Epidemiology of hypertension and its risk factors in a village of west Bengal

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1 Original Research Paper IJRRMS 03;3(3) Epidemiology of hypertension and its risk factors in a village of west Bengal Basu G, Biswas S ABSTRACT Background: Hypertension is a leading public health problem in recent times. Emphasis has been given to risk factors that are measurable under field conditions and that are amenable to intervention. Aim: To estimate the prevalence of hypertension, its risk factors and to find out their biosocial association. Methods: The present cross sectional descriptive study was carried out among 730 participants aged between 5-64 years in a selected village. Data was taken on different aspects with the help of a proforma based on IDSP schedule modification and was analyzed with statistical software using EPI-INFO (version-3.4.3). Results: Study population had nearly 57% males, 0% illiterate and 35 % unemployed..9% used smoked and smokeless tobacco, 75.% were current tobacco users, % were current drinkers, 38.5% had sedentary lifestyle, 46.% took vegetables regularly, and nearly 50% added extra salt most of the times. 80% used unsaturated oil. High normal pressure was recorded in 5.5% of population while 9.7% had mild and 8.4% had moderate / severe hypertension. Hypertension had significant association with age group, level of education, per capita income and employment status, tobacco use, alcohol consumption, physical activity, salt intake, intake of oils/fat which was statistically significant.(p<.0) Conclusion: Increase in level of education with a healthy lifestyle is the need of the hour in battle with hypertension. IJRRMS VOL-3 No.3 JULY - SEP 03 3

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3 IJRRMS 03;3(3) Table.3.Raised blood pressure and socio demographic variables (n=730) Blood pressure N (%) Optimal/(SBP <0,DBP<80) Normal (SBP <30, DBP <85) 4 (56.4) High normal ( SBP = 30-39, DBP = 85-89) 86 (5.5) Grade hypertension (mild) (SBP =40-59,DBP = 90-99) 7 (9.7) Grade hypertension (moderate) (SBP =60-79, DBP=00-09 ) 37 (5.) Grade 3 hypertension (severe) (SBP>=80, DBP>=0) 4 (3.3) Hypertension was found to have significant association with age group, level of education, per capita income and employment status. Statistically significant association was found between hypertension and tobacco use, alcohol consumption, physical activity, salt intake with food, and intake of oils/fat.(p <.0);Table.3 and 4. DISCUSSION 8,9 Prevalence of tobacco use was less in other studies that might be due to different locations, huge variation in age range and socio cultural differences..3% of study subjects used smoked tobacco products whereas 40% used smokeless tobacco products and.9% of study populations used both which was less than what found in another study 0 carried out by Sinha D N et al. Prevalence of current drinkers was 8.5% in present study and the result was similar as found by some authors in their, studies. In the present study, the findings of physical activity were quite similar to a study carried 3 out by Sugathan T N et al. Majority (49.5%) of study population added extra salt which is quite higher 4 compared to another study. 0.4% of present study population consumed saturated oils/fat which was far less than the percentage (47%) found in a study 4 conducted in rural area by Agarwal V K et al. Hypertension was found to be significantly associated with age group, level of education, per capita income and employment status in the present study. Association with age was seen in most of the studies 5,6 by various authors. Association of level of education with hypertension was not found in any other study which might be due to various socio Socio demographic variables Present Statistics OR ( 95% CI ) Age 5-4yrs (n=90) 9(5.3) x = ( ) group (yrs) 5-34yrs (n=45) 49(33.8) df=4, 0.6( ) 35-44yrs (n=49) 36(4.) P= yrs (n=36) 33(4.3) 0.99( ) 55-64yrs (n=0) 3(0.9).3(( ) Sex Male (n=44) 9() x =.00, 0.99( ) Level of Female (n=36) 69(.8) df=, Illiterate/Just P=.96 education literate (n=45) 33(.8) x = ( ) df=4, Primary (n=8) 50(7.6) P= ( ) Middle (n=30) 36(5.7) Secondary (n=7) 37(9.).( ) Higher (n=47) 4(8.5).99( ) Per capita st (n=) 5(4.5) x =5.63 income nd(n=07) (0.6) df=3,.73( ) 3rd (n=0) 5(5.7) P= ( ) (quartile) 4th (n=09) 34(3.) 0.5( ) Unemployed 0(.7).6( ) (n=79) Unskilled labour 6(4.7) x =9.7 (n=47) df=5, Skilled labour 3(.7) P=.00.9( ) (n=60) Employment Service (n=0) 5(5) 0.98( ) status Business (n=88) 4(5.9).73( ) Student (n=6) 5(8.) 3.67( ) Homemaker 5(9.7) 0.78( ) (n=75) Raised blood pressure (Hypertension) cultural background and different settings. A study revealed significant association of hypertension in 7 terms of occupation and socio economic status. Another study carried out by Avadaiammal V et al elicited that the prevalence of hypertension was less among educated persons as compared to less educated persons, but the difference was not 8 statistically significant. In the present study, the maximum prevalence of hypertension was seen in 5-34yr age groups (33.8%), the th respondents in the 4 or richest quartile (3.%) and population having middle education (9.%) and among homemakers (9.7%). IJRRMS VOL-3 No.3 JULY - SEP 03 5

4 IJRRMS 03;3(3) Table.4.Raised blood pressure and risk factors (n=730) Risk factors Raised blood pressure (Hypertension) Present Statistical significance Type of Daily (n=5) 7(8.3) x =93.4, df=3, tobacco users Occasional (n=0) 68(66.7) Ex (n=0) Never (n=79) 0(.7) Alcohol intake Equal/ more than (0.8) P=.000 8(50.9) x =5.7, df=4, 5 days a wk (n=55) P= days a wk(n=59) 7(45.8) -3 d m/<once m (n=94) (.7) Former drinker (n=7) 7(3.6 Life time abstainer(n=450) 77(7.) Physical Sedentary/Inactive(n=8) 87(3.0) activity Medium(n=5) 47(8.7) x =3.94,df=, Heavy(n=98) Sometimes/never (n=43) 6(3.) P=.000 Extra salt Most of times (n=36) 07(9.6) x =5.07, df=, intake Sometimes(n=5) 34(5.) P=.000 with food Never(n=44) 9(3.) Intake of Unsaturated oil/fats(n=58) 90(5.49) x =5.5, df=, oils/fat Saturated fat/oil(n=49) 70(47.0) P=.000 CONCLUSION Hypertension increases the load in term of morbidity and indirectly put immense economic burden on already economically stressed Indian economy. Adoption of healthy lifestyle in regard to behavioural risk factors will surely improve the situation. It is a felt need for the local administrative authority to take initiative in arranging health awareness campaign in grassroots level at regular interval to improve the lifestyle of the respondents. ACKNOWLEDGEMENT We acknowledge Dr. Madhumita Dobe and Late Dr. Ranadeb Biswas of All India Institute of Hygiene & Public Health for their continuous support and motivation throughout the study period. AUTHOR NOTE Gandhari Basu, Assistant Professor, Department of Community Medicine (Corresponding Author); College of Medicine & JNM Hospital,Kalyani, WBUHS: gandhari.basu@gmail.com Subikas Biswas, Associate professor, Department of surgery, College of Medicine & JNM Hospital, Kalyani, WBUHS. Subikas Biswas, Associate professor, Department of surgery, College of Medicine & JNM Hospital, Kalyani, West Bengal REFERENCES. Gupta R, Guptha S. Strategies for initial management of hypertension. Indian J Med Res. Nov 00;3(5): Gupta R, al-odat NA, Gupta VP. Hypertension epidemiology in India: meta-analysis of 50 year prevalence rates and blood pressure trends. J Hum Hypertens. Jul 996;0(7): Mohan V, Deepa M, Farooq S, Datta M, Deepa R. Prevalence, awareness and control of hypertension in Chennai The Chennai Urban Rural Epidemiology Study (CURES-5). J Assoc Physicians India. May 007;55: WHR 00 Overview. page IDSP: Training manual for state and district surveillance officers: A report. 6. Park K. In: Park's Text book of preventive and social medicine; 5th ed. Jabalpur: M/S Banaroidas Bhanot Publishers; 997.p Rose GA, Blackburn H, Gillum RF, Prineas RJ.Cardiovascular survey methods.nd ed. WHO monograph series 98; 56.WHO Geneva. 8. Mehan M B, Surabhi S, Solanki G T. Risk factor profile of non-communicable diseases among middle-income (8-65 years)free-living urban population of India. Int J Diab Dev Ctries.006; 6:69 (76). 9. Chow C, Cardona M, Raju P, Iyengar S, Sukumar A, Raju R et al. Cardiovascular disease and risk factors among 345 adults in rural India the Andhra Pradesh Rural Health Initiative. Int J of Cardiology. 6 (); Sinha D N, Gupta P C, Pednekar M S. Tobacco use in a rural area of Bihar,India.Indian Journal of Community Medicine. 003 ; 8 (4). 6 IJRRMS VOL-3 No.3 JULY - SEP 03

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