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. 2021 Jul-Aug;73(4):481-486.
doi: 10.1016/j.ihj.2021.06.004. Epub 2021 Jun 12.

Regional impact of updated guidelines on prevalence and distribution of blood pressure categories for hypertension in India: Results from the National Family Health Survey 4

Kartik Gupta  1 , Vardhmaan Jain  2 , Armaan Qamar  3 , Aayush K Singal  4 , Sivasubramanian Ramakrishnan  4 , Rajeev Gupta  5 , Navkaranbir S Bajaj  6
Affiliations

Regional impact of updated guidelines on prevalence and distribution of blood pressure categories for hypertension in India: Results from the National Family Health Survey 4

Kartik Gupta et al. Indian Heart J. 2021 Jul-Aug.

Abstract

Introduction: In 2017, the American College of Cardiology/American Heart Association revised guidelines for diagnosis and management of hypertension in adults. The regional impact of the updated guidelines on the prevalence of hypertension in India is unknown.

Methods: Data from nationally representative Indian households were analyzed to estimate the regional prevalence of hypertension according to the old and the new guidelines in men (age 18-54 years) and women (age 18-49 years). The old guidelines defined hypertension as a systolic blood pressure of ≥140 mmHg or diastolic blood pressure of ≥90 mmHg or treatment. The new guidelines define hypertension as a systolic blood pressure of ≥130 mmHg or diastolic blood pressure of ≥80 mmHg or treatment. We calculated the increase in the prevalence of hypertension among the states and union territories of India (hereafter "states").

Results: Among 679,712 participants (85.6% women), the median age was 31 years (interquartile range 24, 40) and was comparable among men and women (33 vs. 31 years, respectively). The overall weighted prevalence according to old and new guidelines was 18.5% (95% CI 18.2, 18.7) and 43.0% (95% CI 42.8, 43.3), respectively. There was a significant increase in hypertension prevalence, both among men and women, and across all regions. The northeast region of the country had the highest prevalence.

Conclusion: The overall prevalence of hypertension significantly increases with the new compared to the old guidelines, however, the regional heterogeneity of prevalence of hypertension is maintained.

Keywords: 2017 ACC/AHA; Epidemiology; Hypertension; India; Prevalence.

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Conflict of interest statement

Declaration of competing interest Dr. Qamar reports receiving institutional grant support from Daiichi-Sankyo, American Heart Association, and fees for educational activities from the American College of Cardiology, Society for Vascular Medicine, Society for Cardiovascular Angiography and Interventions, Janssen and Janssen, Pfizer, Medscape, and Clinical Exercise Physiology Association. The other authors have no conflict of interest related to this work.

Figures

Fig. 1
Fig. 1
Heat map for the prevalence of hypertension among men according to old (Panel A) and new (Panel B) guidelines.
Fig. 2
Fig. 2
Heat map for the prevalence of hypertension among women according to old (Panel A) and new (Panel B) guidelines.
Fig. 3
Fig. 3
Distribution of blood pressure categories among men across states of India (n = 657,282). Dark Blue: Normal blood pressure, Light blue: elevated blood pressure, Grey: Stage 1 hypertension, Red: Stage 2 hypertension.
Fig. 4
Fig. 4
Distribution of blood pressure categories among women across states of India (n = 657,282). Dark Blue: Normal blood pressure, Light blue: elevated blood pressure, Grey: Stage 1 hypertension, Red: Stage 2 hypertension.
See this image and copyright information in PMC

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