Key result
Applying the American College of Cardiology/American Heart Association guidelines yielded a hypertension prevalence of 40.1% compared to 7.5% using Government of India guidelines.
Why the study?
To determine the effect of different hypertension management guidelines and of basing diagnosis on a single blood pressure reading on hypertension prevalence in India.
How does the choice of hypertension guidelines and measurement method affect the estimated prevalence of hypertension in the Indian population?
Cross-Sectional
Yes
How does the choice of hypertension guidelines and measurement method affect the estimated prevalence of hypertension in the Indian population?
Absolute Event Rate: 40.1% vs 7.5%
The estimated prevalence of hypertension in India varies drastically (from 7.5% to 40.1%) depending on the clinical guidelines applied, highlighting the need for universally agreed diagnostic methods.
Guideline choice drives large differences in hypertension prevalence estimates; leaves open the need for standardized criteria in research and surveillance.
OBJECTIVE: To determine the effect of different hypertension management guidelines and of basing diagnosis on a single reading of blood pressure on the hypertension prevalence in the Indian population. METHODS: , 2015 to 2016, over all districts in India. We calculated the proportion of the population within three different age groups (18 to 34, 35 to 49 and 18 to 49 years of age) with raised blood pressure according to six different guidelines, and how prevalence changed if diagnoses were based on a single blood pressure measurement. FINDINGS: We observed that the Government of India and the American College of Cardiology/American Heart Association guidelines consistently yielded the lowest and highest prevalence of raised blood pressure; in the combined age group, we calculated the proportion of the population categorized as having raised blood pressure as 7.5% (95% confidence interval (CI): 7.4 to 7.7) and 40.1% (95% CI: 39.7 to 40.7), respectively. When basing diagnosis on a single reading of blood pressure only, a total of 56 million individuals would be erroneously categorized as hypertensive following the Government of India guidelines. We also showed that prevalence of hypertension in India varies with guidelines adhered to; in the combined age group, the national hypertension prevalence was three times higher when following the American College of Cardiology/American Heart Association compared with the Government of India guidelines. CONCLUSION: To optimize current clinical practice, health-care providers need to follow universally agreed, evidence-based methods of diagnosing hypertension.
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Dubey et al. (2019) conducted a cross-sectional in Hypertension. American College of Cardiology/American Heart Association guidelines vs. Government of India guidelines was evaluated on Prevalence of raised blood pressure. Applying the American College of Cardiology/American Heart Association guidelines yielded a hypertension prevalence of 40.1% compared to 7.5% using Government of India guidelines.
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