Independent urban effect on hypertension of older Indians: identification of a knowledge gap from a Study on Global AGEing and Health

Among older Indians, more cardiovascular diseases and risk factors are observed in the city dwellers than in the rural population. Clustering of socioeconomic privileges and consequent obesity in the Indian cities are known to underlie this phenomenon. But, it is unclear whether an independent urban effect exists on age-related ailments, unexplained by concentration of privileges and excess weight in the Indian cities. Hence, we aimed to estimate the independent urban effect on hypertension among older Indians after controlling for these factors. Nationally representative data of Indians aged 50 years and older (n = 7273) were collected by Study on global AGEing and health. Hypertension was defined as systolic and/or diastolic blood pressure >139 and > 89 mm Hg, respectively, and/or someone receiving antihypertensive medications. Permanent place of residence (urban/rural) during interview was recorded. Socioeconomic determinants included caste, occupation, assets, and education. Body mass index, abdominal circumference, smoking, alcohol, and physical activity were also controlled. The age- and sex-adjusted odds ratio of hypertension for urban residents was 1.64 (146–1.83), which partially attenuated to 1.22 (1.07–1.38) after controlling for all the covariates. This study highlights 22% excess odds of hypertension among the older Indian city dwellers, unexplained by the greater urban concentration of socioeconomic privileges and obesity. Future research should explore the constituents of this urban effect.