29
87 34.8%
30-39
93 37.2%
40-49
53 21.2%
50-60
17 6.8%
SEX
Male
64 25.6%
Female
186
74.4%
EDUCATION
Illiterate
133 53.2%
Primary
78
31.2%
Secondary
32 12.8%
Higher Secondary
4 1.6%
Graduate
3 1.2%
OCCUPATION
Service
9
3.6%
Business
11 4.4%
Farmers
28 11.2%
Labourers
23 9.2%
Housewife
167
66.8%
Unemployed
12 4.8%
MARITAL STATUS
Married
218 87.2%
Unmarried
27 10.8%
Widow
5 2%
ORIGINAL ARTICLE
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Table: 2 Non-modifiable risk factors associated with hypertension
Risk Factors
Non-hypertensive
(n=211)
Hypertensive
(n=39) TOTAL (N=250)
chisquare
value p value
No. % No. % No. %
Age
20-29 84 96.55 3 3.45 87 34.80
34.769 0.0001
30-39 81 87.10 12 12.90 93 37.20
40-49 38 71.70 15 28.30 53 21.20
50-60 8 47.06 9 52.94 17 6.80
Sex
Male 50 78.13 14 21.88 64 25.60
1.972 0.1602
Female 161 86.56 25 13.44 186 74.40
Positive family
history 5 41.67 7 58.33 12 4.80 14.240* 0.0002
*=chisquare value is calculated between Positive Family History and No positive Family History
among hypertensives and Non-hypertensives
Table: 3 Modifiable risk factors affecting hypertension
ORIGINAL ARTICLE
Journal of Evolution of Medical and Dental Sciences/Volume1/ Issue4/October - 2012 Page 525
Risk Factors
Non-
hypertensive
(n=211)
Hypertensive
(n=39) TOTAL (N=250) chisqu
are
value
p value
No. % No. % No. %
Addiction
Smoking
10 47.62 11 52.38 21 8.40
0.354 0.8379 Tobacco chewing
20 54.05 17 45.95 37 14.80
Snuffing
6 46.15 7 53.85 13 5.20
Non Addicted
175 97.77 4 2.23 179 71.60
81.975
* 0.0001
Marital status
Married
182 83.49 36 16.51 218 87.20 0.606 0.4363
Unmarried/widow
29 90.63 3 9.38 32 12.80
Education
Illiterate
110 82.71 23 17.29 133 53.20 0.375 0.5405
Literate
101 86.32 16 13.68 117 46.80
Occupation
Service
7 77.78 2 22.22 9 3.60
1.019 0.9069
Business
9 81.82 2 18.18 11 4.40
Farmer
23 82.14 5 17.86 28 11.20
Labourer
18 78.26 5 21.74 23 9.20
Housewife
142 85.03 25 14.97 167 66.80
Body Mass Index
Over-weight
40 70.18 17 29.82 57 22.80 9.99 0.0016
Non-obese
171 88.60 22 11.40 193 77.20
Associated co-
morbid condition
DM
0 0.00 4 100.00
4 1.60
CHD
0 0.00 7 100.00
7 2.80
*=chi-square value is calculated between
addicted and non-addicted.
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... 20 Naresh et al also found positive family history was strongly associated with hypertension in rural population. 28 Regular fruits intake was significantly associated to normal blood pressure in present study. Misra et al also found that more fruits and vegetables intake was significantly associated with normal blood pressure in Mishing tribe of Assam but Bhadoria et al in their study found that there was no significant effect of fruit intake on hypertension. ...
... Hazarika et al found more prevalence of hypertension among khaini users in tea garden workers and similar results were found in another study done by Naresh et al in rural area of Jamnagar. 31,28 There is high prevalence among sedentary and mild worker but the difference is not statistically significant. Laxmaiah et al and Kandpal et al found significant correlation of hypertension with activity. ...
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... Whereas in an another study done by Makwana N, Shah V, Khambhati S, Choudhary M, Goswami K, Yadav S, hypertension was found in 28.21% of the subjects who were smokers in comparison to 4.74% those who were non-smokers (P value 0.8379). 14 In present study out of total 300 subjects 38(12.66%) were found overweight in which females outnumbered twice than males. ...
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Hypertension is one of the most important causes of cardiovascular morbidity and mortality in the elderly. With the increase in the number of elderly in India, hypertension is likely to emerge as an important public health problem. We performed a cross-sectional survey of a random sample of 357 community-dwelling elderly individuals (191 women, 166 men; mean age 70 years) in Kerala. We measured blood pressure on all study participants using a standardized technique to assess the prevalence of hypertension. We compared the variations in prevalence, awareness, treatment and control of hypertension according to age, sex and place of residence of the subjects, and examined the socio-demographic correlates of hypertension using sex-specific multiple logistic regression. The overall prevalence of hypertension in our sample was 51.8% (95% CI: 46.8%-56.8%), which did not vary with sex but increased with age. Fewer than half of the hypertensive subjects were aware of their condition or were on treatment, and only a quarter of the treated hypertensives achieved adequate control of blood pressure. Rural elderly subjects were especially less likely to be aware of, and on treatment for hypertension. Smoking status and rural residence (in men) and marital status (in women) were important correlates of hypertension. Our findings emphasize the public health importance of hypertension in the elderly in Kerala at present, and point to a likely increase in burden of this problem in India in the near future. A National Hypertension Programme, targeted to meet the imminent public health challenge posed by hypertension seems warranted.
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Research question : What is the prevalence of hypertension and its risk factors among adults aged 20-60 years residing years residing in an urban slum area of Tirupati town, A.P.? Objective : To study the prevalence of hypertension and its risk factors as well as its extent of diagnosis and management among adults aged 20-60 years residing in an urban slum area of Tirupati. Study design : Cross sectional. Study setting : Channa Reddy Colony (Urban slum area) in Tirupati town, A.P. Study subjects : 1000 adults in the age group of 20-60 years (Males-500; Females-500) residing in an urban slum area of Tirupati town, A.P. Study variables : Age, sex, occupation, family history of hypertension, history of cerebrovascular/cardiovascular events, diabetes mellitus, saturated fat intake, intake of excess salt, smoking, alcohol intake and regular physical exercise. Outcome Variables : Number of hypertensives and mean blood pressure level estimations. Statistical analysis : Proportions, Chi--square tests, ′F′ ratios, ′t′ tests, Odds ratios and 95% confidence intervals. Results : The overall prevalence of hypertension was found to be 8.6%. Out of the 86 hypertensives, 72 (83.7%) were aware of their hypertension; all of those aware were under treatment; among the treated, only 30 (41.7%) had satisfactory control of their hypertension. Higher prevalence of hypertension was found with history of cerbrovascular/cardiovascular events (50.0%), diabetes mellitus (33.3%), family history of hypertension (23.3%), smoking (22.4%), age more than 50 years (22.2%), alcohol intake (20.0%), lack of physical exercise (15.8%), B.M.I.>25 (14.9%), male sex (9.6), non-vegetarian diet (8.8%) and saturated fat intake (8.8%). The mean systolic as well as diastolic blood pressures were found to be higher among men, higher age groups, and in business occupation of the respondents. Conclusions : Despite treatment, most of the hypertensives had not achieved satisfactory control of blood pressure. Health education of the public is needed to control the various risk factors of hypertension.
Article
Hypertension is most common cardiovascular disease and it account for large proportion of all cardiovascular deaths and disability worldwide. What is the level of prevalence of hypertension in rural area? What are the soociodemographic factors associated with hypertension? To find out prevalence of hypertension in rural area. A community-based cross-sectional study setting: Rural Health Training Centre Paithan, field practice area of govt. medical college Aurangabad, Maharashtra. 1297 persons aged 19 years and above. June 2005 to December 2006. A house-to-house survey was conducted by the author himself, interviewed the participants by systematic random sampling method, using pretested structured standard questionnaire. Two independent blood pressure (BP) readings were taken in sitting position by visiting each participant at their home. Hypertension was defined as systolic BP more than or equal to 140 mm of Hg or diastolic BP more than or equal to 90 mm of Hg or those individuals currently taking antihypertensive treatment. STATISTICAL TESTS: Percentiles, Chi Square test, Chi-Square for linear trend, multiple logistic regression analysis on SPSS software Version 10. Overall prevalence of hypertension in the study subjects was 7.24%. Multiple logistic regression analysis identified various factors significantly associated with hypertension were age, sex, BMI, additional salt intake, smoking, DM, alcohol consumption, and higher socioeconomic status. The overall prevalence of hypertension in study subjects was 7.24%.
Article
A cross sectional study was carried out in 2005 to find out the magnitude of hypertension among 154 tribal labourers of Gujarat belonging to Naika, Rathwa and Damor tribes. WHO classification of hypertension was taken as operational criteria and data was collected in pre-designed, pretested schedule. Blood pressure measurement was done twice on each subject using mercury sphygmomanometer. Overall magnitude of hypertension was found to be 16.9%, and only smoking was found to have significantly associated with it.
Article
A community based survey of coronary heart disease (CHD) was carried out in Gujarati families settled in Delhi. The number of adults surveyed in the age group 25-64 yr was 1317. CHD was diagnosed either on the basis of clinical history supported by documentary evidence of treatment in the hospital or at home or on ECG evidence in accordance with the Minnesota Code. The prevalence rate of CHD on clinical history was 25.1 (28.2 in males and 22.4 in females) per 1000 adults (25-64 yr). The prevalence rates were slightly lower in Gujaratis than the general Delhi urban population. The prevalence rate based on both clinical history and ECG criteria was estimated at 66.8 as compared to 96.8/1000 in general urban Delhi population. The risk factors for CHD such as socio-economic status, family history, obesity, smoking, physical activity and hypertension were studied. The mean and 5th, 50th and 95th percentile values of blood lipids were also estimated in CHD patients and compared with the control group. Hypertension ranked the leading risk factor. Prevalence rate of CHD was higher in the upper socioeconomic group. The positive correlation of higher levels of serum lipids e.g., total cholesterol, low density lipoprotein cholesterol (LDL-C) and triglyceride with CHD was confirmed.
Article
A community based survey for the prevalence of hypertension was carried out on a random urban sample of 13,723 adults in the age group 25-64 yr from the Union Territory of Delhi (India). Hypertension was defined as systolic pressure greater than 160 mm Hg and/or a diastolic pressure greater than 90 mm Hg or a history of current antihypertensive medication. The overall prevalence rate/1000 adults was 127.5 (116.6 in males and 136.8 in females). Mild hypertension (diastolic pressure between 91-104 mm Hg) predominated in the whole group, the proportion decreasing with increasing age in both sexes. Fifty per cent of the hypertensives were aware of their problem, the awareness being slightly higher in females (51.8% versus 46.5%). Approximately 30 per cent of the hypertensives were on medication for high blood pressure. The status control of blood pressure was low in the population, being only 9 per cent, with little difference between the two sexes. The study emphasises the enormity of the problem of hypertension in an urban population in India and poor control of blood pressure achieved in the community.
Article
Population surveys carried out since the 1970s in 15 developing countries including 23 population groups show that the prevalence of hypertension ranges from as low as 1% in some African countries to over 30% in Brazil. A trend analysis of the mortality statistics for 35-74 year-olds from 16 countries in which data are available shows a downward trend in mortality from hypertension and cerebrovascular diseases in most of these countries. In spite of the current low prevalence in some countries, the total number of hypertensives in the developing world is high, and a cost assessment of possible antihypertensive drug treatment indicates that developing countries cannot afford the same drug treatment levels as developed countries.
Article
Blood pressure and nutritional profiles in the 'Oraon' tribal community of India living in rural and urban areas were studied between 1981-85 after a house to house survey of 4523 rural tribal people (RT) and 935 of their urban tribal counterparts (UT). Prevalence of hypertension was found to be 4.8/1000 males and 4.3/1000 females in rural tribal group giving an overall rate of 4.6/1000. In contrast the same were 27.1/1000 males and 21.4/1000 females in UT group, overall rate being 25.6/1000. Average calorie consumption were 1750 and 2280 and mean 24 hour-urinary sodium excretions 58 and 118 milliequivalents in RT and UT groups respectively. Of the total of 21 subjects in RT and 24 in UT detected to be hypertensive, 7 had common family inheritance. Increased mean arterial pressure correlated with increased sodium consumption and body weight. Hypertensives from both the groups showed higher urinary sodium excretion (P < 0.05). This epidemiologic study proves the role of a genetic factor/defect complicated by higher salt consumption in causation of increased blood pressure.
Article
Epidemics of Cardiovascular Disease (CVD) are presently occuring or accelerating in developing countries, as epidemiologic transition accompanies socio-economic and demographic changes. Hypertension, a major risk factor for coronary and cerebrovascular disease, needs effective programmes for prevention, recognition and control. Strategically, hypertension control is ideally suited to be the initial component of an integrated CVD control programme which has to be implemented in the developing countries. Primary prevention, through a population based lifestyle linked programme, as well as cost-effective methods of detection and management are synergestically complementary approaches. The existing health care infrastructure needs to be reoriented to meet the emerging challenge of CVD, while empowering the community through health education.