Diabetes and Hypertension in India A Nationally Representative Study of 1.3 Million Adults
Diabetes and Hypertension in India A Nationally Representative Study of 1.3 Million Adults
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DOI：
10.1001/jamainternmed.2017.8094
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发表时间：
2018-03-01
影响因子：
39
通讯作者：
Atun, Rifat
中科院分区：
文献类型：
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作者：
Geldsetzer, Pascal;Manne-Goehler, Jennifer;Atun, Rifat
重要性：了解像印度这样大的国家内糖尿病和高血压患病率的变化，对于确定预防、筛查和治疗服务的目标至关重要。然而，据我们所知，目前还没有对这些情况进行具有全国代表性的研究，以指导制定有效的政策。目的确定印度糖尿病和高血压的患病率，以及各州、农村与城市地区和个人层面的社会人口特征的差异。设计,设置。这是一项在2012年至2014年间进行的具有全国代表性的基于人群的横断面研究。共有1320555名18岁或以上的成年人进行了血糖（PG）和血压（BP）测量，纳入了分析。暴露状态、城乡位置、年龄、性别、家庭财富五分位数、教育程度和婚姻状况。糖尿病（空腹时PG水平>= 126 mg/dL，未空腹时>= 200 mg/dL）和高血压（收缩压>= 140 mm或舒张压>= 90 mm Hg）。结果1320555例成人中，女性701408例（53.1%）。糖尿病和高血压的粗患病率分别为7.5% （95% CI, 7.3%-7.7%）和25.3% （95% CI, 25.0%-25.6%）。值得注意的是，高血压在更年轻的年龄组中也很常见（例如，18-25岁：12.1%;95% CI, 11.8%-12.5%）。最富有的五分之一家庭与最贫穷的五分之一家庭相比，患糖尿病（农村：2.81个百分点；95% CI, 2.53-3.08；城市：3.47个百分点；95% CI, 3.03-3.91）和高血压（农村：4.15个百分点；95% CI, 3.68-4.61；城市：3.01个百分点；95% CI, 2.38-3.65）的可能性仅略高。两种情况在教育类别上的概率差异通常很小(
IMPORTANCE Understanding how diabetes and hypertension prevalence varies within a country as large as India is essential for targeting of prevention, screening, and treatment services. However, to our knowledge there has been no prior nationally representative study of these conditions to guide the design of effective policies.OBJECTIVE To determine the prevalence of diabetes and hypertension in India, and its variation by state, rural vs urban location, and individual-level sociodemographic characteristics.DESIGN, SETTING. AND PARTICIPANTS This was a cross-sectional, nationally representative, population-based study carried out between 2012 and 2014. A total of 1320 555 adults 18 years or older with plasma glucose (PG) and blood pressure (BP) measurements were included in the analysis.EXPOSURES State, rural vs urban location, age, sex, household wealth quintile, education, and marital status.MAIN OUTCOMES AND MEASURES Diabetes (PG level >= 126 mg/dL if the participant had fasted or >= 200 mg/dL if the participant had not fasted) and hypertension (systolic BP >= 140 mm or diastolic BP >= 90 mm Hg).RESULTS Of the 1320 555 adults, 701408 (53.1%) were women. The crude prevalence of diabetes and hypertension was 7.5% (95% CI, 7.3%-7.7%) and 25.3% (95% CI, 25.0%-25.6%), respectively. Notably, hypertension was common even among younger age groups (eg, 18-25 years: 12.1%; 95% CI, 11.8%-12.5%). Being in the richest household wealth quintile compared with being in the poorest quintile was associated with only a modestly higher probability of diabetes (rural: 2.81 percentage points; 95% CI, 2.53-3.08 and urban: 3.47 percentage points; 95% CI, 3.03-3.91) and hypertension (rural: 4.15 percentage points; 95% CI, 3.68-4.61 and urban: 3.01 percentage points; 95% CI, 2.38-3.65). The differences in the probability of both conditions by educational category were generally small (