{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T23:52:31Z","timestamp":1793317951852,"version":"4.5.0"},"reference-count":47,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Hypertension is a major cause of morbidity and mortality worldwide. Previous efforts to characterize gaps in the hypertension care continuum\u2014including diagnosis, treatment, and control\u2014in India did not assess district-level variation. Local data are critical for planning, implementation, and monitoring efforts to curb the burden of hypertension.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To examine the hypertension care continuum in India among individuals aged 18 to 98 years.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n The nationally representative Fifth National Family Health Survey study was conducted in 2 phases from June 17, 2019, to March 21, 2020, and from November 21, 2020, to April 30, 2021, among 1\u202f895\u202f297 individuals in 28 states, 8 union territories, and 707 districts of India.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n District and state of residence, urban classification, age (18-39, 40-64, and \u226565 years), sex, and household wealth quintile.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Hypertension was defined as a self-reported diagnosis or a newly measured blood pressure of 140\/90 mm Hg or more. The proportion of individuals diagnosed (self-reported), the proportion of individuals treated among those diagnosed (self-reported medication use), and the proportion of individuals with blood pressure control among those treated (blood pressure &amp;lt;140\/90 mm Hg [aged 18-79 years] or &amp;lt;150\/90 mm Hg [aged \u226580 years]) were calculated based on national guidelines. Age-standardized estimates of treatment and control were also provided among the total with hypertension. To assess differences in the care continuum between or within states (ie, between districts), the variance was partitioned using generalized linear mixed models.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of the 1\u202f691\u202f036 adult respondents (52.6% women; mean [SD] age, 41.6 [16.5] years), 28.1% (95% CI, 27.9%-28.3%) had hypertension, of whom 36.9% (95% CI, 36.4%-37.3%) received a diagnosis. Among those who received a diagnosis, 44.7% (95% CI, 44.1%-45.3%) reported taking medication (corresponding to 17.7% [95% CI, 17.5%-17.9%] of the total with hypertension). Among those treated, 52.5% (95% CI, 51.7%-53.4%) had blood pressure control (corresponding to 8.5% [95% CI, 8.3%-8.6%] of the total with hypertension). There were substantial variations across districts in blood pressure diagnosis (range, 6.3%-77.5%), treatment (range, 8.7%-97.1%), and control (range, 2.7%-76.6%). Large proportions of the variation in hypertension diagnosis (94.7%), treatment (93.6%), and control (97.3%) were within states, not just between states.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cross-sectional survey study of Indian adults, more than 1 in 4 people had hypertension, and of these, only 1 in 3 received a diagnosis, less than 1 in 5 were treated, and only 1 in 12 had blood pressure control. National mean values hide considerable state-level and district-level variation in the care continuum, suggesting the need for targeted, decentralized solutions to improve the hypertension care continuum in India.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.39098","type":"journal-article","created":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T11:01:19Z","timestamp":1698058879000},"page":"e2339098","source":"Crossref","is-referenced-by-count":101,"title":["Hypertension Diagnosis, Treatment, and Control in India"],"prefix":"10.1001","volume":"6","author":[{"given":"Jithin Sam","family":"Varghese","sequence":"first","affiliation":[{"name":"Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, Georgia"},{"name":"Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil Srinivasapura","family":"Venkateshmurthy","sequence":"additional","affiliation":[{"name":"Public Health Foundation of India, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikkil","family":"Sudharsanan","sequence":"additional","affiliation":[{"name":"Professorship of Behavioral Science for Disease Prevention and Health Care, Technical University of Munich, Munich, Germany"},{"name":"Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panniyammakal","family":"Jeemon","sequence":"additional","affiliation":[{"name":"Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivani A.","family":"Patel","sequence":"additional","affiliation":[{"name":"Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, Georgia"},{"name":"Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harsha","family":"Thirumurthy","sequence":"additional","affiliation":[{"name":"Leonard Davis Institute of Health Economics and Perelman School of Medicine, University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ambuj","family":"Roy","sequence":"additional","affiliation":[{"name":"Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Tandon","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. 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