An unattended silent killer: A facility-based cross-sectional study on undiagnosed hypertension from Haryana, India

Abstract

Background: Non-communicable diseases are on the upsurge throughout the world. They take a toll of 71% of overall total death, majorly contributed by cardiovascular disease. Hypertension has been a consistent risk factor for cardiovascular diseases among the various risk factors. Hypertension’s asymptomatic nature makes it a silent killer; many lives are avertable if a timely diagnosis can be assured. Aims and Objectives: The aim of this study was to determine the prevalence of undiagnosed hypertension among the attendees of a sub-district hospital. Materials and Methods: We conveniently chose 100 participants of age 30 years from the out-patient department of a sub-district hospital in Gohana, Haryana. Any attendees aged more than 30 years was requested to participate in the study. The execution of the study was done in accordance to the guidelines laid in Helsinki Declaration 1975, revised 1983. Due permission was taken from the concerned authority of the study facility. After obtaining well-informed consent, data were collected through a semi-structured questionnaire. The blood pressure was measured and classified per JNC-8 guidelines. Any participant having systolic B.P. more than 140 mmHg and diastolic B.P. more than 90 mmHg on two 5 min apart readings was considered hypertensive. The descriptive analysis was done in terms of frequencies and proportions. The Chi-square test was done to determine any association of undiagnosed hypertension with selected risk factors. Results: We report a 59% prevalence of undiagnosed hypertension among study participants. The undiagnosed hypertension was statistically associated (P<0.05) with higher body mass index, less physically active, being a diabetic, alcoholic, smoker, and having a positive family history of hypertension. Only 2% of the participants knew of any health program on non-communicable diseases. Conclusion: A higher prevalence of undiagnosed hypertension even after health facility visits for any other reason warrants the standardized and universal blood pressure measurement of patients visiting health facilities irrespective of the health issue, for which they are visiting.

Incidence of hypertension and its risk factors: a systematic review

“…However, the major contributing factors for hypertension among adults is body mass index, waist circumference and waist-hip ratio. [17][18][19][27][28][29][30][31]39,40,47,48,53 In the current review, waist circumference and body mass index were revealed to be superior predictors of high blood pressure in Haryanvi Baniyas. On the other hand, Jatts of Haryana had a higher body mass index and waistto-hip ratio which are the major risk factors of hypertension.…”

“…50 It was a l s o observed that adults with high blood pressure and a family record of hypertension were found to have high blood cholesterol and triglyceride levels. 19,31,39,48 Uneducated or illiterate persons were positively associated with hypertension in a meta-analysis undertaken in Southeast Asian countries, which may be attributed to a lower level of awareness among them. 51 Higher education, on the other hand, may promote health literacy and the value of leading a healthy lifestyle, which includes regular physical activity, a wellbalanced diet, and regular screenings to reduce the likelihood of developing hypertension.…”

“…are waist circumference, waist-hip ratio, and body mass index. [27][28][29][30][31] Papers from Haryana reported that the prevalence of hypertension rises with age. 32,33 In present study people with higher rank were more prone to hypertension.…”

“…First, the research carried out in both the states revealed that adult males had a substantially greater prevalence of hypertension than females. 16,[22][23][24]29,31,34,37,[39][40][41][42][43][44] However, six studies reported that the frequency was higher among females in both Punjab and Haryana. 18,32,[45][46][47][48] Incidence of hypertension in Punjab was 40.1%.…”

“…26,49 Diabetes mellitus has been identified as a risk factor for hypertension by several authors from Punjab and Haryana. 20,31,36,38…”