Hypertension and Cardiovascular Trends in India

Cardiovascular diseases (CVDs) cause most of the death worldwide. Hypertension (HTN) leads to 57% of cerebrovascular accidents and 24% of all coronary artery disease-deaths in India.[1] According to the World Health Organisation, HTN is one of the leading causes of premature deaths around the globe�[2] The prevalence of CVD is increasing in alarming proportion in India and it accounts for 30% of all deaths. Increasing incidence of CV risk factors such as hypertension (HTN), diabetes mellitus, tobacco use, and metabolic syndrome leads to increasing CVD in India. Apart from tobacco cessation, control of HTN forms the most important of the various treatment strategies to reduce CV mortality. HTN control is poor in developing countries. The Prospective Urban Rural Epidemiology study reported that control of HTN is about 50% in high-income countries and 10% in lowand lower middle-income countries.[3] Studies have reported better control of HTN rates in the past 50 years from Western Europe and the USA.[4] The National Health and Nutrition Examination Surveys from 1988 to 2008 and 1999 to 2012 have reported that the prevalence of HTN remained static at 30–35% during this period, whereas increasing rates of HTN treatment (from 60% to 75%) and its control (from 53% to 69%) were observed.[5] There is a linear relationship between elevation of blood pressure (BP) and CV risk, as the BP rises above 115/75 mmHg.[6] The Global Burden of Diseases (GBD) 2015 analysis reveals that the estimated mortality rate per year associated with systolic BP (SBP) of at least 110–115 mmHg between 1990 and 2015 has risen from 135�6 to 145�2/100,000 persons�[7] Patel et al� have estimated that a decrease of 2 mmHg SBP in the population can prevent approximately 150,000 strokes and coronary artery disease (CAD) deaths in our country�[8] However, prospective data on HTN trends with respect to prevalence, awareness, and treatment from our country are scarce�