Prevalence of Hypertension and its optimal management issues in Rural India: An unmet health care need

Cardiovascular diseases are the number one cause of death globally. They account for approximately 17 million deaths in the world each year (1).Of these deaths, complications of high blood pressure account for more than nine million, including about half of all deaths from heart disease and stroke(2).The number of adults with hypertension in 2025 was predicted to increase by about 60% to a total of 1•56 billion (1•54–1•58 billion)(3). In India too, overall morbidity and mortality from non-communicable diseases (NCDs) is rising rapidly which will have severe impact on the already frail economy (4). Many studies done in different settings in India have shown that the prevalence of hypertension ranges from as high as 20-50 percent in both rural and urban population (Table 1) (5). Contradictory to the earlier reports that the prevalence of hypertension is low in rural areas, the recent studies have shown that the rural-urban differences have largely disappeared and the hypertension and other risk factors for cardiovascular diseases are only equal or slightly greater in the rural population (6). A recent study done by the authors in a rural population in Tamilnadu found that 27.2% of adults between 18 to 60 years have hypertension (7). Also the studies show that more than 50% of the men and women above 60 years old are hypertensive in rural South India (8). This observation has major repercussion on India’s health system and health expenditure in the context of improved life expectancy and a significant increase in the proportion of people living in the age group of 60 years and above in India