Journal of the American Heart Association · 2025
Household Aggregation of Hypertension in India: A Cross-Sectional Study of Nationally Representative Data From 450 000 Households.
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Sanaka Krishna Om, Kocher Erica L, Venkateshmurthy Nikhil Srinivasapura, Tandon Nikhil, Patel Shivani A, Ali Mohammed K, Varghese Jithin Sam
Аннотация
BACKGROUND: Over 315 million adults live with hypertension in India, of whom only 37% are diagnosed. In addition to community-based screening, targeting high-risk households may identify undiagnosed individuals. We estimated the magnitude of household aggregation of diagnosed and undiagnosed hypertension among co-residing adults and evaluated whether household members offer pathways for novel screening and management strategies.
METHODS AND RESULTS: The overall sample consisted of 450 520 households with 1 407 886 adult participants (18-99 years old) of the Indian National Family Health Survey-5, 2019 to 2021. Household aggregation was defined as ≥2 co-residing members of a household having hypertension (self-reported as physician diagnosed, or measured systolic blood pressure ≥140, or diastolic blood pressure ≥90 mm Hg). Among the analytic sample (mean age, 32.5 years; 53.2% women), 25.8% had hypertension, and 48.4% of respondents had ≥1 other members in the household with hypertension. Individuals with diagnosed (prevalence ratio [PR], 2.49 [95% CI, 2.44-2.54]) and undiagnosed hypertension (PR, 1.16 [95% CI, 1.15-1.17]) were more likely to cluster with others of the same status. Exploratory analyses suggest that the number of households to be screened to identify 1 new case of undiagnosed hypertension was lowest for households with a newly detected (ie, previously undiagnosed) individual with hypertension, followed by households of individuals with normal blood pressure and diagnosed hypertension, respectively.
CONCLUSIONS: Our study provides novel evidence about aggregation of hypertension among Indian households. Given the high burden of hypertension in India, household-focused screening and management interventions can augment current strategies for closing the gaps in hypertension diagnosis and control.
METHODS AND RESULTS: The overall sample consisted of 450 520 households with 1 407 886 adult participants (18-99 years old) of the Indian National Family Health Survey-5, 2019 to 2021. Household aggregation was defined as ≥2 co-residing members of a household having hypertension (self-reported as physician diagnosed, or measured systolic blood pressure ≥140, or diastolic blood pressure ≥90 mm Hg). Among the analytic sample (mean age, 32.5 years; 53.2% women), 25.8% had hypertension, and 48.4% of respondents had ≥1 other members in the household with hypertension. Individuals with diagnosed (prevalence ratio [PR], 2.49 [95% CI, 2.44-2.54]) and undiagnosed hypertension (PR, 1.16 [95% CI, 1.15-1.17]) were more likely to cluster with others of the same status. Exploratory analyses suggest that the number of households to be screened to identify 1 new case of undiagnosed hypertension was lowest for households with a newly detected (ie, previously undiagnosed) individual with hypertension, followed by households of individuals with normal blood pressure and diagnosed hypertension, respectively.
CONCLUSIONS: Our study provides novel evidence about aggregation of hypertension among Indian households. Given the high burden of hypertension in India, household-focused screening and management interventions can augment current strategies for closing the gaps in hypertension diagnosis and control.