Socio-demographic factors, overweight/obesity and nutrients associated with hypertension among rural adults (≥18 years): Findings from National Nutrition Monitoring Bureau survey

Q: What are the key findings of this study?

Rural Indian adults had a 22% hypertension prevalence, with higher odds in obesity and low zinc intake.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension and pre-hypertension (n=49323). Intervention: Obesity (BMI ≥25.0 kg/m²), socio-demographic factors, and dietary nutrient intakes vs. Underweight/reference BMI (<18.5 kg/m²) and reference socio-demographic/nutrient groups. Primary outcome: Prevalence and odds of hypertension (SBP ≥140 mmHg and/or DBP ≥90 mmHg or on anti-hypertensive medication) (OR 2.92, 95% CI 2.65-3.23, p=<0.001).

Q: What does this research mean for the field?

The age-standardized prevalence of hypertension among rural Indian adults is approximately 20%, with risk significantly elevated by overweight/obesity, substance use, and lower dietary intake of carbohydrates and zinc. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To assess the prevalence, determinants, and knowledge and practices regarding hypertension among rural adults across India.

Meshram Indrapal; Nagalla Balakrishna; Varanasi Bhaskar; Harikumar Rachakulla; Avula Laxmaiah

doi:10.1016/j.ihj.2022.08.006

August 31, 2022Indian Heart JournalOpen Access

Socio-demographic factors, overweight/obesity and nutrients associated with hypertension among rural adults (≥18 years): Findings from National Nutrition Monitoring Bureau survey

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Key result

Obesity is linked to ~2.9-fold higher odds of hypertension among rural Indian adults.

OR 2.92
95% CI 2.65-3.23
P<0.001
n=49,323

Figures

Why the study?

Hypertension is the leading cause of death globally, but data were needed to assess its prevalence, determinants, and related knowledge and practices among rural adults in India.

What are the prevalence and socio-demographic, anthropometric, behavioral, and dietary determinants of hypertension among rural adults in India?

Key Points

To assess the prevalence, determinants, and knowledge and practices regarding hypertension among rural adults across India.
Conducted a community-based cross-sectional survey covering 49,323 adults (22,075 men and 27,248 women) across 10 major Indian states.
Measured blood pressure, height, weight, waist circumference, and hip circumference, alongside socio-demographic particulars.
Assessed dietary and nutrient intakes using a 24-hour dietary recall method, analyzing risk determinants via multiple logistic regression.
Overall hypertension prevalence was 22% (95% CI: 21.5–22.3; age-standardized 20.2%) and pre-hypertension prevalence was 45.3% (95% CI: 44.6–46.0), with highest hypertension rates in West Bengal (29.5%) and Kerala (28.9%).
Hypertension odds were 2 to 3 times higher in overweight (95% CI: 1.87–2.25) and obese participants (95% CI: 2.65–3.27), and 1.2 times higher with lower tertiles of carbohydrates (95% CI: 1.02–1.41) and zinc (95% CI: 1.11–1.42).
Higher odds of hypertension were also linked to tobacco use, alcohol consumption, forward communities, and business occupations, while 76% of participants were aware of hypertension and 19% were receiving treatment.

Study Design

Type

Cross-Sectional (n=49,323)

Multicenter

Yes

Structured PICO

What are the prevalence and socio-demographic, anthropometric, behavioral, and dietary determinants of hypertension among rural adults in India?

P

Population

49,323 rural adults aged ≥18 years (mean age 41.4 years, 55.3% female) across 10 major states in India surveyed between February 2010 and February 2012.

E

Exposure

Exposure to socio-demographic factors, behavioral risk factors (tobacco use, alcohol consumption, sedentary activity), anthropometric risk factors (overweight/obesity defined as BMI ≥23 kg/m² by Asian cut-offs or ≥25 kg/m² by WHO criteria, abdominal obesity, truncal obesity), and dietary nutrient intake tertiles assessed via 24-hour dietary recall.

C

Comparator

Reference categories for socio-demographic, anthropometric (e.g., BMI <18.5 kg/m², normal WC/WHR), behavioral (non-users of tobacco/alcohol), and dietary intake (3rd/highest tertile of nutrient intake) variables.

O

Outcome

Prevalence and odds of hypertension (defined per JNC-7 as average systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg from three supine measurements at 5-minute intervals, or taking medication for high BP) and pre-hypertension (SBP 120-139 mmHg and/or DBP 80-89 mmHg).hard clinical

Main Result

Odds Ratio: 2.92 (95% CI 2.65–3.23)

Absolute Event Rate: 39.7% vs 14.8%

p-value: p=<0.001

This large 10-state national survey demonstrates a high burden of hypertension (22%) and pre-hypertension (45.3%) among rural Indian adults, strongly linked to overweight/obesity, tobacco and alcohol use, and low dietary intake of zinc and carbohydrates.

Limitations

Cross-sectional study design precludes assessment of causality between the observed associations and hypertension.
Questions regarding history of hypertension and treatment of hypertension are vulnerable to recall bias.
Cross-sectional study design prevents assessment of causality between observed associations and hypertension.
Questions regarding history of hypertension and treatment are vulnerable to recall bias.

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Implication

May warrant expanded rural screening; extends observational associations with obesity and zinc but remains hypothesis-generating.

Abstract

BACKGROUND: Hypertension is the leading cause of death throughout the world. The study was conducted to assess the prevalence, determinants and knowledge & practices about hypertension among rural adults in India. METHODS: A community-based cross-sectional study was carried out in 10 major states of India. Information on socio-economic & demographic particulars was collected and anthropometric measurements like height, weight, waist & hip circumference and blood pressure were measured. Foods and nutrient intakes were assessed by 24-h recall method. Analysis was done using SPSS window 22. RESULTS: The prevalence of pre-hypertension was 45.3% (95% CI: 44.6-46.0) and hypertension was 22% (95% CI: 21.5-22.3) (age standardized prevalence; 20.2%) while, overweight/obesity was 22.6% (95% CI: 22.2-23.0) as per Asian cut offs (BMI≥23). The prevalence of hypertension was higher in West Bengal (29.5%) and Kerala (28.9%) and low in Madhya Pradesh and Uttar Pradesh (16-19%). The odds of hypertension was 1.2 times higher among forward communities, businessmen, tobacco users and those consuming alcohol, 2-3 times higher among overweight (CI: 1.87-2.25) and obese (2.65-3.27). The odds of hypertension was 1.2 times higher among those consuming lower tertile of carbohydrates (CI = 1.02-1.41) and zinc (CI = 1.11-1.42). About 76% were aware of hypertension, 21% were old hypertensive & 19% were on treatment. CONCLUSIONS: Age standardized prevalence of hypertension was 20% among adults and was associated with age, occupation, overweight/obesity, tobacco and alcohol use, low intake of carbohydrates and zinc. Therefore, increasing awareness and consumption of healthy diet through behavior change communication will help to control hypertension among adults.

Discussion

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Cite This Study

Indrapal et al. (2022) conducted a cross-sectional in Hypertension and pre-hypertension (n=49,323). Obesity (BMI ≥25.0 kg/m²), socio-demographic factors, and dietary nutrient intakes vs. Underweight/reference BMI (<18.5 kg/m²) and reference socio-demographic/nutrient groups was evaluated on Prevalence and odds of hypertension (SBP ≥140 mmHg and/or DBP ≥90 mmHg or on anti-hypertensive medication) (OR 2.92, 95% CI 2.65-3.23, p=<0.001). Rural Indian adults had a 22% hypertension prevalence, with higher odds in obesity and low zinc intake.

synapsesocial.com/papers/6a7b604a4353fbf0600232d0 https://doi.org/10.1016/j.ihj.2022.08.006

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Socio-demographic factors, overweight/obesity and nutrients associated with hypertension among rural adults (≥18 years): Findings from National Nutrition Monitoring Bureau survey

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Socio-demographic factors, overweight/obesity and nutrients associated with hypertension among rural adults (≥18 years): Findings from National Nutrition Monitoring Bureau survey

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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