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ORIGINAL CONTRIBUTION |
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| Year : 2000 | Volume
: 54
| Issue : 9 | Page : 380-383 |
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Prevalence of hypertension in Mumbai
SV Joshi1, JC Patel2, HL Dhar3
1 Technical Officer, Research Dept, Medical Research Centre, Bombay Hospital, Bombay-20, India
2 Hon. Physician, Medical Research Centre, Bombay Hospital, Bombay-20, India
3 Director, Medical Research Centre, Bombay Hospital, Bombay-20, India
Correspondence Address:
H L Dhar
Director, Medical Research Centre, Bombay Hospital, Bombay-20
India
PMID: 11966061
How to cite this article:
Joshi S V, Patel J C, Dhar H L. Prevalence of hypertension in Mumbai. Indian J Med Sci 2000;54:380-3 |
There is increasing trend of hypertension (HT) due to increase in longevity, change in life style, increasing obesity and postmenopausal state yin women. More attention is given to the treatment of HT because it leads to additional burden to the family member if it is not treated. Very little work has been reported on the prevalence of HT in India. In north Indian study on general urban population [1] prevalence of HT was found to be 23.71 % while in the Western region, general population was 26% against 36% in adult population. [2] In a village in Nagpur district, prevalence rose from 4% (young) to 17.2% in (60+) [3] while in Haryana it was reported to be 3.57% [4] in general population. Patel reported prevalence of hypertension (7.82%) in rural population (3,500 patients) of Gujarat. [5]
Present work is an attempt to highlight the prevalence of essential hypertension in the out patient department of a hospital where lower middle and upper lower class of population take advantage due to better attention even though there are 3 other general free large government run hospitals situated within a distance of less than one kilometer.
| ¤ Patients and Methods | |  |
In the out patient department of one of the authors we have been keeping meticulous records of all the patients attended. A detailed history of complaints, family and personal history was taken. Body weight, was taken and blood pressure was recorded on each visit. During the period 1993-1999 three thousand patients have been studied. The main idea of keeping the record was to investigate the reason of their O.P.D. visit, the cause of the ailment which brought them. Number of them who could afford and carry out the investigations at the hospital were recorded and outcome of treatment given was analysed. The investigations suggested by us were minimum required for the purpose of diagnosis of main ailment. Present report was to study the prevalence of hypertension in a consecutive 3000 OPD patients. The criteria for HT in this series was the presence of blood pressure on two consecutive OPD visits higher than 140 mm of systolic BP and 90 mm diastolic.
| ¤ Results | | |
There was rise in mean blood pressure in male and female subjects in different age groups [Table 1]. Hypertensive subjects (7.77%) showed increased prevalence with age which increased nearly fourfold in 30-49 age group and incidence was higher in females (10.57%) than in males (6.13%). Body weight also does not have effect on the blood pressure in males although there was insignificant rise in blood pressure in females. Diabetes mellitus was associated with hypertension in 43.37%. In males, smoking as a risk factor of HT was found in 9.04% and alcohol intake in 7.83%. in post menopausal women HT was noticed in 7.94%. All biochemical parameters were within normal limits.
| ¤ Discussion | | |
The prevalence of 7.77% hypertension in urban population attending general medical OPD in Mumbai (10-79 yrs) is lower than those under similar conditions from North India (23.7%). [1] In rural area, prevalence of hypertension was found to be 7.82%. [5] In total Western Population prevalence was 26% in general population and 36% in adult. [2] Even recent cross sectional Canadian heart health survey [6] from 1986 to 1992 non institutionalized respondents between 18-74 years, 22% showed hypertension (26% men and 18% women). Compared to rural India 4% in Nagpur [3] and 3.57% from Haryana [4] our values are almost double (7.77%). The difference could be due to the socioeconomic status of our patients. However, North Indians [1] from high socioeconomic group had much higher prevalence compared to our series which comprised of 50% from lower class and 50% from middle class. Bunker et al. [7] reported higher risk of hypertension in males of higher socioeconomic status. Prevalence of HT in our study, increased with age from 3.5% in 30-34 yrs. to 22.22% in 60+ age group. Similar findings in rural population [3] were reported upto the age of 50 years however it increases with age in urban population, 21.30% (51-60) years and 22.22% (60+), compared to 11.54% (51-60 years) and 19.21% (60+) in rural population.
Higher prevalence of HT (10.57%) in females than men (6.13%) was in contrast to the previous study. [3] However higher diastolic B.P. was reported by Vulkou. [8]
WHO MONICA project [9] shows low systolic blood pressure in women of 35-44 age group with steep rise in age group of 55-64 Our findings are similar showing low Systolic BP in the age group of 30-49. Prevalence of hypertension was 11% in 30-49 compared to 21.25% in the age group (50-59).
20% female nurses in U.S [10] (30-55 years) were hypertensive due to weight gain below the age of 45 years than older women (>55 years). Higher incidence in upper age group in female subjects might be attributed to menopause [11] suggesting that this effect may be mediated through reduction in arterial compliance.
Obesity which is an important risk factor [12] for hypertension was not observed in our study. Diabetes mellitus was associated with hypertension in 43.37% and 25.30% respondents had strong family history of hypertension.
Cigarette smoking which is an important and established risk factor [13] had inverse relationship with blood pressure as reported by Joshi et al. [3]
Since Mumbai is a cosmopolitan city having different cross section of people drawing from different socioeconomic strata of the country our results showing B.P. attending out patient department of Bombay Hospital may be more representative.
| ¤ Summary | | |
There are few reports on prevalence of hypertension in India. We are presenting a study of its incidence in OPD of hospital patients in Mumbai. Prevalence of hypertension was 7.82% in all subjects, however, it was higher in females 10.5% than in males 6.1%.
| ¤ References | | |
| 1. | Singh RB, Beegom R, Ghosh S, Niaz MA. Epidemiological study of hypertension and its determinants in an urban population. J Hum Hypertens 1997:11:679-85.  |
| 2. | Kennes WB, Thom JJ. Incidence, prevalence and mortality of cardiovascular disease. In Hurst WJ. ed. Heart 6th ed. NY McGraw Hill Inc. 1986, 560. |
| 3. | Joshi PP, Kate SK, Shegokar. Blood pressure trends and life style risk factors in rural India 1993, JAP1 41;579-581. |
| 4. | Gupta SP, Siwach SB, Gupta MS. Hypertension & blood pressure trends in the general population of Haryana JAPI 1979;27:119-26. |
| 5. | Patel JC Prevalence of hypertension and diabetes mellitus in rural villages J Diab Ass Ind 1986;26:68-76. |
| 6. | Jotters MR, Ghadirian P, Foder JG, et al. Awareness, treatment and control of hypertension in Canada. Am J Hypertens 1997;10:1097-1102. |
| 7. | Bunger CH, Okoro FI, Markovic N et al. Health 1996:33-45. |
| 8. | Vulkou I. Percentile reference values of arterial B.P. for Individuals aged 20 to 60 years from plovdiv region. Folia Med (Poldiv) 1997;39:31-36. |
| 9. | Wolf HK, Tuomilehto J, Kaulasmass K, et al. Blood pressure levels in the 41 populations of the WHO MONICA project. J Hum Hypertens 1997;11:733-42. |
| 10. | Huang Z, Willett WC, Manson JE. et al. Body weight, weight change and risk for hypertension in women. Ann Intern Med 1998;128;81-88. |
| 11. | Staessen JA, Ginocchio G, Thijs L, Fargatd R. Conventional and ambulatory BP and menopause in a prospective population study. J Hum Hypertens 1997:11:507-14. |
| 12. | Vander Sande MA, Bailey R, Faal H, Banga WA, et al. Nationwide prevalence study of hypertension and related noncommunicable diseases in the Gambia. Trop Med Int Health 1997;2:1039-48. |
| 13. | The 1988 report of the Joint National Committee on detection, evaluation and treatment of high blood pressure. Arch Intern Med 1988: 143 . 1023. |
[Table 1]
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