Prevalence of hypertension in a rural district of Sri Lanka

Abstract

INTRODUCTION & OBJECTIVES: Hypertension is a leading cause of cardiovascular morbidity and mortality. Data on prevalence of hypertension in rural settings of Sri Lanka is limited. We conducted a study to determine the prevalence of hypertension among adults over 40 years of age in the Puttalam district.METHODS: A community-based prevalence study was conducted in selected Grama Niladhari divisions in ten Medical Officer of Health areas in the Puttalam district. Adults over 40 years of age living in consecutive households were screened by trained research assistants using digital blood pressure (BP) meters. Basic demographic data were obtained using an intervieweradministered questionnaire. Previously undiagnosed adults with persistent elevation of BP (SBP > 140 and /or DBP > 90 mmHg on two readings) and those already on treatment for hypertension were identified. RESULTS: A total of 2289 were screened. The mean (SD) of SBP and DBP were 134.5(21.3) and 82.1 (13.5) mmHg respectively. The overall hypertension prevalence was 458.5 (95% CI 438.1– 478.8) per 1000 population. 16.3% were newly diagnosed. Prevalence of uncontrolled hypertension among those on treatment was 516.2 (95% CI 479.4–552.9) per 1000. 98.7 (95% CI 86.6–110.9) per 1000 had blood pressure >160/110 mmHg. There was an increasing trend in blood pressure with increasing age (OR=1.07, 95% CI 1.06–1.08, p<0.01) but not with the male sex. CONCLUSION: Prevalence of hypertension is high in this rural adult cohort. Previously undetected hypertension and uncontrolled hypertension among those already on treatment are common. Community-based approaches targeting screening and BP control are essential to reduce adverse outcomes of hypertension.