In:
PLOS Medicine, Public Library of Science (PLoS), Vol. 18, No. 8 ( 2021-8-24), p. e1003740-
Abstract:
Lack of nationwide evidence on awareness, treatment, and control (ATC) of hypertension among older adults in India impeded targeted management of this condition. We aimed to estimate rates of hypertension ATC in the older population and to assess differences in these rates across sociodemographic groups and states in India. Methods and findings We used a nationally representative survey of individuals aged 45 years and over and their spouses in all Indian states (except one) in 2017 to 2018. We identified hypertension by blood pressure (BP) measurement ≥140/90 mm Hg or self-reported diagnosis if also taking medication or observing salt/diet restriction to control BP. We distinguished those who (i) reported diagnosis (“aware”); (ii) reported taking medication or being under salt/diet restriction to control BP (“treated”); and (iii) had measured systolic BP 〈 140 and diastolic BP 〈 90 (“controlled”). We estimated age–sex adjusted hypertension prevalence and rates of ATC by consumption quintile, education, age, sex, urban–rural, caste, religion, marital status, living arrangement, employment status, health insurance, and state. We used concentration indices to measure socioeconomic inequalities and multivariable logistic regression to estimate fully adjusted differences in these outcomes. Study limitations included reliance on BP measurement on a single occasion, missing measurements of BP for some participants, and lack of data on nonadherence to medication. The 64,427 participants in the analysis sample had a median age of 57 years: 58% were female, and 70% were rural dwellers. We estimated hypertension prevalence to be 41.9% (95% CI 41.0 to 42.9). Among those with hypertension, we estimated that 54.4% (95% CI 53.1 to 55.7), 50.8% (95% CI 49.5 to 52.0), and 28.8% (95% CI 27.4 to 30.1) were aware, treated, and controlled, respectively. Across states, adjusted rates of ATC ranged from 27.5% (95% CI 22.2 to 32.8) to 75.9% (95% CI 70.8 to 81.1), from 23.8% (95% CI 17.6 to 30.1) to 74.9% (95% CI 69.8 to 79.9), and from 4.6% (95% CI 1.1 to 8.1) to 41.9% (95% CI 36.8 to 46.9), respectively. Age–sex adjusted rates were lower ( p 〈 0.001) in poorer, less educated, and socially disadvantaged groups, as well as for males, rural residents, and the employed. Among individuals with hypertension, the richest fifth were 8.5 percentage points (pp) (95% CI 5.3 to 11.7; p 〈 0.001), 8.9 pp (95% CI 5.7 to 12.0; p 〈 0.001), and 7.1 pp (95% CI 4.2 to 10.1; p 〈 0.001) more likely to be aware, treated, and controlled, respectively, than the poorest fifth. Conclusions Hypertension prevalence was high, and ATC of the condition were low among older adults in India. Inequalities in these indicators pointed to opportunities to target hypertension management more effectively and equitably on socially disadvantaged groups.
Type of Medium:
Online Resource
ISSN:
1549-1676
DOI:
10.1371/journal.pmed.1003740
DOI:
10.1371/journal.pmed.1003740.g001
DOI:
10.1371/journal.pmed.1003740.g002
DOI:
10.1371/journal.pmed.1003740.g003
DOI:
10.1371/journal.pmed.1003740.g004
DOI:
10.1371/journal.pmed.1003740.g005
DOI:
10.1371/journal.pmed.1003740.t001
DOI:
10.1371/journal.pmed.1003740.t002
DOI:
10.1371/journal.pmed.1003740.t003
DOI:
10.1371/journal.pmed.1003740.s001
DOI:
10.1371/journal.pmed.1003740.s002
DOI:
10.1371/journal.pmed.1003740.s003
DOI:
10.1371/journal.pmed.1003740.s004
DOI:
10.1371/journal.pmed.1003740.s005
DOI:
10.1371/journal.pmed.1003740.s006
DOI:
10.1371/journal.pmed.1003740.s007
DOI:
10.1371/journal.pmed.1003740.s008
DOI:
10.1371/journal.pmed.1003740.s009
DOI:
10.1371/journal.pmed.1003740.s010
DOI:
10.1371/journal.pmed.1003740.s011
DOI:
10.1371/journal.pmed.1003740.s012
DOI:
10.1371/journal.pmed.1003740.s013
DOI:
10.1371/journal.pmed.1003740.s014
DOI:
10.1371/journal.pmed.1003740.s015
DOI:
10.1371/journal.pmed.1003740.s016
DOI:
10.1371/journal.pmed.1003740.s017
DOI:
10.1371/journal.pmed.1003740.s018
DOI:
10.1371/journal.pmed.1003740.s019
DOI:
10.1371/journal.pmed.1003740.s020
DOI:
10.1371/journal.pmed.1003740.s021
DOI:
10.1371/journal.pmed.1003740.s022
DOI:
10.1371/journal.pmed.1003740.s023
DOI:
10.1371/journal.pmed.1003740.s024
DOI:
10.1371/journal.pmed.1003740.r001
DOI:
10.1371/journal.pmed.1003740.r002
DOI:
10.1371/journal.pmed.1003740.r003
DOI:
10.1371/journal.pmed.1003740.r004
DOI:
10.1371/journal.pmed.1003740.r005
DOI:
10.1371/journal.pmed.1003740.r006
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2021
detail.hit.zdb_id:
2164823-2
Permalink