Is the Rule of Halves in Hypertension Valid Uniformly across India? A Cross-sectional Analysis of National Family Health Survey-4 Data
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Date
2022-09
Journal Title
Journal ISSN
Volume Title
Publisher
Wolters Kluwer – Medknow
Abstract
Background: Hypertension is widely prevalent across India. The rule of halves is commonly used to describe the attrition and gaps in the care cascade of hypertension management across detection, availing treatment, and having controlled blood pressure (BP) on treatment. Objectives: Using nationally representative data, we aimed to assess the rule of halves in hypertension management in different states of India and across sociodemographic, health system, and personal factors. Methods: A descriptive analysis of secondary data from the National Family Health Survey?4 was conducted. We included 770,662 individuals(112,122 men and 658,540 nonpregnant women) of 15–49 years of age. The proportion of individuals not aware of hypertension status among those with high BP, known hypertensives not availing of treatment, and uncontrolled BP among those on treatment were expressed as percentage with a 95% confidence interval (CI). Results: Of those with high BP, 48.5% (95% CI: 47.8%–49.3%) were not aware of their hypertensive status. Among known hypertensives, 72% (95% CI: 71.2%–72.8%) had not availed treatment for hypertension. Among those on treatment, 39.8% (95% CI: 38.7%–40.9%) had uncontrolled hypertension. Conclusion: The rule of halves of India shows that the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke has made relatively good progress with the detection of hypertension and achieving BP control among those on treatment. However, with three?fourth of known hypertensives not availing treatment, more dividends from the detection of hypertension efforts could be realized. The program needs to especially focus on ensuring the treatment for those detected with hypertension.
Description
Keywords
Awareness, hypertension, India, National Family Health Survey?4, noncommunicable disease, rule of halves
Citation
Maroof Mohd, Faizi Nafis, Thekkur Pruthu, Raj Sonika, Goel Sonu. Is the Rule of Halves in Hypertension Valid Uniformly across India? A Cross-sectional Analysis of National Family Health Survey-4 Data. Indian Journal of Public Health. 2022 Sept; 66(3): 269-275