Population-based surveillance for hypertension awareness, treatment, and control in nine districts - India Hypertension Control Initiative, 2018–19

Hypertension control is the crucial indicator for cardiovascular disease programs. We conducted a baseline cross-sectional survey to estimate hypertension awareness, treatment, and control in the selected districts in 2018-19, where the India Hypertension Control Initiative is being implemented. We conducted cross-sectional surveys in nine project districts for 18-69 years age group. The sample size was 624 per district. The study population was individuals with raised BP/diagnosed HT. We estimated the proportion and 95% confidence intervals (CI) for each district's awareness, treatment, and control. We computed unadjusted and adjusted prevalence ratios (APR) with 95% CI for factors associated with BP control. Hypertension was defined as systolic blood pressure (SBP) > = 140 or diastolic blood pressure (DBP) > = 90 mmHg or treatment in the previous two weeks. Control was defined as SBP < 140 and DBP < 90 mmHg. Among 7047 who had hypertension, 52.4% were aware, 40.8% were on treatment, and 14.5% had BP control. BP control was below 5% in two districts, 5-15% in three districts, and more than 15% in four districts. Among hypertensives aware of the diagnosis, the factors (APR with 95% CI) associated with control were lack of alcohol consumption [1.28 (1.09-1.52)], recent visit to government [1.98 (1.57-2.50)] or private facility [1.99 (1.61-2.46)] and treatment with single drug [2.40 (1.98-2.90)] or multiple drugs [2.84 (2.27-3.55)]. The simple, rapid population-based surveys can document awareness, treatment, and control changes. Improving access to treatment for hypertension through the public or private sector should be a high priority for India.