Prevalence and Determinants of Hypertension among Adults in a Rural Community: A Community-Based Cross-Sectional Study from India

Abstract

Background: Hypertension has emerged as a leading contributor to cardiovascular morbidity and premature mortality in India, and its burden is now rising most steeply in rural populations undergoing rapid epidemiological transition. Community-based estimates anchored to defined rural catchment areas, together with quantification of modifiable determinants, remain limited. Methods: A community-based cross-sectional study was conducted among 800 adults aged 18 years and above residing in the rural field practice area of the Department of Community Medicine over a period of twelve months. Thirty clusters were selected by probability proportional to size sampling and households were enrolled by systematic random sampling. Data were obtained using the World Health Organization STEP wise instrument. Blood pressure was recorded in triplicate using a validated automated device, and participants with elevated readings were re-examined after seven days. Anthropometry and capillary blood glucose were measured using standard protocols. Hypertension was defined by JNC 7 criteria. Associations were examined using the chisquare test, Student t test and multivariable logistic regression. Results: The prevalence of hypertension was 30.4 percent (95% CI 27.2 to 33.6), and 150 of 243 hypertensive participants (61.7 percent) were newly detected. Prevalence increased from 11.4 percent among those aged 18 to 29 years to 56.3 percent among those aged 60 years and above (chisquare for trend 118.42, p less than 0.001). On multivariable analysis, age 45 years and above (aOR 3.02), body mass index 25 kg/m2 and above (aOR 2.38), central obesity (aOR 1.86), family history of hypertension (aOR 2.11), diabetes mellitus (aOR 2.24), physical inactivity (aOR 1.71), current tobacco use (aOR 1.64) and addition of extra salt at the table (aOR 1.58) remained independently associated with hypertension. Only 27 hypertensive participants (11.1 percent) had controlled blood pressure. Conclusion: Nearly one in three rural adults was hypertensive, the majority were previously undiagnosed and control was poor. Opportunistic screening and structured lifestyle intervention at the primary care level are warranted.