Prevalence and contributing risk factors for hypertension in urban and rural areas of Pakistan; a study from second National Diabetes Survey of Pakistan (NDSP) 2016–2017

ABSTRACT

Aim: To assess the prevalence and its associated risk factors for hypertension in urban and rural areas of Pakistan.

Methods: This study is the part of second National Diabetes Survey of Pakistan (NDSP) 2016–2017, a large community-based epidemiological survey. Hypertension was determined for urban/rural areas of all four provinces of Pakistan. Known hypertensives were considered as individuals with self-reported history of hypertension and/or taking any antihypertensive drug and newly diagnosed hypertension is defined; as systolic blood pressure was ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg. Detailed information of the survey participants were obtained from the second NDSP 2016–2017 predesigned questionnaire, which has been published earlier.

Results: Overall, age adjusted weighted prevalence of hypertension was 46.2%, of which 24.9% had self-reported hypertension and 21.3% were newly diagnosed hypertensive. Prevalence of hypertension in urban and rural areas was 44.3% and 46.8%, respectively. Highest weighted prevalence of hypertension was observed in Punjab 49.2% followed by Sindh 46.3%, Baluchistan 40.9%, and Khyber Pakhtunkhwa 33.3%. Hypertension was more prevalent in rural areas compared to urban areas except in Khyber Pakhtunkhwa where it was more prevalent in urban areas. Age, female gender, marital status, positive family history of hypertension, low physical activity, positive family history of diabetes, obesity, and dyslipidemia were significantly associated with hypertension.

Conclusion: This study concludes that 46.2% prevalence of hypertension is alarming in Pakistan with its associated risk factors. Hence, implementation laws with lifestyle changes and educating people are required on urgent basis to control or reduce hypertension prevalence.

KEYWORDS:

• Hypertension
• NDSP
• Prevalence
• Pakistan
• Epidemiological

Acknowledgments

We acknowledge the support of Research and Laboratory department of Baqai Institute of Diabetology and Endocrinology (BIDE), Karachi for data management and we would also like to thank Pakistan Health Research Council (PHRC), Karachi. We are grateful to all study subjects for their participation in the 2^nd NDSP. Prof. Abdul Basit and Dr. Asher Fawwad, is a guarantor and undertakes the full responsibility for the contents of the article submitted for publication.

Declaration of Competing Interests

The authors report no conflicts of interest.

Author contributions

Basit A: Concept, design, interpretation of data; edited and approved the final submitted version

Tanveer S: Concept, design, and involved in the quality control; edited and approved the final submitted version

Fawwad A: Concept, design, literature search, designing quality assurance measures, research data; wrote and approved the final submitted version

Naeem N: Wrote, interpreted the data, and approved the final submitted version

NDSP members: Members were responsible for the supervision of the survey, concept, design, involved in the quality control, and data management in their respective areas. All members approved the final submitted version.

Additional information

Funding

Funding source for the survey was remained same as second NDSP (2016-17) (17). Hemoglobin A1cs, and lipid profiles were performed by Pakistan Health Research Council (PHRC). Field visits and data collection including clinical and anthropometric measurements and also fasting plasma glucose and 2-hour post/glucose load samples were run by the respective teams through their own funds. The whole survey was coordinated and supported by the Baqai Institute of Diabetology & Endocrinology (BIDE) on their own resources.