Hypertension is an important risk determinant for chronic kidney disease: results from a cross-sectional, observational study from a rural population in South India

Hypertension (HTN) is an important cause for chronic kidney disease (CKD). There is a paucity of studies exploring the association of HTN with CKD from rural India. The objective of the study was to determine the prevalence and the determinants for HTN in a rural population in South India, focusing on the association with CKD. In a cross-sectional study on 2984 adults in three villages, demographic and anthropometric data were collected. Blood pressure was recorded on all individuals and prevalence was estimated. Proteinuria, microalbuminuria (MA) and estimated glomerular filtration rate (eGFR) were determined in a subgroup of 1331 subjects and the relation with HTN was analysed. Prevalence of HTN was 30.4% (95% CI 28.75-32.05%). In all, 78.08% had stage 1 HTN while 22% had stage 2 HTN. In total, 27.4% (249/908) subjects were aware of their hypertensive status. Of them, only 14.4% had adequate control of blood pressure. Age>50 years, diabetes, body mass index >25 and eGFR < 60 ml min(-1) were independent significant predictors of HTN (P<0.05). HTN was found to be an important risk factor for CKD even after adjusting for age, diabetes and cardiovascular risk factors (OR 2.22, 95% CI 1.46-3.36, P<0.001). The high prevalence of HTN, very low level of awareness and control, and the significant association with kidney disease indicate a need for stronger public health initiative with better penetration for awareness and screening for HTN and CKD in India's villages.