2015-2021年印度不同分类高血压前期(血压升高或正常血压偏高)的患病率和决定因素:来自大型全国调查的证据

IF 2.6 3区 综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES
PLoS ONE Pub Date : 2025-06-11 eCollection Date: 2025-01-01 DOI:10.1371/journal.pone.0325437
Geetu Singh, Renu Agrawal, Sanjeev Kumar, Shubham Kumar, Rudresh Negi, Sonu Goel, Tanya Agarwal
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引用次数: 0

摘要

背景:自美国联合全国委员会(JNC-7)指南问世以来,流行病学研究报道,高血压前期是一般人群的常见表现,全球患病率为25%至55%。本研究旨在利用印度第四和第五轮国家家庭健康调查(NHFS)的大量基于人群的数据,根据不同的标准分类,估计高血压前期(血压升高或正常血压高)的患病率及其决定因素。我们还打算在国家、州和地区层面确定NFHS-4和NFHS-5之间的高血压前期趋势。方法:分析2015-16年和2019-20年全国家庭健康调查(NFHS) 4和5的数据。高血压前期的患病率及其等效术语,血压升高和正常血压高分别根据全国联合委员会(JNC 7), 2017年美国心脏病学会/美国心脏协会(ACC/AHA)和印度高血压指南(IGH -IV)进行报告。使用GeoDa(空间和聚类地图)计算空间关联的局部指标(LISA)。我们还计算了Moran指数来解释数据的整体聚类,并预测了空间自相关的强度和模式,以代表地区水平的结果。结果:在印度,从NFHS-4到NFHS-5的所有三种分类中,高血压前期(血压升高或正常血压升高)的患病率呈增加趋势(JNC 7为35.8%对48.8%,ACC/AHA为6.1%对8.8%,high - iv为12.5%对20.8%)。根据JNC 7和IGH -IV指南,在两项调查中,年龄bb - 29岁是高血压前期的重要危险因素。根据这两项调查的三项指导方针,女性患高血压前期的几率更高。从NFHS-5的数据中可以明显看出,教育在各个分类中都有保护作用,而在之前的NFHS-4调查中,这是可变的。然而,果阿邦、锡金、阿萨姆邦、那加兰邦和西孟加拉邦的高血压前期患病率呈下降趋势。在NFHS-5中,117个地区被观察到为热点(“高-高”聚集)聚集区,主要在**、拉贾斯坦邦、中央邦、北方邦和旁遮普邦。结论:我们发现印度人群高血压前期患病率较高。研究结果还强调了基于不同分类的高血压前期(血压升高或正常血压升高)估计的显著差异。这些结果将有助于指导研究人员、公共卫生决策者和临床医生统一定义高血压前期的有效管理。这些趋势应被视为一个临时警告信号,以制定指南,并强有力地实施干预措施,以预防和控制高血压前期和高血压。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Prevalence and determinants of prehypertension (elevated blood pressure or high normal BP) according to different classifications in India during 2015-2021: Evidence from the large national surveys.

Prevalence and determinants of prehypertension (elevated blood pressure or high normal BP) according to different classifications in India during 2015-2021: Evidence from the large national surveys.

Prevalence and determinants of prehypertension (elevated blood pressure or high normal BP) according to different classifications in India during 2015-2021: Evidence from the large national surveys.

Prevalence and determinants of prehypertension (elevated blood pressure or high normal BP) according to different classifications in India during 2015-2021: Evidence from the large national surveys.

Background: Since the advent of American Joint National Commission (JNC-7) guidelines, epidemiological studies have reported that prehypertension is a common presentation in the general population, with a prevalence of 25% to 55% globally. The present study aimed to estimate the prevalence of prehypertension (elevated blood pressure or high normal BP) and its determinants based on different standard classifications using the large population-based data from the fourth and fifth rounds of National Family Health Surveys (NHFS), India. We also intended to identify the trends of prehypertension between NFHS-4 and NFHS-5 at national, state and district levels.

Methods: We analyzed the data from the National Family Health Surveys (NFHS) 4 and 5 conducted in 2015-16 and 2019-20, respectively. Prevalence of pre-hypertension and its equivalent terms, elevated blood pressure and high normal BP was reported as per the Joint National Committee (JNC 7), 2017 American College of Cardiology/American Heart Association (ACC/AHA), and Indian Guidelines for Hypertension (IGH -IV) respectively. GeoDa (spatial and cluster maps) was used to compute Local Indicators of Spatial Association (LISA). We also calculated Moran's Index to explain the data's overall clustering and project the strength and patterns of spatial autocorrelation to represent district-level results.

Results: Prevalence of prehypertension (elevated blood pressure or high normal BP) showed an increasing trend across all three classifications from NFHS-4 to NFHS-5 in India (35.8% vs. 48.8% as per JNC 7, 6.1% vs 8.8% as per ACC/AHA and 12.5% vs 20.8% according to IGH-IV). Age > 29 years was significant risk factors for pre-hypertension in both the surveys as per JNC 7 and IGH -IV guidelines. Women had higher odds of having prehypertension according to all three guidelines in both surveys. Education had a protective effect across classifications as evident from NFHS-5 data, which was variable in the previous NFHS-4 survey. The prevalence of prehypertension (JNC 7/8) has increased above 50% in NFHS-5 survey in most states of India, namely, Delhi, most districts of Punjab, Himachal Pradesh, Haryana, Rajasthan, Uttarakhand, Uttar Pradesh, Chhattisgarh, Madhya Pradesh, Jharkhand, Odisha, Manipur, Mizoram, Arunachal Pradesh, Tamil Nadu, Lakshadweep and Andaman and Nicobar Islands. However, Goa, Sikkim, Assam, Nagaland and West Bengal demonstrated a declining trend in prevalence of prehypertension. In NFHS-5, 117 districts were observed as hotspots ("high-high" clustering) clustered zones, mostly in Arunachal Pradesh, Rajasthan, Madhya Pradesh, Uttar Pradesh, and Punjab.

Conclusion: We found a high prevalence of prehypertension in large population based survey in Indian population. The findings also highlighted marked differences in estimates of prehypertension (elevated blood pressure or high normal BP) based on different classifications. These results will help guide researchers, public health policymakers and clinicians to uniformly define prehypertension for its effective management. These trends should be considered as an interim warning signal to formulate guidelines with strong implementation of interventions to prevent and control prehypertension and hypertension.

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来源期刊
PLoS ONE
PLoS ONE 生物-生物学
CiteScore
6.20
自引率
5.40%
发文量
14242
审稿时长
3.7 months
期刊介绍: PLOS ONE is an international, peer-reviewed, open-access, online publication. PLOS ONE welcomes reports on primary research from any scientific discipline. It provides: * Open-access—freely accessible online, authors retain copyright * Fast publication times * Peer review by expert, practicing researchers * Post-publication tools to indicate quality and impact * Community-based dialogue on articles * Worldwide media coverage
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