Special Section: Cardiovascular Diseases

Cardiovascular diseases have emerged as an important health problem in India. High blood pressure (BP) is a major risk factor and better control can lead to prevention of 300,000 of the 1.5 million annual deaths from cardiovascular diseases in India. Epidemiological studies demonstrate that prevalence of hypertension is increasing rapidly among Indian urban populations and using the current definitions more than two-fifths of the Indian urban adult population has hypertension. The prevalence is lower in rural populations, but is increasing. Jaipur Heart Watch (JHW) is an ongoing cross-sectional epidemiological study in western India. Successive studies have been performed in rural (JHW-R, 1992–93) and urban locations (JHW-1, 1993–94; JHW-2, 1999–2000; JHW-3, 2002–03, and JHW-4, 2004–05). The studies evaluated adults ≥20 years using standardized methodology and in the present analyses subjects aged 20–59 years from these JHW studies [4102 men (1700, 1294, 469, 179 and 413) and 2872 women (1063, 655, 486, 195 and 433)] have been included. Prevalence of various cardiovascular risk factors: smoking/tobacco use, sedentary habits, overweight/obesity (body mass index ≥ 25 kg/m), central obesity (waist : hip ratio >0.95 men, >0.85 women), hypertension, dyslipidemias, metabolic syndrome and diabetes was determined. Trends were analysed using least squares linear analyses. Results show that mean systolic BP increased with age in all the study cohorts, while there was no significant difference in diastolic BP. Age-adjusted prevalence of hypertension in JHW-R, JHW-1, JHW-2, JHW-3 and JHW-4 studies in men was 21.6, 29.1, 29.6, 42.5 and 45.1% and in women it was 15.7, 21.7, 25.5, 35.2 and 38.2% (P for trend <0.05). There was a significant association of escalating hypertension with obesity and truncal obesity in both men (two-line regression analysis, unadjusted r = 0.91 and 0.50 respectively) and women (r = 0.88 and 0.57; P < 0.05). Increasing hypertension in India is related to increasing adiposity levels. Population and individual-based measures to prevent and control high BP should focus on measures to prevent obesity.