Understanding the Level of Hypertension among Indian Adults: A Systematic Review (Meta-Analysis)

Background: Non-communicable diseases (NCDs) account for 60 percent of all deaths in India, as mentioned in the report of National Family Health Survey (NFHS-4) of India. While the National Family Health Survey (NFHS-1) conducted in 1992-93, NFHS-2 conducted in 1998-99 and NFHS-3 conducted in 2005-06 did not bring out estimates of hypertension; the clinical, anthropometric and biochemical (CAB) component of NFHS-4 conducted in 2015-16 provided vital estimates of the prevalence of hypertension through a series of biomarker tests and measurements. Hypertension is one of the important risk factors for cardiovascular disease and is a significant health concern, especially in India. Analysis of worldwide data for estimation of the global prevalence of hypertension in 2005 highlighted the lack of a national study investigating the prevalence in India. Objective: This paper is an attempt to conduct a cross – sectional study to determine the prevalence of hypertension, who are aware of the condition, who take antihypertensive treatment and who are able to achieve control over the condition of hypertension. Possible actions to improve the Indian Public Health System for control of hypertension in India has also been assessed and presented in this paper. Main Measure: Hypertension has been defined as the condition where Systolic Blood Pressure (SBP) is greater than or equal to 140 mmHg; or Diastolic Blood Pressure (DBP) is greater than or equal to 90 mmHg; or when the person is on treatment for hypertension. Methods and Statistical Analysis: Search Strategy: PubMed databases were searched for terms such as blood pressure, systolic blood pressure, diastolic blood pressure, high BP, hypertension and raised blood pressure which were combined with terms related to desired outcomes such as prevalence, disease burden, estimate, awareness, treatment and control among Indian adults. Web of Science databases were searched for terms such as hypertension with applied filter as Country/Region: INDIA. Of the total 3892 articles, 35 were included. Statistical Analysis: The statistical analysis has been done on the captured data that has been referred from PubMed and Web of Science databases. Some of the statistical analysis done are Mean, Quartile, Confidence Interval (CI) etc. Conclusion: The proportion of prevalence, awareness, treatment and control of Hypertension was calculated using the available data and it was found out that the overall prevalence for hypertension in India was 25.6% (95% confidence interval: 21.6 – 29.6). Effective policy starting from primary health care level will enable better control of hypertension in India.