Purpose: Despite the huge burden of diabetes and hypertension, limited information is available on the burden of undetected hypertension and associated factors among diabetics in India.
Methods: We conducted a cross-sectional study and selected 12284 adults aged ≥ 30 years, using a multistage cluster random sampling technique, from rural and urban areas of North and South India. Trained interviewers administered a questionnaire to collect data on socio-demographics, lifestyle characteristics and phlebotomists collected venous blood samples. Blood pressure was measured using standard protocols. Diabetes was defined as FPG ≥ 126 mg/dl or HbA1C ≥ 6.5% or self-reported physician diagnosis or treatment and the known-diabetes was defined as self-reported physician diagnosis or treatment. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥ 90 mmHg or self-reported physician diagnosis or treatment and undetected hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥ 90 mmHg without self-reported physician diagnosis or treatment.
Results: The age-adjusted prevalence of diabetes was 17.5% (16.9-18.2), known diabetes was 10.2% (9.7-10.7) and hypertension among those with diabetes was 47.3% (45.0-49.6). The age-adjusted prevalence of undetected hypertension among those with known-diabetes was 27.0% (22.0-31.9). The prevalence of undetected hypertension among known-diabetics was higher in urban area [29.4% (23.2-35.6)] than the rural area [21.5% (13.2-29.7)]. In the multinomial logistic regression, undetected hypertension among those with known-diabetes was positively associated with older age [adjusted Relative Risk Ratio (aRRR): 3.4 (1.7-6.9)], dyslipidemia [aRRR: 2.2 (1.2-4.1)] and chronic kidney disease [aRRR: 3.3 (1.2-9.2)].
Conclusions: There is a need to implement health system interventions to increase the detection of hypertension among diabetics.
S.Mohan: None. P.Jarhyan: None. D.Prabhakaran: None.
