HYPERTENSION EPIDEMIOLOGY IN INDIA - METAANALYSIS OF 50 YEAR PREVALENCE RATES AND BLOOD-PRESSURE TRENDS

Recent studies among Indians have shown a high prevalence of hypertens ion. To determine changing trends in hypertension prevalence, in mean blood pressure (BP) levels and to study urban and rural differences we performed meta-analysis of all available Indian studies. The first su ch study was reported by Chopra in 1942, Since then many studies (n = 33) in urban and rural areas of India have been peformed. In urban pop ulations earlier studies of Dotto (1949), Dubey (1954) and Sathe (1959 ) showed prevalence of hypertension of 1.24 +/- 0.2, 4.24 +/- 0.4 and 3.03 +/- 0.3% in populations of Calcutta, Kanpur and Bombay respective ly. Studies since 1959 used World Health Organisation (WHO) guidelines and have shown increasing trend in hypertension prevalence. Recent st udies from Ludhiana (1985) and Jaipur (1995) show that prevalence is 1 4.08 +/- 1.1 and 10.99 +/- 0.7% respectively. Trend analysis in studie s among urban areas (n = 10) shows a significant increase in hypertens ion prevalence (Mantel-Haenzel chi(2) = 5.99, P = 0.014). Studies in r ural areas (n = 14) also show a significant increase in hypertension p revalence (Mantel-Haenzel chi(2) = 5.93, P = 0.014) although the rise is not as sharp as in urban populations (r value, urban = 0.70, rural = 0.67), Changes in mean BP levels were analysed by using mean systoli c (S) and diastolic (D) BP in urban men aged 40-49 years from 1959-199 5. For SEP there was a significant increase (r = 0.95, P < 0.001) and not with DBP (r = 0.43, P > 0.2). It is concluded that in India hypert ension is emerging as a major health problem more so in urban than in rural subjects. The increasing prevalence is related to a rising mean SEP.