Salud Comunitaria

258 258Journal of Epidemniology and Community Health 1994;48:258-261

Hypertension and determinants of blood pressure with special reference to socioeconomic status in a rural south Indian community
Ericus C A M Gilberts, Marinus J C W J Arnold, Diederick E Grobbee

Department of Epidemiology and Biostatistics, Erasmus University Rotterdam, Postbus 1738, 3000 DR Rotterdam, The Netherlands
EC A M Gilberts M J C W J Arnold D E Grobbee
Dr D E Grobbee. Accepted for publication September 1993

Abstract Objectives - The objective of the study was to establish the prevalence of hypertension and to assess determinants of blood pressure with special reference to socioeconomic status in a rural south Indian community. Design - This was a door to door, cross sectional survey. Setting - Arural south Indian community, KV Kuppam panchayat, North Arcot District, Tamil Nadu. Subjects- The area has a total population of 3500 people. Those aged over 20 years who were available at the time of measurement were asked to participate (mean age 39 5 years). This convenience sample totalled 1027 (456 men, 571 women). Out of 697 families, 487 were visited; 15 people refused to participate.Measurements and main results - The following potential determinants of blood pressure were assessed: age, body weight, pulse rate, salt intake, meat intake, and socioeconomic class. The prevalence of hypertension was 12-5%. Using multiple linear regression analysis, the most important positive determinants of high blood pressure seemed to be age, body weight, and pulse rate. Salt and meat intake werenot significantly associated with hypertension. The prevalence of hypertension in the highest socioeconomic group (22-5%) was more than twice that in the lowest socioeconomic group (8-8%). When adjusted for body weight, the mean (SEM) difference in systolic blood pressure between the highest and lowest socioeconomic classes was 5 83 mmHg (1-63). Conclusion - Hypertension is not yet as important ahealth problem in rural southern India as it is in westernised societies. Those particularly at risk of hypertension, however, are the elderly and overweight people of high socioeconomic class.
(J7 Epidemiol Community Health 1994;48:258-261)

Indian origin who live overseas.5-" The disease prevalence in Indian immigrants often exceeds that of the host country.'2 Since hypertension is one of themost important established risk factors for atherosclerosis, information about high blood pressure and its determinants is becoming increasingly important for health services in India. Results from studies on hypertension in communities in northern India indicate a prevalence ranging from 0-4% in rural areas up to 15% in towns.'3-'" There are, however, no data about the prevalence of hypertensionin south India. Since two studies have suggested that the prevalence of coronary heart disease is greater in south than in north India,8'9 we were interested to investigate hypertension in south India. We studied its prevalence and some potentially important and modifiable determinants of hypertension in a rural area of south India. Emphasis was placed on the association between blood pressureand socioeconomic status.

Correspondence to:

Atherosclerosis is the most important cause of death in western countries. In general, this does not apply in developing countries' but there are indications that the incidence of cardiovascular morbidity and mortality is Moreover, increasing in these countries. migration studies have pointed out a high susceptibility for atherosclerosis in peopleof

Methods The study was carried out in a rural area known as KV Kuppam panchayat. Mainly because of agricultural activities, the area is economically self sufficient. This panchayat was chosen because sufficient numbers of subjects belonging to different socioeconomic groups were available. Out of a total population of 3500 people, all those over 20 years and available at the time of...