Rates of diabetes and hypertension are high among middle-aged and elderly people across all geographic measures and sociodemographic groups in India, according to the first nationally representative study of those conditions in the country. The study, led by researchers at Harvard T.H. Chan School of Public Health, also found unexpectedly high rates of hypertension among young adults.
"Understanding how diabetes and hypertension prevalence varies within a country as large as India is essential for targeting of prevention, screening, and treatment services," said lead author Pascal Geldsetzer, a doctoral student in the Department of Global Health and Population.
The study appears online January 29, 2018 in JAMA Internal Medicine.
India, home to more than a sixth of the world's population, is in the midst of a rapid epidemiological transition. Rates of noncommunicable diseases have risen in recent decades and are likely to continue as India's population ages and urbanizes. Meanwhile, many areas of India still face substantial burdens of infectious diseases and poor maternal and child health.
The researchers wanted to find out how the prevalence of diabetes and hypertension in India varied by state, rural vs. urban location, and by sociodemographic characteristics such as education and household wealth. They used health data collected from 1,320,555 adults across India between 2012 and 2014, which included plasma glucose and blood pressure measurements.
The findings showed that diabetes and hypertension were prevalent across all geographies and sociodemographic groups.
- Overall, prevalence of diabetes was 6.1% among women and 6.5% among men; for hypertension, 20.0% among women and 24.5% among men
- Rates of diabetes and hypertension varied widely among states
- Household wealth and urban location were positively associated with both conditions, and the prevalence of diabetes and hypertension among middle-aged adults in the poorest households in rural areas was also high (5.9% had diabetes and 30% had hypertension)
- Hypertension was higher among adults under 45 than previously estimated and was higher than in Central and Eastern Europe, the region previously estimated to have the highest rates for young adults
"India has a window of opportunity to invest in its health system to effectively tackle hypertension and diabetes—both major killers. The potential for harnessing new technologies to reach the millions affected by these diseases and reverse the course of these epidemics is real. However, because the epidemics are worsening rapidly, now is the time for urgent action," said Rifat Atun, co-senior author and professor of global health systems in the Department of Global Health and Population.
"Diagnosis of hypertension and diabetes is straightforward but mostly untapped due lack of awareness and regular medical checkups," added Ashish Awasthi, co-author and faculty at the Indian Institute of Public Health, Gandhinagar, India. "India needs to focus on these two silent killers as well as other non-communicable diseases to reduce the burden of preventable premature morbidity and mortality. If unchecked, we will see a lot more victims of these two diseases in next two decades."
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"Diabetes and Hypertension in India: A Nationally Representative Study of 1.3 Million Adults," Pascal Geldsetzer, Jennifer Manne-Goehler, Michaela Theilmann, Justine Davies, Ashish Awasthi, Sebastian Vollmer, Lindsay Jaacks, Till Bärnighausen, Rifat Atun, JAMA Internal Medicine, online January 29, 2018, DOI: 10.1001/jamainternmed.2017.8094