A study led by researchers at Harvard TH Chan School of Public Health has found hypertension more prevalent among young adults in India than previously thought, and rates of diabetes and hypertension among middle-aged and elderly people high across all geographical areas and sociodemographic groups.
Described by the authors as the first nationally representative study of these conditions, it was published online in JAMA Internal Medicine Monday. It looked at health data, which included plasma glucose and blood pressure measurements, from 1.32 million adults in 27 states (except Gujarat and J&K) and five UTs between 2012 and 2014.
Standardised for age, diabetes prevalence in India was 6.1% among women and 6.5% among men; for hypertension, it was 20% among women and 24.5% among men. For comparison, the paper cites corresponding estimates for prevalence in the US — for diabetes, 6.4% among women and 8.1% among men; for hypertension, 10.8% among women and 15.5% among men.
The prevalence of both conditions among middle-aged adults in the poorest households in rural areas, too, was high (5.9% had diabetes and 30% had hypertension), contrary to the perception that these are conditions affecting the city wealthy.
Diabetes was most prevalent in Andhra Pradesh, Goa, Karnataka, Kerala, Tamil Nadu, Delhi and West Bengal, said Ashish Awasthi, co-author of the study and faculty at the Indian Institute of Public Health in Gandhinagar. “The hypertension prevalence tended to be highest in Punjab, Himachal Pradesh, Kerala, Sikkim and Nagaland,” Awasthi told The Indian Express.
The prevalence of diabetes varied from 2.33% among women in Madhya Pradesh to 17.90% among men in Goa. Hypertension was higher among adults under 45 but common even among younger groups — for example, at 12.1% in age group 18-25.
“Understanding how diabetes and hypertension prevalence varies within a country as large as India is essential for targeting of prevention, screening, and treatment services,” said lead author Pascal Geldsetzer, a doctoral student in the Department of Global Health and Population.
The study is the latest reaffirmation of India’s dual burden of rising noncommunicable diseases and continuing communicable diseases. “India has a window of opportunity to invest in its health system to effectively tackle hypertension and diabetes — both major killers. The potential for harnessing new technologies to… reverse the course of these epidemics is real. However, because the epidemics are worsening rapidly, now is the time for urgent action,” said Rifat Atun, co-senior author and professor of global health systems in the Department of Global Health and Population.
“Diagnosis of hypertension and diabetes is straightforward, but mostly untapped due lack of awareness and regular medical checkups,” said Awasthi. “Our study is the first to analyse nationally representative individual level blood glucose level and blood pressure data in the country. There is a need to focus on these two silent killers as well as other noncommunicable diseases to reduce the burden of preventable premature morbidity and mortality. If unchecked, we will see a lot more victims of these two diseases in next two decades.”