Population Attributable Risk of Elevated Fasting Plasma Glucose for Hypertension among Native Rural and Tea Garden Communities in Northeast India

Q: What are the key findings of this study?

Elevated fasting plasma glucose (≥100 mg/dL) was significantly associated with hypertension (adjusted OR 1.63, p=0.001), accounting for a population attributable risk of 18.49% in rural Northeast India.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=1238). Intervention: Elevated fasting plasma glucose (≥100 mg/dL) vs. Normal fasting plasma glucose (<100 mg/dL). Primary outcome: Hypertension (SBP ≥140 mmHg and/or DBP ≥90 mmHg, or current use of antihypertensive medication) (OR 1.63, 95% CI 1.24-2.14, p=0.001).

Q: What does this research mean for the field?

Elevated fasting plasma glucose is significantly associated with hypertension and accounts for nearly one-fifth (18.49%) of hypertension cases in rural and tea garden communities in Northeast India. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Prasanta Kumar Borah; Trishnakhi Swargiari; Devid Kardong; Manoj Kalita

doi:10.21203/rs.3.rs-10152079/v1

October 7, 2026Open Access

Population Attributable Risk of Elevated Fasting Plasma Glucose for Hypertension among Native Rural and Tea Garden Communities in Northeast India

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Key result

Elevated fasting plasma glucose is linked to ~63% higher odds of hypertension.

OR 1.63
95% CI 1.24-2.14
P=0.001
n=1,238

Key Points

To estimate the population attributable risk of elevated fasting plasma glucose for hypertension among native rural and tea garden communities in Assam, Northeast India.
Conducted a cross-sectional study recruiting 1238 eligible adults (age ≥18 years) at the Dibrugarh Health and Demographic Surveillance Site in Assam, India.
Classified participants as hypertensive or normotensive using European Society of Hypertension 2023 guidelines, defining elevated fasting plasma glucose as fasting plasma glucose ≥100 mg/dL.
Applied multivariable logistic regression adjusted for sociodemographic, anthropometric, lifestyle, lipid, and renal markers to calculate odds ratios and population attributable risk.
Elevated fasting plasma glucose was significantly associated with hypertension in unadjusted analysis (OR: 2.11, 95% CI: 1.66–2.68) and adjusted analysis (AOR: 1.63, 95% CI: 1.24–2.14, p=0.001).
The estimated population attributable risk of hypertension due to elevated fasting plasma glucose was 18.49% (95% CI: 7.83–29.10), representing nearly one in five cases.
Hypertension affected 37.40% of the total cohort, with elevated fasting plasma glucose present in 46.7% of hypertensive adults compared to 29.3% of normotensive adults.

Study Design

Type

Cross-Sectional (n=1,238)

Multicenter

Yes

Structured PICO

P

Population

1,238 adults aged ≥18 years without prior cardiovascular disease from 10 rural villages and 1 tea garden in Assam, Northeast India, evaluated in a cross-sectional survey.

E

Exposure

Elevated fasting plasma glucose (eFPG), defined as FPG ≥100 mg/dL (combining impaired fasting glucose 100–125 mg/dL and diabetic-range FPG ≥126 mg/dL per ADA 2025 criteria).

C

Comparator

Normal fasting plasma glucose (<100 mg/dL); participants were also grouped into hypertensive cases and normotensive controls based on ESH 2023 guidelines.

O

Outcome

Hypertension (defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, or current use of antihypertensive medication) and the population attributable risk (PAR%) of hypertension attributable to elevated fasting plasma glucose.surrogate

Main Result

Odds Ratio: 1.63 (95% CI 1.24–2.14)

p-value: p=0.001

Elevated fasting plasma glucose accounts for nearly one-fifth (18.49%) of the hypertension burden in native rural and tea garden communities in Northeast India, highlighting the potential of early dysglycemia management for hypertension prevention.

Limitations

Cross-sectional observational design limits causal inference
Reliance on a single-time measurement of fasting blood glucose
Potential residual confounding from unmeasured factors such as genetic markers
Limited generalizability beyond populations with similar rural and tea garden sociodemographic characteristics
Observational cross-sectional nature of the study limits the ability to draw causal inferences
Dependence on single-time measurements of fasting blood glucose
Hidden unmeasured confounding factors including genetic markers cannot be ruled out
Findings may not be directly generalizable to populations beyond those with similar sociodemographic characteristics

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Implication

May inform local hypertension prevention in rural Northeast India; leaves open causality and intervention effects.

Abstract

Aim: Elevated fasting plasma glucose (eFPG) is associated with increased risk of hypertension, contributing cardiovascular risks. However, its population-level impact on hypertension remains insufficiently measured. This study aimed to estimate the population attributable risk (PAR) of eFPG for hypertension among native rural and tea garden communities of Assam, Northeast India. Methods: The participants of a cross-sectional study conducted in Dibrugarh Health and Demographic Surveillance Site, Assam, India were grouped into cases (hypertensive) and control (normotensive) based on European Society of Hypertension (ESH) guidelines 2023. A total of 1238 eligible adults (≥18 years) were consecutively recruited after obtaining informed consent. Sociodemographic, lifestyle, anthropometric, and biochemical data were collected using standardized protocols. eFPG was defined as FPG ≥100 mg/dL. Logistic regression used to estimate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Population attributable risk (PAR) was estimated using adjusted ORs and the prevalence of eFPG. Two-sided p <0.05 considered statistically significant. Results: eFPG was significantly associated with hypertension [AOR: 1.63 (1.24–2.14)]. Estimated PAR of hypertension attributable to eFPG was 18.49% (95% CI: 7.83–29.10), indicating that nearly one in five hypertension cases could be attributed to elevated blood glucose levels. Conclusion: eFPG contributes significantly to the burden of hypertension in these rural populations. Early detection and proper treatment of dysglycemia may decrease the risk of hypertension and associated risks.

Discussion

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Cite This Study

Borah et al. (2026) conducted a cross-sectional in Hypertension (n=1,238). Elevated fasting plasma glucose (≥100 mg/dL) vs. Normal fasting plasma glucose (<100 mg/dL) was evaluated on Hypertension (SBP ≥140 mmHg and/or DBP ≥90 mmHg, or current use of antihypertensive medication) (OR 1.63, 95% CI 1.24-2.14, p=0.001). Elevated fasting plasma glucose (≥100 mg/dL) was significantly associated with hypertension (adjusted OR 1.63, p=0.001), accounting for a population attributable risk of 18.49% in rural Northeast India.

synapsesocial.com/papers/6ae28f47cbadf70daf6c44a7 https://doi.org/10.21203/rs.3.rs-10152079/v1

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Population Attributable Risk of Elevated Fasting Plasma Glucose for Hypertension among Native Rural and Tea Garden Communities in Northeast India

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Population Attributable Risk of Elevated Fasting Plasma Glucose for Hypertension among Native Rural and Tea Garden Communities in Northeast India

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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