Hypertension, pre-hypertension, and associated risk factors in a subsistent farmer community in remote rural central India

Aim: Eighty percent of global burden of hypertension is in low-income and middle-income areas. We aimed to assess the point prevalence of hypertension, pre-hypertension, associated risk factors, and awareness about high blood pressure in a subsistent farmer community in India. Methods: We performed a cross-sectional study of randomly selected adults above 40 years in six villages in Jamkhed, measuring blood pressure and abdominal girth, and administering a comprehensive questionnaire with both closed and open-ended questions assessing socio-demographics and risk factors for cardiovascular diseases in the summer of the 2010. Results: Of 224 adults, 57 % were women. Average age was 56.8 years (±11.76). The majority were farmers, reporting a high salt diet. 30.3 and 38.3 % met the criteria for hypertension and pre-hypertension respectively, and all but 1 was newly detected. High abdominal girth was 8.6 %, and 7.5 % had blood pressure consistent with stage 2 hypertension. Tobacco use was over 80 %. In regression analysis only abdominal girth predicted pre-hypertension. Conclusion: The age-adjusted high blood pressure rate comparable to the United States and a very low awareness about hypertension are alarming. Role of psychosocial stress and other potential risk factors needs further exploration. A strong public health response with emphasis on prevention, improving awareness, low cost and sustainable interventions for risk factors, and consistent treatment and follow up through community health workers using the existing model for controlling communicable diseases is feasible and warranted.