Prevalence and correlates of hypertension in Maharashtra, India: A multilevel analysis

Abstract

Background and aimIn the last few decades, the prevalence of hypertension has been drastically increased in India. The present study estimates the current prevalence of hypertension and its correlates in the state of Maharashtra. The variation in the prevalence of hypertension associated with individual-level characteristics is explained at the community and district level.MethodsData is used from the recent round of District Level Household & Facility Survey (DLHS-4), 2012–13. The DLHS-4 has used the nationally representative sample, collected through multistage stratified sampling procedure. A similar sampling frame, used in NSSO-2007-08, has been followed. The chi-square test is used to show the significance level of the association between the estimated prevalence of hypertension and its correlates. Multilevel regression analysis is carried out to investigate the effects of individual and community level factors on the prevalence of hypertension.ResultsThe overall prevalence of hypertension is 25% in Maharashtra, and a huge variation in the prevalence of hypertension is found across the districts. Dhule, Gadchiroli (with a low HDI rank), Mumbai and Satara (with higher HDI rank) are the districts with the higher (above 30%) prevalence of high blood pressure. The prevalence also significantly varies according to different correlates. The prevalence of high blood pressure is higher among elderly population (40%), among males (28%), in the urban areas (27%) and in the richest wealth quintile (28%). The prevalence is also higher among cigarette smokers (31%), alcohol consumers (30%) and people with obesity (38%) as compared to their counterparts. The results of the multilevel analysis show that the older and obese persons are at four-time higher risk of hypertension. Again, age, sex, marital status, place of residence, wealth status, unhealthy habits (i.e. smoking and alcohol consumption) and BMI are significantly associated with hypertension. The results of VPC statistics show that 14% of hypertension prevalence could be attributed to differences at the community level.ConclusionThe prevalence of hypertension largely varies in the districts of Maharashtra irrespective of their level of socio-economic development (i.e. HDI rank). The variation in the rate of prevalence of hypertension is higher in the community (PSU) level as compared to the variation in the prevalence rate at the district level. Hypertension is attributable to the modifiable factors like risky lifestyle practices.

Prevalence and risk factors of anemia among children 6–59 months in India: A multilevel analysis

“…54,55 The likelihood of children being anemic, residing in poorest households appeared to increase the risk of childhood anemia when compared with other wealth index individuals. The finding is consistent with previous studies 50,56,57 and plausibly reflecting better household nutritional status. 58 In addition, even after controlling for drinking water and sanitation facilities, Diarrhoea shows significant association with anemia.…”

“…Several studies have recorded the higher prevalence of anemia including India and in other countries. [47][48][49][50] The study confirmed prevalence estimates differed by some key variables associated with anemia, as well as regional variation. These regional differences could be due to inadequate dietary intake; access to health care centres; and infectious disease risk.…”

Changes in levels of morbidity and hospitalisation in Kerala: A district level analysis (1995–2014)

“…20,23 Recent examination shows that hypertension was significantly higher among urban females when compared to rural females. 18,19 Studies suggest that accessibility to health services, health ideals, nutritional status, domestic violence, education levels, socioeconomic status, lifestyle of the population are mostly the explanations for variations in self-reported morbidity. 11,16,20,21 The people of higher-economic status and educated elderly might be more mindful of medical problems and accordingly be generally less inclined to underreport minor medical issues or intense sicknesses than their counterparts in a poorer economic situation.…”

“…25 It is a well-known fact that diarrhea alone accounts for the highest number of deaths among infants followed by acute respiratory infection. 8 Other infectious diseases with a high percentage of hospitalization are for gastric and peptic ulcers which are found to be higher among young (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) and prior elderly groups (45-59) in urban areas. 27 Furthermore, Tuberculosis also accounts for a high percentage across ages in both the rural and urban areas.…”

Investigating The Risk Factors for Hypertension in A Population-Based Study: Fasa PERSIAN COHORT Data

“…The study by Patra & Bhise (2018) also investigated factors related to HTN in India population and reported general prevalence of HTN about 25%. This study reports factors associated with the disease as age, gender, marital status, habitat, Socioeconomic status, unhealthy behaviors such as tobacco and alcohol and higher BMI [21][22]. Results of our study investigated more variables comparing to most studies which were done in the environment similar to the region we performed the study.…”