Epidemiology of Hypertension in a North Indian Population

Based on Rural-Urban Community Surveys

Abstract

The epidemiology of hypertension was studied on the basis of total community surveys in defined urban (mostly non-agricultural) and rural (agricultural) populations of Haryana, using WHO criteria. A total of 4, 068 subjects, comprising 95% of the eligible populations, were examined. Hypertension was found to be almost twice as common in the urban (64.3/1, 000) as in the rural group (35.7/1, 000). The prevalence of hypertension as well as the mean pressures were greater in men than in women in the 3rd and 4th decades, after which the pattern was reversed in all the subsequent age groups. The regression lines intersected at approximately 45 years of age. However, there was no appreciable sex difference in either group in the overall prevalence of hypertension.
The mean systolic and diastolic pressures rose significantly with increasing age. These were generally lower in rural than in urban subjects and there was a difference of almost one decade group. Only one out of every four hypertensives detected during the survey was aware of his disease, and even among these three-fourths were either untreated or inadequately controlled.
The lower prevalence of hypertension was associated with lesser mean pressures in the rural community, and both these observations are ascribed to a much larger proportion of rural people (compared to city dwellers) being thinner in size, engaging in hard physical activity, and belonging to a lower socio-economic group. The data have also been compared with other studies from India and abroad and the possible reasons for the observed differences discussed.