Impact of the 2017 ACC/AHA guidelines on the prevalence of hypertension among Indian adults: Results from a cross-sectional survey.
International Journal of Cardiology. Hypertension
Background: The impact of the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for diagnosis and management of hypertension on the prevalence of hypertension in India is unknown.
Methods: We analyzed data from the Cardiac Prevent 2015 survey to estimate the change in the prevalence of hypertension. The JNC8 guidelines defined hypertension as a systolic blood pressure of ≥140 mmHg or diastolic blood pressure of ≥90 mmHg. The 2017 ACC/AHA guidelines define hypertension as a systolic blood pressure of ≥130 mmHg or diastolic blood pressure of ≥80 mmHg. We standardized the prevalence as per the 2011 census population of India. We also calculated the prevalence as per the World Health Organization (WHO) World Standard Population (2000-2025).
Results: Among 180,335 participants (33.2% women), the mean age was 40.6 ± 14.9 years (41.1 ± 15.0 and 39.7 ± 14.7 years in men and women, respectively). Among them, 8,898 (4.9%), 99,791 (55.3%), 35,694 (11.9%), 23,084 (12.8%), 9,989 (5.5%) and 2,878 (1.6%) participants belonged to age group 18-19, 20-44, 45-54, 55-64, 65-74 and ≥ 75 years respectively. The prevalence of hypertension according to the JNC8 and 2017 ACC/AHA guidelines was 29.7% and 63.8%, respectively- an increase of 115%. With the 2011 census population of India, this suggests that currently, 486 million Indian adults have hypertension according to the 2017 ACC/AHA guidelines, an addition of 260 million as compared to the JNC8 guidelines.
Conclusion: According to the 2017 ACC/AHA guidelines, 3 in every 5 Indian adults have hypertension.
Gupta K, Ramakrishnan S, Zachariah G, Rao JS, Mohanan PP, Venugopal K, Sateesh S, Sethi R, Jain D, Bardolei N, Mani K, Kakar TS, Jain V, Gupta P, Gupta R, Bansal S, Nath RK, Tyagi S, Wander GS, Gupta S, Mandal S, Senguttuvan NB, Subramanyam G, Roy D, Datta S, Ganguly K, Routray SN, Mishra SS, Singh BP, Bharti BB, Das MK, Deb PK, Deedwania P, Seth A; CSI-Great India BP Campaign Investigators. Impact of the 2017 ACC/AHA guidelines on the prevalence of hypertension among Indian adults: Results from a cross-sectional survey. Int J Cardiol Hypertens. 2020 Oct 7;7:100055. doi: 10.1016/j.ijchy.2020.100055. PMID: 33465185; PMCID: PMC7803035.