1 in 3 suffering from prehypertension in India: ICMR study

New Delhi: More than 33 per cent of Indians suffer from prehypertension, a recent Indian Council of Medical Research study has said, raising concerns on the impact of the condition as it often progresses to full-blown hypertension.

In the study comprising 7,43,067 adults aged between 18 and 54 years, researchers from the ICMR's National Centre for Disease Informatics and Research (NCDIR) conducted a secondary analysis of data from the National Family Health Survey (NFHS-5) that covered 707 districts in 28 Indian states and eight Union territories.

"Higher odds of prehypertension were observed in individuals from wealthier households and those overweight or obese," the study published on March 18 in the International Journal of Public Health said.

Interestingly, the study found that women, literate individuals, alcohol consumers and individuals with elevated blood glucose levels had lower odds of being prehypertensive.

There was no statistically significant link between tobacco consumption and the prevalence of prehypertension, it also said.

"The burden of prehypertension, an intermediate state between normal blood pressure and hypertension, is equally concerning, as it often progresses to full-blown hypertension," the study said.

Prehypertension prevalence varied widely across Indian districts, with an overall rate of 33.7 per cent, ranging from 15.6 per cent to 63.4 per cent.

The southern region of the country has a lower average prevalence at 30.2 per cent. The prevalence in Puducherry was 27.7 per cent, Telangana 28.2 per cent, Tamil Nadu 29.7 per cent and Andhra Pradesh 29.8 per cent.

The northern region also performed well with an average rate of 39.4 per cent, with Himachal Pradesh at 35.3 per cent and Chandigarh at 28.6 per cent.

Conversely, Jammu and Kashmir showed a higher hypertension rate of 45.2 per cent, Ladakh 48.8 per cent, Rajasthan 43.5 per cent and Chhattisgarh 38.8 per cent, according to the study.

The 'India State-Level Disease Burden Initiative' highlighted that prehypertension contributed substantially to cardiovascular diseases, warranting urgent attention.

Multiple studies have reported the rising prevalence of prehypertension in various regions of the country.

The ICMR study also found that the prevalence of raised blood pressure in India was at 15.9 per cent, exhibiting considerable variation across districts.

The prevalence of 'ever-measured' blood pressure among individuals in India was at 66.7 per cent, revealing significant regional disparities ranging from 30.3 per cent to 98.5 per cent.

Alcohol consumption was associated with higher odds of ever-measured blood pressure and raised blood pressure prevalence, according to the study.

General and central obesity, along with raised blood glucose levels, were consistently associated with higher odds of raised blood pressure, aligning with numerous studies conducted in India that have examined the impact of alcohol consumption, tobacco use, obesity, and elevated blood glucose levels on ever-measured blood pressure, prevalence of prehypertension, and raised blood pressure.

The objective of the study was to determine the prevalence and determinants of ever-measured blood pressure, prehypertension and raised blood pressure at national, state and district levels in India.

"Despite India's pioneering role in adopting the global NCD action plan and setting national targets, achieving a 25 per cent relative reduction in high blood pressure prevalence among adults aged 18 and above by 2025 proved challenging," the study said.

"Our study sheds light on the varying landscape of blood pressure measurement, prehypertension, and raised blood pressure prevalence in India.

"These variations underscore the urgent need for targeted interventions to address healthcare disparities, especially among vulnerable populations.

"Strategies should encompass health education, healthcare access, and awareness campaigns, promoting proactive healthcare-seeking behaviour, particularly among men," it said.

Factors like age, gender, education, wealth, and urban residence influence these conditions, while factors like alcohol consumption, obesity, and elevated blood glucose levels need attention, highlighting the need for targeted interventions.

Noncommunicable diseases (NCDs) are the leading cause of mortality worldwide. It is estimated that 64.9 per cent of all deaths in India are attributed to non-communicable diseases. Among them, cardiovascular diseases (CVDs) alone contributed to 27.4 per cent of total mortality.

Hypertension is a major preventable risk factor for cardiovascular disease (CVD).

The National Family Health Survey-5 (2019-21) reported that 21 per cent of women and 24 per cent of men aged 15 and over have hypertension and 39 per cent of women and 49 per cent of men have prehypertension.

Several studies have shown considerable heterogeneity in hypertension prevalence across different states and regions of India. However, national-level analysis fails to capture disparities within states.

Understanding the prevalence of pre-hypertension and raised blood pressure at the district level, can help in identifying high-risk areas and prioritizing resources accordingly, the study said.