Hypertension Treatment Cascade in Rural Delhi: Prevalence, Awareness, Treatment, and Control Among Adults

Introduction: A majority of patients with hypertension remain undiagnosed, untreated, non-compliant, and poorly controlled at every stage. However, there is a paucity of information on the hypertension treatment cascade, especially among the population in rural areas. The aim of this study was to find out the prevalence of different stages of the hypertension treatment cascade among the rural adult population of Delhi. Methods: A community-based cross-sectional study was conducted among 325 adult participants in a rural area of Delhi, using a pre-tested, pre-coded, semi-structured, interviewer-administered questionnaire. Blood pressure was measured on two separate occasions, one week apart. Results: The overall prevalence of hypertension was 116 (35.7% (95% CI: 30.5-40.9)). Male participants had a higher prevalence of hypertension than female participants. Among the 116 participants identified as hypertensive, 71 (61.2%) were aware of their hypertensive status. Of these, 52 individuals (44.8% of all hypertensives) reported being on treatment. Blood pressure control was achieved in 17 individuals (14.6% of all hypertensives). Non-compliance with treatment was common, with financial constraints (10; 19.2%) and fear of side effects (7; 3.4%). Significant factors associated with hypertension included age, time spent sitting/reclining, tobacco use, comorbidity, and waist circumference (p < 0.05). Conclusion: The present study revealed a high burden of hypertension among adults in rural Delhi. Although the rate of awareness was relatively high, the rates of treatment and control were far from desirable. Compliance with medication and lifestyle interventions was also poor. Strengthening community screening and primary care services is necessary for early detection, continuous management, and improved health outcomes.