International Journal of
Clinical Cardiology
Research Article: Open Access
ClinMed
International Library
Citation: Arlappa N, Laxmmaiah A, Balakrishna N, Harikumar R, Mallikharjuna Rao K,
Brahmam GNV (2014) Prevalence of Hypertension and its Relationship with Adiposity
among Rural Elderly Population in India.Int J Clin Cardiol 1:003
Received: September 18, 2014: Accepted: September 30, 2014: Published: October
02, 2014
Copyright: © 2014 Arlappa N. This is an open-access article distributed under the terms of
the Creative Commons Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are credited.
Prevalence of Hypertension and its Relationship with Adiposity among
Rural Elderly Population in India
Nimmathota Arlappa*, Avula Laxmmaiah, Nagalla Balakrishna, Rachakula Harikumar, Ko-
davanti Mallikharjuna Rao and GNV Brahmam
National Institute of Nutrition (ICMR), Hyderabad, India
*Corresponding author: Arlappa N, Scientist ‘D’, Division of Community Studies, National Institute of Nutrition,
(Indian Council of Medical Research), Jamai-Osmania, P O, Hyderabad – 500 007, Telangana, India; Tel: 91-040-
27197255; E-mail: arlappan@yahoo.com
Introduction
he size of the elderly segment of the population is increasing in
developing countries, with a concomitant increase in life expectancy
[1]. his development in demographic transition is associated with
an epidemiological shit from communicable to non-communicable
disease [2] leading to an enormous economical burden on
households as well as on nations. Of these, hypertension is one of
the most important causes of mortality and morbidity in the elderly
[3], and accounts for a large proportion of cardiovascular diseases
in the elderly [4]. As per the World Health Organization reports,
the prevalence of hypertension among elderly was 69% and 55%
respectively, in urban and rural areas of India [1].
Anthropometric evaluation is an essential feature of geriatric
nutritional evaluation for determining malnutrition, being
overweight, obesity, muscular mass loss, fat mass gain and adipose
tissue redistribution [5]. he study of nutritional status of elderly is of
particular importance, as they are at greater risk of malnutrition [6],
and at the same time have an increased prevalence of many chronic
diseases, which may be associated with nutritional status [7,8]. he
prevalence of obesity is increasing drastically in many countries in
the recent decade, [9] and it has become particularly high in the
elderly population [10-12], and in India about 54% (Body mass index
>22.25) of elderly had overweight/obesity [1]. In the elderly, obesity
has been associated not only with increased mortality [13,14], but also
with elevated risks of type 2 diabetes, impaired glucose tolerance [15],
hypertension [16], lipid abnormalities [17], stroke [18], and coronary
heart disease [19]. Obesity also contributes to functional decline and
disability in elderly people [20].
Anthropometric indicators are used to evaluate the prognosis of
chronic and acute diseases, and to guide medical intervention in the
elderly [21]. he use of simple anthropometric measures as health
outcome indicators, suitable for population screening, has aroused
much interest [22]. Body Mass Index (BMI), waist Circumference
(WC), and Waist-to-Hip Ratio (WHR) have been used as simple
Anthropometric Indices (AI) for assessing the amount and
distribution of body fat [23,24] and are useful indices in predicting the
risks of type 2 diabetes, hypertension, and Cardio Vascular Diseases
Abstract
Background: The world has witnessed the demographic transition in
which there is increased proportion of elderly (≥ 60 years) population.
This increased longevity is associated with the burden of chronic non-
communicable diseases.
Objective: To assess the prevalence of hypertension and its
relationship with adiposity among the elderly in rural India.
Subjects and methods: A community based cross-sectional study
was carried out among 3133 elderly (Men: 1677; Women: 1456).
Height, weight, waist circumference (WC), and blood pressure were
recorded on selected subjects.
Results: The overall prevalence of hypertension was 50% among
rural elderly and signiicantly (p<0.001) a higher proportion of women
(53.3%) had hypertension compared to men (47.3%). Prevalence of
hypertension was signiicantly (p<0.001) higher among overweight /
obese elderly and it increased signiicantly (p<0.001) with increasing
body mass index (BMI), waist circumference and age. According to
un-adjusted odds ratio (OR), higher BMI had twice the risk of having
hypertension among both elderly men (OR=1.9; CI: 1.4-2.5) and
women (OR=2.2; CI: 1.7-2.8). However, abdominal obesity, in terms
of WC had higher risk (OR=2.6; CI: 2.0-3.3) of having hypertension
compared to high BMI among elderly women. Similarly, other
covariates such as older age, sedentary physical activity, wealth
index in both genders and high consumption of sugar and salt in case
of elderly women were signiicantly (p<0.05 to 0.01) associated with
hypertension.
Conclusions: Prevalence of hypertension is a serious public health
problem among elderly in India. Overweight/obesity is signiicantly
associated with the high prevalence of hypertension in elderly.
Therefore, effective preventive interventions, such as healthy
lifestyles, regular physical activity and prudent dietary practices have
to be adopted during middle age for the health promotion during old
age.
Keywords
Hypertension, Elderly, BMI, WC, Overweight, Obesity
Abbreviations
BMI: Body Mass Index; WC: Waist Circumference; NNMB: National
Nutrition Monitoring Bureau
Arlappa, Int J Clin Cardiol 2014, 1:1