Prevalence, correlates, awareness, treatment, and control of hypertension in Kumarakom, Kerala: Baseline results of a community-based intervention program

BACKGROUND: Hypertension is one of the major causes of cardiovascular morbidity and mortality. However, awareness, treatment, and control of hypertension remain major challenges worldwide. In this article, we present the baseline prevalence of hypertension from an ongoing intervention program for its control in a community-based sample in Kerala, Southern India. METHODS: We measured blood pressure, body weight, and height of 4955 individuals above the age of 30 years (men: 2159; meanage: 50 years) and collected information on alcohol use, tobacco use, and other demographic variables using a pre-tested structured questionnaire. RESULTS: The overall prevalence of hypertension (JNC VII) was 36.7% (95% CI: 35.3-38.0; men: 36.0% and women 37.2%). In multiple logistic regression analysis, a body mass index of ≥25 kg/m ² was associated with a 1.65-fold (95% CI: 1.37-1.98) prevalence of hypertension compared to a body mass index <25 kg/m ². Individuals with diabetes mellitus had 2.10 higher odds of hypertension prevalence (95% CI: 1.62-2.73) compared to people without diabetes mellitus. Participants with increased waist circumference (90 cm in men and 85 cm in women) were 1.84 times more likely to be hypertensive compared to those with normal waist circumference (95% CI: 1.55-2.19). Among hypertensives, 24% were aware of the condition, 20% were on treatment, and 6.4% achieved effective blood pressure control. CONCLUSIONS: A higher body mass index, increased waist circumference, and self-reported diabetes mellitus were the important correlates of hypertension in our community-based sample. Our data emphasize the importance of educational interventions and appropriate lifestyle modifications that target increased body mass index and waist circumference to reduce the community burden of hypertension.