Prevalence and Risk Factors of Hypertension among Rural Adults: A Community-Based Cross-Sectional Study

Abstract

Background: Hypertension is the single largest modifiable risk factor for cardiovascular disease and premature mortality worldwide. Despite the escalating burden of noncommunicable diseases in rural India, population-level data on hypertension prevalence, awareness, treatment, and control remain inadequate. This study was undertaken to determine the prevalence and identify independent risk factors for hypertension among rural adults in a community-based setting. Methods: A community-based cross-sectional study was conducted among 800 adults aged 18 years and above residing in a rural block of northern India between January and December 2025. Participants were selected through multi-stage cluster sampling. Blood pressure was measured using a validated digital sphygmomanometer following a standardised protocol. Hypertension was defined as systolic blood pressure of 140 mmHg or more, diastolic blood pressure of 90 mmHg or more, or current use of antihypertensive medication. Sociodemographic, anthropometric, dietary, and lifestyle data were collected using a pre-tested questionnaire. Multivariate logistic regression analysis was performed to identify independent risk factors. Results: The overall prevalence of hypertension was 28.6% (95% CI 25.5–31.9), with higher rates in males (31.4%) than females (25.4%). Among hypertensive individuals, only 44.1% were previously aware of their condition, 35.9% were receiving treatment, and 19.5% had controlled blood pressure below 140/90 mmHg. On multivariate analysis, age above 45 years (OR 3.62, 95% CI 2.42– 5.42, p < 0.001), body mass index above 25 kg/m² (OR 2.84, 95% CI 1.92–4.20, p < 0.001), co-existing diabetes mellitus (OR 2.46, 95% CI 1.54–3.92, p < 0.001), family history of hypertension (OR 2.18, 95% CI 1.42–3.34, p = 0.006), tobacco consumption (OR 1.96, 95% CI 1.28–3.00, p = 0.014), excessive dietary salt intake (OR 1.82, 95% CI 1.18–2.80, p = 0.024), and physical inactivity (OR 1.74, 95% CI 1.14–2.66, p = 0.032) were independently associated with hypertension. Conclusion: Hypertension is highly prevalent in rural India with alarmingly poor awareness, treatment, and control rates. Community-based screening initiatives, salt reduction campaigns, tobacco cessation programmes, and integration of hypertension management into primary healthcare are urgently warranted.