Abstract 20082: High Prevalence, Poor Awareness and Suboptimal Treatment and Control of Hypertension in North and South India.

Introduction: Hypertension is the major driver of the escalating cardiovascular epidemic in India accounting for 10% of all deaths. Despite its high burden, hypertension prevention and control is suboptimal. Methods: We conducted a representative population based cross-sectional survey, among 12243 participants aged ≥30 years, to determine the prevalence, awareness, treatment and control of hypertension in epidemiologically transitioning rural and urban areas of North (Sonipat, Haryana) and South (Visakhapatnam, Andhra Pradesh) India. Participants were selected using a multistage cluster random sampling technique. Data were obtained using an interviewer administered questionnaire, anthropometry and bio sample collection. Hypertension and cardiovascular risk factors were measured using standard definitions and protocols. Age-standardized estimates were calculated using the WHO standard population. Results: The mean age was 47.7(SD± 12.5) years. Age-standardized prevalence of hypertension was 28.2% [95% CI: 27.4-29.0] in this large sample. Among those with hypertension, awareness rate was 40.4% [38.5-42.3], treatment rate was 36.3% [34.5-38.2] and control rate was 20.3% [18.8-21.9]. There were wide rural-urban [rural: 22.3% (21.3-23.3), urban: 34.5% (33.3-35.6)] and gender differences [men: 29.9% (28.7-31.1), women: 27.2% (26.1-28.2)] in the prevalence of hypertension. The awareness [men: 33.3% (30.9-35.6); women: 48.3% (45.3-51.2)], treatment [men: 28.7% (26.6-30.9), women: 44.8% (41.9-47.7)] and control [men: 15.8% (14.1-17.6), women: 25.6% (23.1-28.3)] rates were higher in women compared with men. In the regression analysis, younger age, male gender, urban residence, lesser education, depression, high waist circumference, current tobacco and alcohol use were associated with poor control of hypertension. Conclusions: In transitioning communities in India the burden of hypertension is high and its management suboptimal. Context specific public health measures to improve the prevention and management are warranted to improve vascular health of the population and reduce death and disability associated with uncontrolled hypertension.