Open Access Highly Accessed Research article

Burden and predictors of hypertension in India: results of SEEK (Screening and Early Evaluation of Kidney Disease) study

Youssef MK Farag1, Bharati V Mittal1, Sai Ram Keithi-Reddy1, Vidya N Acharya2, Alan F Almeida3, Anil C4, Ballal HS5, Gaccione P1, Issacs R6, Sanjiv Jasuja7, Kirpalani AL8, Kher V9, Modi GK10, Georgy Nainan11, Jai Prakash12, Mohan M Rajapurkar13, Rana DS14, Rajanna Sreedhara154, Sinha DK16, Bharat V Shah17, Sham Sunder18, Raj Kumar Sharma19, Sridevi Seetharam4, Tatapudi Ravi Raju20 and Ajay K Singh1*

Author Affiliations

1 Renal Division, Brigham & Women’s Hospital & Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA

2 NKF-India, Mumbai, India

3 Hinduja Hospital, Mumbai, India

4 Vivekananda Memorial Hospital, H.D.Kote, Saragur, Mysore, India

5 Manipal Institute of Nephrology & Urology, Bangalore, India

6 Deep Hospital, Ludhiana, India

7 Indraprastha Apollo Hospital, New Delhi, India

8 Bombay Hospital, Mumbai, India

9 Fortis Flt. Lt. Rajan Dhall Hospital, New Delhi, India

10 Bhopal Memorial Hospital & Research Center, Bhopal, India

11 PVS Memorial Hospital, Cochin, India

12 Institute of Medical Sciences, BHU, Varanasi, India

13 Muljibhai Patel Urological Hospital, Nadiad, India

14 Sir Ganga Ram Hospital, New Delhi, INdia

15 Wockhardt Hospitals, Bangalore, India

16 Kanpur Rotary Kidney Foundation, Kanpur, India

17 Lilavati Hospital, Mumbai, India

18 Dr. R.M.Lohia Hospital, New Delhi, India

19 Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India

20 Andhra Medical College & King George Hospital, Vishakhapatanam, India

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BMC Nephrology 2014, 15:42  doi:10.1186/1471-2369-15-42

Published: 6 March 2014

Abstract

Background

Hypertension (HTN) is one of the major causes of cardiovascular morbidity and mortality. The objective of the study was to investigate the burden and predictors of HTN in India.

Methods

6120 subjects participated in the Screening and Early Evaluation of Kidney disease (SEEK), a community-based screening program in 53 camps in 13 representative geographic locations in India. Of these, 5929 had recorded blood pressure (BP) measurements. Potential predictors of HTN were collected using a structured questionnaire for SEEK study.

Results

HTN was observed in 43.5% of our cohort. After adjusting for center variation (p < 0.0001), predictors of a higher prevalence of HTN were older age ≥40 years (p < 0.0001), BMI of ≥ 23 Kg/M2 (p < 0.0004), larger waist circumference (p < 0.0001), working in sedentary occupation (p < 0.0001), having diabetes mellitus (p < 0.0001), having proteinuria (p < 0.0016), and increased serum creatinine (p < 0.0001). High school/some college education (p = 0.0016), versus less than 9th grade education, was related with lower prevalence of HTN. Of note, proteinuria and CKD were observed in 19% and 23.5% of HTN subjects. About half (54%) of the hypertensive subjects were aware of their hypertension status.

Conclusions

HTN was common in this cohort from India. Older age, BMI ≥ 23 Kg/M2, waist circumference, sedentary occupation, education less, diabetes mellitus, presence of proteinuria, and raised serum creatinine were significant predictors of hypertension. Our data suggest that HTN is a major public health problem in India with low awareness, and requires aggressive community-based screening and education to improve health.

Keywords:
Hypertension; CKD; Awareness