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The burden of hypertension and unmet need for hypertension care among men aged 15–54 years: a population-based cross-sectional study in India

Published online by Cambridge University Press:  04 October 2021

Ajinkya Kothavale Open the ORCID record for Ajinkya Kothavale [Opens in a new window] ,
Parul Puri Open the ORCID record for Parul Puri [Opens in a new window]  and
Suryakant Yadav
Ajinkya Kothavale*
Affiliation:
International Institute for Population Sciences, Mumbai, India
Parul Puri
Affiliation:
International Institute for Population Sciences, Mumbai, India
Suryakant Yadav
Affiliation:
International Institute for Population Sciences, Mumbai, India
*
*Corresponding author. Email: [email protected]
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Abstract

Hypertension is one of the primary causes of morbidity and premature mortality among the working-age population in India. This study evaluated the burden of hypertension and unmet need for hypertension care among working-age men aged 15–54 years in India using data from the fourth round of the National Family Health Survey (NFHS-4, 2015–16). An individual was recognized as hypertensive if his blood pressure was over 140/90 mmHg or if he was consuming anti-hypertensive medication to lower his blood pressue. The study design was based on the Rule of Halves framework. Hypertensive cases were segmented into five analytical levels: (1) total, (2) screened, (3) diagnosed, (4) treated and (5) controlled cases. The prevalence of hypertension was 16% (n=16,254) among the men aged 15–54 years. Of the total hypertensive individuals, 63.2% (10,314) were screened, 21.5% (3428) were diagnosed, 12.6% (1862) were treated and only 6.1% (905) had controlled blood pressure. Of the screened individuals, 66.8% (6886) had never been diagnosed, 45.7% (1566) of those diagnosed had not receive treatment and 51.4% (957) of those treated still had uncontrolled blood pressure. The analyses revealed that 36.5% (5940) of hypertensive individuals were lost at the screening stage. The results demonstrate that there is a significant burden of hypertension and unmet need for hypertension care among men aged 15–54 in India. There is an urgent need to develop suitable strategies and programmes to manage this rising burden of hypertension among men, and reduce losses in the hypertension care continuum.

Keywords

Hypertension care continuumUnmet needRule of Halves
Type
Research Article
Information
Journal of Biosocial Science , Volume 54 , Issue 6 , November 2022 , pp. 1078 - 1099
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

American Heart Association (2018) How to Measure Blood Pressure. URL: CCC_Poster_new_URL _10 22 18 - letter (heart.org)Google Scholar
Andersen, RM (1995) Revisiting the behavioral model and access to medical care: does it matter? Journal of Health and Social Behavior 36(1), 1–10.CrossRefGoogle ScholarPubMed
Arokiasamy, P and Yadav, S (2014) Changing age patterns of morbidity vis-à-vis mortality in India. Journal of Biosocial Science 46(4), 462–479.CrossRefGoogle ScholarPubMed
Asayama, K, Ohkubo, T, Kikuya, M, Metoki, H, Obara, T, Hoshi, H et al. (2005) Use of 2003 European Society of Hypertension-European Society of Cardiology guidelines for predicting stroke using self-measured blood pressure at home: the Ohasama Study. European Heart Journal 26(19), 2026–2031.CrossRefGoogle ScholarPubMed
Benetos, A, Petrovic, M and Strandberg, T (2019) Hypertension management in older and frail older patients. Circulation Research 124(7), 1045–1060.CrossRefGoogle ScholarPubMed
Bloom, DE, Cafiero-Fonseca, ET, Candeias, V, Adashi, E, Bloom, L, Gurfein, L et al. (2014) Economics of Non-Communicable Diseases in India: The Costs and Returns on Investment of Interventions to Promote Healthy Living and Prevent, Treat, and Manage NCDs. World Economic Forum, Harvard School of Public Health.Google Scholar
Curini, L, Franzese, R and Steenbergen, M (2020) Multilevel analysis. Curini, L and Franzese, R (eds) The SAGE Handbook of Research Methods in Political Science and International Relations. Sage Publications, pp, 679–700, doi: 10.4135/9781526486387.n39.CrossRefGoogle Scholar
de Burgos-Lunar, C, del Cura-González, I, Salinero-Fort, MA, Gómez-Campelo, P, Pérez de Isla, L and Jiménez-García, R (2013) Delayed diagnosis of hypertension in diabetic patients monitored in primary care. Revista Española de Cardiología (English Edition) 66(9), 700–706.CrossRefGoogle ScholarPubMed
Faizi, N, Ahmad, A, Khalique, N, Shah, M, Khan, M and Maroof, M (2016) Existence of rule of halves in hypertension: an exploratory analysis in an Indian village. Materia Socio Medica 28(2), 95.CrossRefGoogle Scholar
Gamage, AU and Seneviratne, RDA (2016) Perceived job stress and presence of hypertension among administrative officers in Sri Lanka. Asia-Pacific Journal of Public Health 28(6), 41S–52S.CrossRefGoogle ScholarPubMed
GBD 2016 Risk Factors Collaborators (2017) Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet 390(10100), 1345.CrossRefGoogle Scholar
Gupta, R, Gaur, K and Ram, CV (2019) Emerging trends in hypertension epidemiology in India. Journal of Human Hypertension 33(8), 575–587.CrossRefGoogle ScholarPubMed
Herxheimer, A, Dahlöf, B, Lindholm, LH, Hansson, L, Scherstén, B, Ekbom, T et al. (1992) Managing hypertension in the elderly. The Lancet 339(8787), 252.CrossRefGoogle ScholarPubMed
Husain, K, Ansari, RA and Ferder, L (2014) Alcohol-induced hypertension: mechanism and prevention. World Journal of Cardiology 6(5), 245.CrossRefGoogle ScholarPubMed
International Institute for Population Sciences (2017) National Family Health Survey (NFHS-4) 2015–16 India. IIPS and ICF, pp. 1–192, doi:kwm120 [pii]10.1093/aje/kwm120.Google Scholar
Kasthuri, A (2018) Challenges to healthcare in India – the five A’s. Indian Journal of Community Medicine 43(3), 141–143.Google ScholarPubMed
Kokubo, Y and Iwashima, Y (2015) Higher blood pressure as a risk factor for diseases other than stroke and ischemic heart disease. Hypertension 66(2), 254–259.CrossRefGoogle ScholarPubMed
Maheswaran, R, Gill, JS, Davies, P and Beevers, DG (1991) High blood pressure due to alcohol: a rapidly reversible effect. Hypertension 17(6), 787–792.CrossRefGoogle ScholarPubMed
Motkuri, V and Naik, SV (2016) Growth and structure of workforce in India. The Indian Economic Journal 64(1–4), 57–74.CrossRefGoogle Scholar
Munshi, V, Yamey, G and Verguet, S (2016) Trends in state-level child mortality, maternal mortality, and fertility rates in India. Health Affairs 35(10), 1759–1763.CrossRefGoogle ScholarPubMed
O’Donnell, MJ, Denis, X, Liu, L, Zhang, H, Chin, SL, Rao-Melacini, P et al. (2010) Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. The Lancet 376(9735), 112–123.CrossRefGoogle ScholarPubMed
Panda, BB, Pati, MR and Sahu, PK (2015) Survey of prescription pattern of anti-hypertensive drugs in hypertensive and diabetic hypertensive patients. Asian Journal of Pharmaceutical and Clinical Research 8(1), 250–252.Google Scholar
Pinto, E (2007) Blood pressure and ageing. Postgraduate Medical Journal 83(976), 109–114.CrossRefGoogle ScholarPubMed
Prenissl, J, Manne-Goehler, J, Jaacks, LM, Prabhakaran, D, Awasthi, A, Bischops, AC et al. (2019) Hypertension screening, awareness, treatment, and control in india: a nationally representative cross-sectional study among individuals aged 15 to 49 years. PLoS Medicine 16(5), 1–18.CrossRefGoogle ScholarPubMed
Prinja, S, Kanavos, P and Rajesh, K (2012) Health care inequities in north India: role of public sector in universalising health care. Indian Journal of Medical Research 136(3), 421–431.Google Scholar
Puri, P, Singh, SK and Srivastava, S (2020) Reporting heterogeneity in the measurement of hypertension and diabetes in India. Journal of Public Health (Germany) 28(1), 23–30.CrossRefGoogle Scholar
Ramakrishnan, S, Zachariah, G, Gupta, K, Shivkumar Rao, J, Mohanan, PP, Venugopal, K et al. (2019) Prevalence of hypertension among Indian adults: results from the great India blood pressure survey. Indian Heart Journal 71(4), 309–313.CrossRefGoogle ScholarPubMed
Rashid, P, Leonardi-Bee, J and Bath, P (2003) Blood pressure reduction and secondary prevention of stroke and other vascular events: a systematic review. Stroke 34(11), 2741–2748.CrossRefGoogle ScholarPubMed
Saikia, D and Das, K (2012) Rural health infrastructures in the north-east India. The NEHU Journal 12(2), 77–100.Google Scholar
Sayon-Orea, C, Martinez-Gonzalez, MA and Bes-Rastrollo, M (2011) Alcohol consumption and body weight: a systematic review. Nutrition Reviews 69(8), 419–431.CrossRefGoogle ScholarPubMed
Shekhar, C and Shil, A (2020) Linkages between occupation and elevated blood pressure among men in India: a cross-sectional study. International Journal of Public Health 65 (6), 835–846.CrossRefGoogle ScholarPubMed
Traversy, G and Chaput, JP (2015) Alcohol consumption and obesity: an update. Current Obesity Reports 4(1), 122–130.CrossRefGoogle ScholarPubMed
United Nations Population Fund (2015) India Country Office at a Glance. URL: 1-A&YProfile_Size-GrowthRateandDistribution.pdf (unfpa.org)Google Scholar
Wei, Y, Wang, Z, Wang, H, Li, Y and Jiang, Z (2019). Predicting population age structures of China, India, and Vietnam by 2030 based on compositional data. PLoS One 14(4), e0212772.CrossRefGoogle ScholarPubMed
Weinehall, L, Öhgren, B, Persson, M, Stegmayr, B, Boman, K, Hallmans, G and Lindholm, LH (2002) High remaining risk in poorly treated hypertension: the “rule of halves” still exists. Journal of Hypertension 20(10), 2081–2088.CrossRefGoogle ScholarPubMed
Wilber, JA (1973) The problem of undetected and untreated hypertension in the community. Bulletin of the New York Academy of Medicine: Journal of Urban Health 49(6), 510–520.Google ScholarPubMed
Wolf-Maier, K, Cooper, RS, Kramer, H, Banegas, JR, Giampaoli, S, Joffres, MR et al. (2004) Hypertension treatment and control in five European Countries, Canada, and the United States. Hypertension 43(1), 10–17.CrossRefGoogle ScholarPubMed
Wu, AS, Dodhia, H, Whitney, D and Ashworth, M (2019) Is the rule of halves still relevant today? A cross-sectional analysis of hypertension detection, treatment and control in an urban community. Journal of Hypertension 37(12), 2470–2480.CrossRefGoogle Scholar