Premkumar Ramaswamy, Pothen John, Rima Jeeva, Arole Shobha
Comprehensive Rural Health Project (Institute of Training & Research in Community Health & Population), Jamkhed, Maharashtra State, India.
Department of Distance Education, Christian Medical College, Vellore, India.
Indian Heart J. 2016 May-Jun;68(3):270-7. doi: 10.1016/j.ihj.2015.08.013. Epub 2016 Jan 13.
The objective of this study is to evaluate the effects of a community-based effort in a rural area of central India to decrease the prevalence of hypertension among the middle-aged and older population by using multiple blood pressure measurements.
With a prevalence of 16.8% (error of 3.36, and 95% confidence interval) from a recent study in a nearby district, the sample size required for this study was 495 subjects. A proportionally stratified random sample design was used. With maps of ten villages, where in a community-based health project had been in place for many years, 20 households and 20 backups were randomly selected from a list of all households. Multiple BP measurements were obtained and categorized and one-month period prevalence was calculated. Statistical analyses of frequency and percentage were performed.
Approximately one-fifth of the population above 40 years of age in central India where a community-based approach is in place was hypertensive. This is significantly lower than the previously documented prevalence rate of one-third or even more prevalence rate in India. The attribute of caste and religion, a specific rural Indian characteristic did not have any significant bearing on the above results. The prevalence tended to increase progressively with age until 70 years, after which it declined. Multiple blood pressure measurements may yield an accurate prevalence of hypertension.
With the documented evidences from India, the current reduced prevalence of hypertension could have been influenced by the community-based interventions in this population.
本研究的目的是评估印度中部农村地区基于社区的一项举措通过多次测量血压来降低中老年人群高血压患病率的效果。
根据最近在附近地区的一项研究,患病率为16.8%(误差为3.36,95%置信区间),本研究所需样本量为495名受试者。采用按比例分层随机抽样设计。利用十个村庄的地图,在一个已实施多年的社区健康项目所在的村庄,从所有家庭名单中随机选取20户家庭及20户备用家庭。获取多次血压测量值并进行分类,计算一个月期间的患病率。进行了频率和百分比的统计分析。
在印度中部采用基于社区方法的地区,40岁以上人群中约五分之一患有高血压。这显著低于印度先前记录的三分之一甚至更高的患病率。种姓和宗教属性这一印度农村特有的特征对上述结果没有任何显著影响。患病率在70岁之前往往随年龄逐渐上升,之后下降。多次血压测量可能得出准确的高血压患病率。
根据印度的记录证据,目前高血压患病率的降低可能受到了该人群中基于社区的干预措施的影响。