title: Normotension, prehypertension, and hypertension in urban middle-class subjects in India: prevalence, awareness, treatment, and control.
abstract: OBJECTIVE
  We conducted a multisite study to determine the prevalence and determinants of normotension, prehypertension, and hypertension, and awareness, treatment, and control of hypertension among urban middle-class subjects in India.
  
  
  METHODS
  We evaluated 6,106 middle-class urban subjects (men 3,371; women, 2,735; response rate, 62%) in 11 cities for sociodemographic and biological factors. The subjects were classified as having normotension (BP < 120/80), prehypertension (BP 120-139/80-89), and hypertension (documented or BP ≥ 140/90). The prevalence of other cardiovascular risk factors was determined and associations evaluated through logistic regression analysis.
  
  
  RESULTS
  The age-adjusted prevalences in men and women of normotension were 26.7% and 39.1%, of prehypertension 40.2% and 30.1%, and of hypertension 32.5% and 30.4%, respectively. The prevalence of normotension declined with age whereas that of hypertension increased (P-trend < 0.01). A significant association of normotension was found with younger age, low dietary fat intake, lower use of tobacco, and low obesity (P < 0.05). The prevalence of hypercholesterolemia, diabetes, and metabolic syndrome was higher in the groups with prehypertension and hypertension than in the group with normotension (age-adjusted odds ratios (ORs) 2.0-5.0, P < 0.001). The prevalences in men and women, respectively, of two or more risk factors were 11.1% and 6.4% in the group with normotension, 25.1% and 23.3% in the group with prehypertension, and 38.3% and 39.1% in the group with hypertension (P < 0.01). Awareness of hypertension in the study population was in 55.3%; 36.5% of the hypertensive group were receiving treatment for hypertension, and 28.2% of this group had a controlled BP (< 140/90 mm Hg).
  
  
  CONCLUSIONS
  The study found a low prevalence of normotension and high prevalence of hypertension in middle-class urban Asian Indians. Significant associations of hypertension were found with age, dietary fat, consumption of fruits and vegetables, smoking, and obesity. Normotensive individuals had a lower prevalence of cardiometabolic risk factors than did members of the prehypertensive or hypertensive groups. Half of the hypertensive group were aware of having hypertension, a third were receiving treatment for it, and quarter had a controlled BP.
authors: Department of Medicine, Fortis Escorts Hospital, Jaipur, India. rajeevg@satyam.net.in
authors: Rajeev
authors: R
authors: Gupta
authors: Prakash C
authors: PC
authors: Deedwania
authors: Vijay
authors: V
authors: Achari
authors: Anil
authors: A
authors: Bhansali
authors: Bal Kishan
authors: BK
authors: Gupta
authors: Arvind
authors: A
authors: Gupta
authors: Tulika G
authors: TG
authors: Mahanta
authors: Arthur J
authors: AJ
authors: Asirvatham
authors: Sunil
authors: S
authors: Gupta
authors: Anuj
authors: A
authors: Maheshwari
authors: Banshi
authors: B
authors: Saboo
authors: Mallikarjuna V
authors: MV
authors: Jali
authors: Jitendra
authors: J
authors: Singh
authors: Soneil
authors: S
authors: Guptha
authors: Krishna Kumar
authors: KK
authors: Sharma
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D004041:Dietary Fats / Q000008:administration & dosage; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology* / Q000628:therapy; D007194:India / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D058246:Prehypertension / Q000453:epidemiology* / Q000628:therapy; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012923:Social Class; D014505:Urban Population
chemical_list: D004041:Dietary Fats