title: Prevalence and determinants of comorbid diabetes and hypertension: Evidence from non communicable disease risk factor STEPS survey, India.
abstract: OBJECTIVE
  Comorbidity of non-communicable diseases carries a significant risk of cardiovascular events and mortality. With the rising burden of diabetes, hypertension and other risk factors, and ageing population in India, this is likely to pose a major threat to the health system. It is therefore essential to understand this high risk group. This article reports prevalence of comorbid diabetes and hypertension and its associated risk factors in the North Indian state of Punjab.
  
  
  METHODS
  A household NCD STEPS survey was done in Punjab, India in a multistage stratified sample of 5127 individuals. All the subjects were administered the WHO STEPS questionnaire, anthropometric and blood pressure measurements. Every alternate respondent in the sample (n=2499) were assayed for blood glucose and lipid parameters.
  
  
  RESULTS
  The prevalence of comorbid DM and HTN was 4.5% in the general adult population. DM, HTN and dyslipidemia co-existed in 1.8% of the population. Obesity and dyslipidemia are the most common comorbidities among persons with DM and HTN alone and comorbid DM and HTN. Factors strongly associated with comorbid DM and HTN include elderly age group, dyslipidemia, obesity and family history of DM.
  
  
  CONCLUSIONS
  The study reported high burden of comorbid diabetes and hypertension among the elderly, strongly associated with obesity and dyslipidemia. This emphasizes the role of nonpharmacological intervention such as weight reduction, physical activity, and dietary modification.
authors.affiliation: Operational Research Fellow, International Union Against Tuberculosis and Lung Disease, The Union South East Asia Office, New Delhi, India. Electronic address: ijay.doc@gmail.com.
authors.forename: Jaya Prasad
authors.initials: JP
authors.lastname: Tripathy
authors.affiliation: Professor of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: jsthakur64@gmail.com.
authors.forename: J S
authors.initials: JS
authors.lastname: Thakur
authors.affiliation: Research Fellow, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: gsj_2008@yahoo.com.
authors.forename: Gursimer
authors.initials: G
authors.lastname: Jeet
authors.affiliation: Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: sanjayvanita@yahoo.com.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Jain
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D048909:Diabetes Complications / Q000453:epidemiology*; D050171:Dyslipidemias / Q000150:complications; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology*; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors
keywords: Comorbidity; Diabetes; Hypertension; India; Non-communicable disease; STEPS survey