Meta-analysis of prevalence of hypertension in India

Abstract

To determine the changing trends in prevalence of hypertension and mean blood pressure (BP) levels in India and to study the urban and rural differences, a meta-analysis of all available epidemiological studies was performed. The first such study was reported by Chopra in 1942. Since then many studies (n = 34) in urban and rural areas of India have been carried out. The earlier studies of Dotto (1949), Dubey (1954) and Sathe (1959) showed hypertension prevalence of 1.24 +/- 0.2, 4.24 +/- 0.4 and 3.03 +/- 0.3 percent in urban populations of Calcutta, Kanpur and Mumbai, respectively. Studies since 1959 used the World Health Organization's guidelines and have shown an increasing trend in the prevalence of hypertension. Studies from Ludhiana (1985) and Jaipur (1995) have shown the prevalence to be 14.08 +/- 1.1 and 10.99 +/- 0.7 percent, respectively. Trend analysis comparable studies among urban areas (n = 10) shows a significant increase in the prevalence of hypertension (Mantel-Haenszel chi 2 = 5.99, p = 0.014). Studies in rural areas (n = 14) also show an increase in prevalence of hypertension although the rise is not as steep as in urban populations (Mantel-Haenszel chi 2 = 2.75, p = 0.097). Changes in mean BP levels were analysed using the data on mean systolic and diastolic BP in urban men aged 40-49 years from 1959 to 1995. There was a significant increase in systolic BP (r = 0.95, p < 0.001) and not in diastolic BP (r = 0.43, p = 0.2). In India, hypertension is emerging as a major health problem and is more in urban than in rural subjects.