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Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension

Anchala, Raghupathya,b; Kannuri, Nanda K.b; Pant, Hirab; Khan, Hassana; Franco, Oscar H.c; Di Angelantonio, Emanuelea; Prabhakaran, Dorairajd

doi: 10.1097/HJH.0000000000000146
Reviews

Background: A region-specific (urban and rural parts of north, east, west, and south India) systematic review and meta-analysis of the prevalence, awareness, and control of hypertension among Indian patients have not been done before.

Methods: Medline, Web of Science, and Scopus databases from 1950 to 30 April 2013 were searched for ‘prevalence, burden, awareness, and control of blood pressure (BP) or hypertension (≥140 SBP and or ≥90 DBP) among Indian adults’ (≥18 years). Of the total 3047 articles, 142 were included.

Results: Overall prevalence for hypertension in India was 29.8% (95% confidence interval: 26.7–33.0). Significant differences in hypertension prevalence were noted between rural and urban parts [27.6% (23.2–32.0) and 33.8% (29.7–37.8); P = 0.05]. Regional estimates for the prevalence of hypertension were as follows: 14.5% (13.3–15.7), 31.7% (30.2–33.3), 18.1% (16.9–19.2), and 21.1% (20.1–22.0) for rural north, east, west, and south India; and 28.8% (26.9–30.8), 34.5% (32.6–36.5), 35.8% (35.2–36.5), and 31.8% (30.4–33.1) for urban north, east, west, and south India, respectively. Overall estimates for the prevalence of awareness, treatment, and control of BP were 25.3% (21.4–29.3), 25.1% (17.0–33.1), and 10.7% (6.5–15.0) for rural Indians; and 42.0% (35.2–48.9), 37.6% (24.0–51.2), and 20.2% (11.6–28.7) for urban Indians.

Conclusion: About 33% urban and 25% rural Indians are hypertensive. Of these, 25% rural and 42% urban Indians are aware of their hypertensive status. Only 25% rural and 38% of urban Indians are being treated for hypertension. One-tenth of rural and one-fifth of urban Indian hypertensive population have their BP under control.

aDepartment of Public Health & Primary Care, University of Cambridge, Strangeways Research Laboratory, Wort's Causeway, Cambridge, UK

bPublic Health Foundation of India, Indian Institute of Public Health, Hyderabad, India

cDepartment of Epidemiology, Erasmus MC, Rotterdam, The Netherlands

dCentre for Chronic Disease Control, New Delhi, India

Correspondence to Dr Raghupathy Anchala, Associate Professor, Public Health Foundation of India, The Indian Institute of Public Health, Hyderabad; Plot # 1, A N V Arcade, Amar Co-operative Society, Kavuri Hills, Madhapur, Hyderabad- 500033, India. Tel: +91 40 49006000; fax: +91 40 49006060; e-mail: docraghu8@gmail.com

Abbreviations: BP, blood pressure; GBD, global burden of disease; HTN, hypertension; NCD, noncommunicable disease; NEWS, north, east, west, and south

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Received June 18, 2013

Accepted January 22, 2014

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