Society for Health and Demographic Surveillance, Suri, West Bengal, India.
Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA.
Am J Hypertens. 2020 May 21;33(6):552-562. doi: 10.1093/ajh/hpaa034.
India is home to the largest number of hypertensive individuals, and factors responsible for the incidence of hypertension are poorly understood. This study examines predictors of transition to different stages of hypertension-incidence of hypertension, incidence of prehypertension, and incidence of prehypertension to hypertension.
Population-based survey data from the Birbhum Population Project, located in West Bengal, India were used. A cohort of 8,977 individuals (male: 3,934, female: 5,043), participated in the 2012-13 survey, and were followed up for resurvey in 2017-18. The Seventh Report of the Joint National Committee (JNC 7) guidelines were followed to define hypertension. Bivariate and multivariate Poisson regression analyses were conducted to attain the study objective.
The incidence of hypertension, prehypertension among males (7.9% and 45.3%, respectively) is higher than that among females (5.9% and 32.7%, respectively). However, the incidence of prehypertension to hypertension is lower among males (23.6%) than among females (33.6%). Among both sexes, with age, the incidence of hypertension, and incidence of prehypertension to hypertension appeared to increase, whereas incidence of prehypertension among females increased with age. Findings indicate a diverse gradient of socioeconomic, behavioral, and anthropometric characteristics influencing the incidence of different stages of hypertension.
With a focus on females and the richest individuals, this study proposes that an appropriate intervention be designed in keeping with the socioeconomic, behavioral gradient of incidence of different stages of hypertension. The role of anthropometric indicators in hypertension is proposed to be further studied for better population-based screening.
印度是高血压患者人数最多的国家，导致高血压发生的因素尚未得到充分了解。本研究旨在探讨不同阶段高血压（高血压发生率、前期高血压发生率和前期高血压向高血压的转化率）的预测因素。
本研究使用了印度西孟加拉邦比尔布姆人口项目的基于人群的调查数据。一个 8977 人的队列（男性 3934 人，女性 5043 人）参加了 2012-13 年的调查，并在 2017-18 年进行了随访。本研究遵循第七次联合国家委员会（JNC 7）指南来定义高血压。采用双变量和多变量泊松回归分析来实现研究目的。
男性高血压（7.9%）和前期高血压（45.3%）的发生率高于女性（分别为 5.9%和 32.7%）。然而，男性前期高血压向高血压的转化率（23.6%）低于女性（33.6%）。在男女两性中，随着年龄的增长，高血压和前期高血压向高血压的转化率似乎有所增加，而女性的前期高血压发生率则随年龄的增长而增加。研究结果表明，社会经济、行为和人体测量特征存在多样化的梯度，影响着不同阶段高血压的发生。
本研究针对女性和最富裕的个体，提出设计一个适当的干预措施，以适应不同阶段高血压的社会经济、行为梯度。建议进一步研究人体测量指标在高血压中的作用，以便更好地进行基于人群的筛查。
