Convergence in urban–rural prevalence of hypertension in India

Hypertension has emerged as important public health problem in India. During the later half of the last century, epidemiological studies in India reported that hypertension (diagnosed by systolic blood pressure (BP) ⩾160 and/or diastolic BP ⩾95 mm Hg) increased from about 1% in 1950’s to 15% in 1990’s in urban (R2=0.47) and from 0.5 to 7% in rural (R2=0.21) populations. Hypertension epidemiological studies from India in the last twenty years have shown that prevalence of hypertension (diagnosed by systolic BP ⩾140 mm Hg and/or diastolic BP ⩾90 mm Hg) in urban locations has stabilized to about 25–30% (R2=0.08) but it has increased in rural populations from 15 to 25% (R2=0.04). This urban–rural convergence of hypertension in India is due to rapid urbanization of rural populations with consequent changes in lifestyles (sedentariness, high dietary salt, sugar and fat intake) and increase in overweight and obesity. Hypertension prevention, screening and control, policies and programs, need to be widely implemented in India, especially in rural populations.