Bhise Mahadev D, Patra Shraboni
Population Studies, International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, Maharashtra, India.
PLoS One. 2018 Feb 5;13(2):e0191948. doi: 10.1371/journal.pone.0191948. eCollection 2018.
In the last few decades, the prevalence of hypertension has been drastically increased in India. The present study estimates the current prevalence of hypertension and its correlates in the state of Maharashtra. The variation in the prevalence of hypertension associated with individual-level characteristics is explained at the community and district level.
Data is used from the recent round of District Level Household & Facility Survey (DLHS-4), 2012-13. The DLHS-4 has used the nationally representative sample, collected through multistage stratified sampling procedure. A similar sampling frame, used in NSSO-2007-08, has been followed. The chi-square test is used to show the significance level of the association between the estimated prevalence of hypertension and its correlates. Multilevel regression analysis is carried out to investigate the effects of individual and community level factors on the prevalence of hypertension.
The overall prevalence of hypertension is 25% in Maharashtra, and a huge variation in the prevalence of hypertension is found across the districts. Dhule, Gadchiroli (with a low HDI rank), Mumbai and Satara (with higher HDI rank) are the districts with the higher (above 30%) prevalence of high blood pressure. The prevalence also significantly varies according to different correlates. The prevalence of high blood pressure is higher among elderly population (40%), among males (28%), in the urban areas (27%) and in the richest wealth quintile (28%). The prevalence is also higher among cigarette smokers (31%), alcohol consumers (30%) and people with obesity (38%) as compared to their counterparts. The results of the multilevel analysis show that the older and obese persons are at four-time higher risk of hypertension. Again, age, sex, marital status, place of residence, wealth status, unhealthy habits (i.e. smoking and alcohol consumption) and BMI are significantly associated with hypertension. The results of VPC statistics show that 14% of hypertension prevalence could be attributed to differences at the community level.
The prevalence of hypertension largely varies in the districts of Maharashtra irrespective of their level of socio-economic development (i.e. HDI rank). The variation in the rate of prevalence of hypertension is higher in the community (PSU) level as compared to the variation in the prevalence rate at the district level. Hypertension is attributable to the modifiable factors like risky lifestyle practices.
在过去几十年中，印度高血压患病率急剧上升。本研究估算了马哈拉施特拉邦目前高血压的患病率及其相关因素。在社区和地区层面解释了与个体特征相关的高血压患病率差异。
使用2012 - 13年最新一轮地区级家庭与设施调查（DLHS - 4）的数据。DLHS - 4采用了通过多阶段分层抽样程序收集的全国代表性样本。遵循了与2007 - 08年全国抽样调查组织（NSSO）中使用的类似抽样框架。卡方检验用于显示高血压估计患病率与其相关因素之间关联的显著水平。进行多水平回归分析以研究个体和社区层面因素对高血压患病率的影响。
马哈拉施特拉邦高血压总体患病率为25%，各地区高血压患病率存在巨大差异。杜尔、加德奇罗利（人类发展指数排名较低）、孟买和萨塔拉（人类发展指数排名较高）是高血压患病率较高（超过30%）的地区。患病率也因不同相关因素而有显著差异。老年人群（40%）、男性（28%）、城市地区（27%）以及最富裕的五分之一人群（28%）中高血压患病率较高。与不吸烟、不饮酒和不肥胖者相比，吸烟者（31%）、饮酒者（30%）和肥胖者（38%）中高血压患病率也较高。多水平分析结果表明，老年人和肥胖者患高血压的风险高出四倍。此外，年龄、性别、婚姻状况、居住地点、财富状况、不健康习惯（即吸烟和饮酒）以及体重指数与高血压显著相关。VPC统计结果表明，14%的高血压患病率可归因于社区层面的差异。
无论社会经济发展水平（即人类发展指数排名）如何，马哈拉施特拉邦各地区高血压患病率差异很大。与地区层面患病率的差异相比，社区（ PSU）层面高血压患病率的差异更大。高血压可归因于诸如危险生活方式等可改变因素。
