Twin load of hypertension and diabetes amongst adults: community based study from Jammu and Kashmir, India
Keywords:
Hypertension, Diabetes, Community based cross sectional study, Jammu & KashmirAbstract
Background: Data regarding the occurrence of hypertension and diabetes in the community are crucial for optimum allocation and utilization of health resources. Objective was to assess the efficacy of such field based exercise in detection of new undiagnosed cases and calculation of the consequent prevalence.
Methods: A cross sectional community based study was carried out to find out prevalence of hypertension and diabetes amongst adults (35-64 years) in Chatergam, Budgam (Jammu and Kashmir) during Oct 2011 to Feb 2012 on a pre-tested structured questionnaire. Blood pressure was measured in 2077 adults and random blood sugar (RBS) was measured in 1732 subjects to detect diabetes. Data was analyzed to find out the distribution of systolic (SBP) and diastolic (DBP) and the prevalence of hypertension and diabetes along with 95 percent confidence intervals.
Results: Mean SBP and DBP of 2077 subjects were 130.7 ± 40.3 and 83.1 ± 11.4 mm of mercury respectively. Values were the highest for both SBP and DBP amongst women of urban areas and in the 55 – 64 years of age. Quarter of studied persons (24.4%) had the family history of hypertension or diabetes or both. Based on the criteria of JNC 7, 41.1% subjects (95 % CI 38.9 – 43.2) were found hypertensive including 593 known cases (496 alone & 97 in combinations with diabetes). Prevalence of new cases of hypertension was 17.5 percent; it significantly increased with increasing age and was high amongst males and those residing in urban areas. 4.6% subjects (95% CI 3.6-5.7) were positive for diabetes based on RBS.
Conclusions: Considering high load of twin diseases and their impact on coronary vascular diseases (CVD), study emphasizes the need to implement an integrated population-based cost-effective control program with a focus on primordial and primary prevention.
Metrics
References
Abbas Ali Mansour. Prevalence and Control of Hypertension in Iraqi Diabetic Patients: A Prospective Cohort Study. Open Cardiovasc Med J. 2012;6:68
Ostergren J, Poulter NR, Sever PS et al. ASCOT investigators. The anglo-scandinavian cardiac outcomes trial: blood pressure- lowering limb: effects in patients with Type II diabetes. J Hypertension. 2008;26:2103-11.
Donald C. Simonson. Etiology and Prevalence of Hypertension in Diabetic Patients. Diabetes care. 1988;11(10):822-7.
Government of India Ministry of Home Affairs. Provisional Population Totals India: Paper 1, 2011. Available at: www.censusindia.gov.in-Cached. Accessed 11 January 2013.
Gupta R. Hypertension in India--definition, prevalence and evaluation J Indian Med Assoc. 1999 Mar;97(3):74-80.
Kumar P, Desai VK, Kosambiya JK. Prevalence of hypertension amongst the employee of a mega industry of South Gujarat. Indian Journal of Community Medicine. 2002;27(1):19-25.
Reddy SS, Prabhu GR. Prevalence and Risk Factors of Hypertension in Adults in an Urban Slum, Tirupati, A.P. Indian Journal of Community Medicine. 2005;30(2):84-6.
Jacob John, Jayaprakash Muliyal, Vinodhar Balraj. Screening for Hypertension among Older adults; a primary Care ‘High Risk Approach’. Indian Journal of Community Medicine. 2010;35(1):67-9.
Middha Tanu, Idris MZ, Saran RK, Srivasatava AK, Singh SK. Isolated systolic hypertension and its determinants – a cross sectional study in the adult population of Lucknow district in North India. Indian Journal of Community Medicine. 2010;35(1):89-93.
Raosoft. Sample size calculator, 2004. Available at: http://www.raosoft.com/samplesize.html. Accessed 30 January 2013.
Chobanian Aram V, Bakris George L, Black Henry R et al. The Seventh Report of the Joint National Committee on prevention, Detection, Evaluation, and Treatment of High Blood pressure The JNC 7 Report. The Journal of American Medical Association. 2003;289(19):2560-72.
World Health Organization. Primary Prevention of CHD. Euro report and studies. World Health Organization, Copenhagen, 1998. Available at: www.euro.who.int/__data/assets/pdf_file/0005/98438/e81384.pdf.
Gupta R. Trends in hypertension epidemiology in India. J Hum Hypertens. 2004;18(2):73-8.
American Diabetes Association. Treatment of Hypertension in Adults with Diabetes. Diabetes Care. 2003 January;26(Suppl 1):S80-2.
Ramachandran A, Snehalatha C, Kapur A, Vijay V, Mohan V, Das AK et al. High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey. Diabetologia. 2001;44:1094-1101.
Rao Chythra R, Veena G, Kanath Kamath, Avinash, Shetty Asha Kanath. In J Diabetes devctries. 2010;30(2):80-5.