Why the study?
Kerala has a higher prevalence of hypertension than India's national average despite better health indicators, warranting targeted research into its prevalence and risk factor associations.
Nearly half of the adult population in Ernakulam district, Kerala, has hypertension, which is strongly associated with poor sleep quality, caffeine consumption, higher socioeconomic status, and dyslipidemia.
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High prevalence in Ernakulam adults signals need for local screening; leaves open causal factors and intervention effects for prospective studies.
Background and objectives Hypertension is a major public health concern, contributing significantly to cardiovascular diseases, stroke, and chronic kidney disease. The burden of hypertension is increasing, particularly in low- and middle-income countries, due to lifestyle transitions, urbanization, and dietary changes. Kerala, despite its better health indicators, has a higher prevalence of hypertension compared to the national average, warranting targeted research and interventions. This study aims to determine the prevalence of hypertension among adults in Ernakulam district, Kerala, and to assess its association with sleep quality and other risk factors. Materials and methods A community-based cross-sectional study was conducted among 1,110 adults aged ≥30 years in Ernakulam district, Kerala, from September 2021 to March 2022. Cluster sampling using the probability proportional to size method was employed, selecting 30 clusters with 37 participants each. Data on sociodemographic characteristics, lifestyle factors, comorbidities, and sleep quality were collected using a structured questionnaire. Hypertension was defined per the Eighth Joint National Committee (JNC 8) guidelines based on blood pressure (BP) measurements obtained using a validated digital monitor. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), with a score of >5 indicating poor sleep quality. Consumption of caffeinated drinks was recorded based on self-reported intake of tea, coffee, soft drinks, or energy drinks, categorized into <2 cups, 2-4 cups, and >4 cups per day. Dyslipidemia, diabetes, and other comorbidities were self-reported based on prior medical diagnoses. Socioeconomic status (SES) was determined using the Kerala Public Distribution System's ration card classification, with above poverty line (APL) and below poverty line (BPL) as categories. Data were analyzed using IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States), with multivariable logistic regression performed to determine associations between hypertension and risk factors. Statistical significance was set at p < 0.05. Results The mean age of participants was 54.46 ± 14.22 years. The prevalence of hypertension was 49.8% (95% CI: 49.34%-50.25%). Significant risk factors included poor sleep quality (aOR = 2.14, p < 0.001), consumption of caffeinated drinks (aOR = 11.43, p < 0.001), higher SES (aOR = 2.14, p < 0.001), and dyslipidemia (aOR = 12.804, p < 0.001). Conclusion Nearly half of the adult population in Ernakulam district has hypertension. Addressing modifiable risk factors such as poor sleep quality, caffeine consumption, higher SES, and dyslipidemia is crucial in hypertension prevention strategies.
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Ajay et al. (2025) studied this question.
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