Moser Kath A, Agrawal Sutapa, Davey Smith George, Ebrahim Shah
Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India.
PLoS One. 2014 Jan 23;9(1):e86043. doi: 10.1371/journal.pone.0086043. eCollection 2014.
Hypertension is a major contributing factor to the current epidemic of cardiovascular disease in India. Small studies suggest high, and increasing, prevalence especially in urban areas, with poor detection and management, but national data has been lacking. The aim of the current study was to use nationally-representative survey data to examine socio-demographic inequalities in the prevalence, diagnosis and management of hypertension in Indian adults.
Using data on self-reported diagnosis and treatment, and blood pressure measurement, collected from 12,198 respondents aged 18+ in the 2007 WHO Study on Global Ageing and Adult Health in India, factors associated with prevalence, diagnosis and treatment of hypertension were investigated.
22% men and 26% women had hypertension; prevalence increased steeply with body mass index (<18.5 kg/m(2): 18% men, 21% women; 25-29.9 kg/m(2): 35% men, 35% women), was higher in the least poor vs. poorest (men: odds ratio (95%CI) 1.82 (1.20 to 2.76); women: 1.40 (1.08 to 1.81)), urban vs. rural men (1.64 (1.19 to 2.25)), and men recently vs. never using alcohol (1.96 (1.40 to 2.76)). Over half the hypertension in women, and 70% in men, was undetected with particularly poor detection rates in young urban men, and in poorer households. Two-thirds of men and women with detected hypertension were treated. Two-thirds of women treated had their hypertension controlled, irrespective of urban/rural setting or wealth. Adequate blood pressure control was sub-optimal in urban men.
Hypertension is very common in India, even among underweight adults and those of lower socioeconomic position. Improved detection is needed to reduce the burden of disease attributable to hypertension. Levels of treatment and control are relatively good, particularly in women, although urban men require more careful attention.
高血压是印度当前心血管疾病流行的一个主要促成因素。小型研究表明高血压的患病率很高且呈上升趋势，特别是在城市地区，其检测和管理情况较差，但一直缺乏全国性数据。本研究的目的是利用具有全国代表性的调查数据，来审视印度成年人高血压患病率、诊断和管理方面的社会人口不平等情况。
利用2007年世卫组织印度全球老龄化与成人健康研究中从12198名18岁及以上受访者收集的自我报告诊断和治疗数据以及血压测量数据，对与高血压患病率、诊断和治疗相关的因素进行了调查。
22%的男性和26%的女性患有高血压；患病率随体重指数急剧上升（体重指数<18.5千克/平方米：男性18%，女性21%；25 - 29.9千克/平方米：男性35%，女性35%），最不穷与最穷人群相比患病率更高（男性：优势比（95%置信区间）1.82（1.20至2.76）；女性：1.40（1.08至1.81）），城市男性与农村男性相比（1.64（1.19至2.25）），近期饮酒的男性与从不饮酒的男性相比（1.96（1.40至2.76））。女性中超过一半的高血压患者以及男性中70%的高血压患者未被检测出，年轻城市男性和较贫困家庭的检测率尤其低。在检测出患有高血压的男性和女性中，三分之二接受了治疗。在接受治疗的女性中，无论城市/农村环境或财富状况如何，三分之二的女性高血压得到了控制。城市男性的血压控制情况未达最佳水平。
高血压在印度非常普遍，即使在体重过轻的成年人和社会经济地位较低的人群中也是如此。需要改进检测以减轻高血压所致的疾病负担。治疗和控制水平相对较好，特别是在女性中，不过城市男性需要更多关注。
