Prevalence, awareness, treatment and control of hypertension among the elderly in Bangladesh and India: a multicentre study

Objective To evaluate the prevalence, awareness, treatment and control of h ypertension among elderly individuals in Bangladesh and India. Method A community-based sample of 1203 elderly individuals (670 women; mea n age, 70 years) was selected using a multistage cluster sampling technique from two sites in Bangladesh and three sites in India. Findings The overall prevalence of hypertension (WHO-International Society for Hypertension criteria) was 65% (95% confidence interval = 62-67%). The prevalence was higher in urban than rural areas, but did not differ signifi cantly between the sexes. Multiple logistic regression analyses identified a higher body mass index, higher education status and prevalent diabetes me llitus as important correlates of the prevalence of hypertension. Physical activity, rural residence, and current smoking were inversely related to th e prevalence of hypertension. Among study subjects who had hypertension, 45 % were aware of their condition, 40% were taking anti-hypertensive medicati ons, but only 10% achieved the level established by the US Sixth Joint Nati onal Committee on Detection, Evaluation and Treatment of Hypertension (JNC VI)/WHO criteria. A visit to a physician in the previous year, higher educa tional attainment and being female emerged as important correlates of hyper tension awareness. Conclusions Our findings emphasize the need to implement effective and low cost management regimens based on absolute levels of cardiovascular risk ap propriate for the economic context. From a public health perspective, the o nly sustainable approach to the high prevalence of hypertension in the Indi an subcontinent is through a strategy to reduce the average blood pressure in the population.