Prevalence, awareness, and control of hypertension in the slums of Kolkata

BACKGROUND: Slum dwellers have poor socio-environmental conditions and less access to medical care, which make them susceptible to illnesses. Studies on urban slums have primarily focused on communicable diseases and less on lifestyle diseases, such as hypertension. Consequently, there is a paucity of prevalence studies of hypertension in slums in different parts of the country. The aim of the study was to provide estimates of the prevalence, awareness, and control of hypertension in an adult population sample of the slums of Kolkata. METHODS: A population-based cross-sectional study was conducted in the slums of Kolkata in collaboration with Kolkata Municipality Corporation. Door-to-door survey was conducted by trained healthcare workers using a structured questionnaire. Age, sex, religion, housing conditions (house/hut), average monthly household income, education status, current use of tobacco, history of hypertension, and whether on antihypertensive treatment were recorded. Blood pressure (BP) was recorded as per standard guidelines. Hypertension was diagnosed by JNC-VII criteria. A total of 10,175 adults aged ≥20 years were enrolled in the study. RESULTS: Overall prevalence of hypertension was 42%. Hypertension was newly detected in 19% of the population. Fifty-four percent of the hypertensive subjects were aware of their hypertension status, 38% were on antihypertensive treatment, and 12% had their BP controlled to target level. Subgroup analysis showed that the prevalence of hypertension was higher in men, above 60 years age, in the minority community, in those with a higher household income, and among the tobacco users. CONCLUSION: There is a high prevalence of hypertension in the slums of Kolkata. Although the awareness of the condition is high, the control of hypertension is poor.