PREVALENCE AND DETERMINANTS OF HYPERTENSION IN THE INDIAN SOCIAL-CLASS AND HEART SURVEY

To determine the association of socio-economic status (SES) and preval ence of hypertension and its risk factors in a rural population, a cro ss sectional survey was conducted in two randomly selected villages in the Moradabad district in North India. There were 1935 residents aged over 25 (984 men and 951 women) who were randomly selected and catego rised into social classes 1-4 depending upon SES based on occupation, housing conditions, land holding, total per capita income, ownership o f consumer durables and education. The prevalence of hypertension diag nosed by JNCV criteria (>140/90 mm Hg) was significantly higher among social class 1 and 2 and showed positive relation with SES in both sex es. Among social class 1 and 2 subjects, there was a higher prevalence of overweight and obesity and sedentary lifestyle. Logistic regressio n analysis with adjustment of age showed that SES had a positive relat ion with hypertension (odds ratio: men 1.09, 95% Cl 1.05-1.14; women 1 .08, 95% Cl 1.05-1.13), body mass index (odds ratio: men 1.12, 1.08-1. 18; women 1.11, 1.06-1.16) and sedentary lifestyle (odds ratio: men 1. 45, 1.32-1.58; women 1.38, 1.26-1.49). Only weak but significant assoc iations were observed with smoking, alcohol and salt intake. The assoc iation of hypertension with social class was reduced after adjustment of body mass index, sedentary lifestyle, smoking and salt intake (odds ratio: men 0.96, 0.81-1.14; women 0.73, 0.54-1.04). There was an incr ease in the prevalence of hypertension and age-specific blood pressure (BP) with increasing age in both sexes. The overall prevalence of hyp ertension by WHO criteria (>160/95) was 4.6% and by JNC V criteria 20. 8%, and the rates were comparable in both sexes. Social class 1 and 2 subjects in rural North India have a higher prevalence of hypertension and its risk factors of overweight and sedentary lifestyle.