Prevalence and determinants of hypertension in the urban population of Jaipur in western India

OBJECTIVES: To determine age-specific blood pressure levels and prevalence of hypertension in an urban Indian population. DESIGN AND SETTING: A cross-sectional survey in six randomly selected municipal blocks in Jaipur city, India. SUBJECTS AND METHODS: There were 2122 subjects (1415 male, 797 female) aged 20 years or more. Evaluation was by physician-administered questionnaire, physical examination and electrocardiography. Diagnosis of hypertension used World Health Organization (WHO) and USA Fifth Joint National Committee (JNC-V) guidelines. Hypertension was subclassified according to the Framingham Study criteria. RESULTS: The mean +/- SD blood pressures (mmHg) were 125 +/- 19 systolic and 81 +/- 24 diastolic in men and 126 +/- 20 systolic and 81 +/- 12 diastolic in women. A significant correlation of blood pressure with increasing age groups was seen. The prevalence of hypertension according to the JNC-V criteria was 30% in men and 33% in women; by WHO criteria it was 11% in men and 12% in women and increased with age in all subjects. In the JNC-V hypertensive group borderline isolated systolic hypertension was present in 13% of men and 17% of women, definite isolated systolic hypertension was present in 7% of men and 2% of women, isolated diastolic hypertension was present in 65% of men and 57% of women and definite hypertension was present in 16% of men and 24% of women. Multivariate analysis revealed that age, smoking and higher body mass index were independently associated with higher prevalence of hypertension both in men and in women. CONCLUSIONS: A high prevalence of JNC-V-defined hypertension was found in an Indian urban population. Isolated diastolic hypertension was the commonest subtype. Significant determinants of hypertension were age, smoking and body mass index.