Sex differences in hypertension prevalence and risk factors in India ‒ a comparative study based on National Family Health Survey IV and V

Authors

DOI:

https://doi.org/10.15584/ejcem.2025.4.22

Keywords:

hypertension, prevalence, India, NFHS, risk Factors

Abstract

Introduction and aim. Hypertension is increasing universally, mainly in developing countries like India. This study analyzed sex differences in hypertension using data from National Family Health Survey (NFHS) rounds IV and V, with a focus on prevalence trends and associated risk factors.

Material and methods. This study utilized data from NFHS rounds IV and V, focusing on males and females aged 15–49 years. The samples included 103,525 males and 667,258 females in NFHS-IV, and 93,267 males and 695,707 females in NFHS-V. Univariate, bivariate, and multivariate analytical techniques were employed to address the study’s objectives.

Results. The NFHS-IV and V data revealed a notable increase in hypertension prevalence across India, with significantly higher odds observed among individuals in the older reproductive age group (45–49 years) for both sexes. Hypertension occurred 4.85 times higher among male in the age group 45‒49 compared to 15-24 age group, which rose to 5.23 in NFHS-V. Among female, the odds increased from 5.39 in NFHS-IV to 6.40 in NFHS-V. Remarkably, illiterate male showed lower odds of hypertension linked to their educated peers in both survey rounds, while female with only primary education showed higher odds. Regional disparities were also evident, with both male and female from the Northeast showing elevated odds ‒ particularly female, who had an odds ratio of 1.47 in NFHS-IV.

Conclusion. The observed sex-specific variations in hypertension and its risk factors indicate a need for public health strategies to designed for each gender. Tailored interventions addressing education, lifestyle behaviors, and regional disparities are essential to effectively manage and prevent hypertension in India’s diverse population.

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References

World Health Organization. First WHO report details devastating impact of hypertension and ways to stop it. WHO website. https://www.who.int/news/item/19-09-2023-first-who-report-details-devastating-impact-of-hypertension-and-ways-to-stop-it. Accessed April 29, 2025.

World Health Organization. Hypertension fact sheet. WHO website. https://www.who.int/news-room/fact-sheets/detail/hypertension. Accessed April 29, 2025.

Anchala R, Kannuri NK, Pant H, et al. Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hypertens. 2014;32(6):1170-1177. doi:10.1097/HJH.0000000000000146

Gupta R, Xavier D. Hypertension: the most important noncommunicable disease risk factor in India. Indian Heart J. 2018;70(4):565-572. doi: 10.1016/j.ihj.2018.02.003

Regitz-Zagrosek V. Sex and gender differences in cardiovascular disease. Nat Rev Cardiol. 2012;9(8):477-485. doi: 10.1038/nrcardio.2012.91

Doumas M, Papademetriou V, Faselis C, Kokkinos P. Gender differences in hypertension: myths and reality. Curr Hypertens Rep. 2013;15(4):321-330. doi: 10.1007/s11906-013-0364-9

Choudhury N, Wadhwa S, Kumari R, et al. Gender differences in health-seeking behavior and healthcare access in India: a review. PLoS One. 2024;19(1):e0314309. doi: 10.1371/journal.pone.0314309

Doumas M, Papademetriou V, Tsioufis C. The gender gap in hypertension control: is it closing? Curr Hypertens Rep. 2018;20(9):71. doi: 10.1007/s11906-018-0873-z

Everett B, Zajacova A. Gender differences in hypertension and hypertension awareness among young adults. Biodemography Soc Biol. 2015;61(1):1-17. doi: 10.1080/19485565.2014.929488

Forouhi NG, Wareham NJ. Epidemiology of diabetes. Medicine (Abingdon). 2014;42(12):698-702. doi: 10.1016/j.mpmed.2014.09.007

Doumas DM, Faselis C, Papademetriou V, et al. Gender differences in the prevalence of hypertension and hypertension-related behaviors. J Hypertens. 2010;28(3):421-429. doi:10.1097/HJH.0b013e3283344e1b

Everett BG, Zajacova A. The role of gender in health disparities: a life course perspective. J Womens Health (Larchmt). 2015;24(10):851-859. doi:10.1089/jwh.2015.5236

Wang Y, Chen J, Li X, et al. Gender differences in antihypertensive therapy and cardiovascular outcomes: a global review. Lancet Public Health. 2021;6(1):e47-e56. doi:10.1016/S2468-2667(20)30145-7

Campbell DJ, Anand SS, Yusuf S, Islam S, Rosengren A, Franzosi MG. Risk factors for myocardial infarction in women and men: insights from the INTERHEART study. Eur Heart J. 2008;29(7):932-940. doi:10.1093/eurheartj/ehn018

World Health Organization. WHO STEPS surveillance: the WHO STEPwise approach to chronic disease risk factor surveillance. WHO website. https://www.who.int/ncds/surveillance/en/. Accessed April 29, 2025.

Masi S, Rizzoni D, Agabiti-Rosei E, et al. Genetic and epigenetic factors influencing blood pressure regulation: sex-specific differences. Hypertens Res. 2020;43(3):175-182. doi:10.1038/s41440-019-0337-6

Muntner P, Shimbo D, Carey RM, et al. The genetic basis of hypertension: insights from recent research. Curr Hypertens Rep. 2019;21(9):66. doi:10.1007/s11906-019-0964-4

Wasserman M, Badolato GM, Rivera LM, et al. Sex differences in cardiovascular disease: a review of epidemiological data and interventions. Am J Public Health. 2021;111(2):219-226. doi:10.2105/AJPH.2020.306118

Rosenfield A. Gender and health: implications for cardiovascular disease prevention. Lancet Public Health. 2020;5(8):e421-e423. doi:10.1016/S2468-2667(20)30133-7

Chaturvedi S, Desai A, Ghosh S, et al. Gender disparities in the management of hypertension in India: the need for public health strategies. Indian Heart J. 2017;69(2):147-153. doi:10.1016/j.ihj.2017.02.017

Lancet Commission on Women and Cardiovascular Disease. Women and cardiovascular disease: a call to action. Lancet. 2021;397(10289):2250-2261. doi:10.1016/S0140-6736(21)00531-1

National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS). Strategic plan and guidelines. Ministry of Health and Family Welfare, Government of India; 2020. https://main.mohfw.gov.in/. Accessed April 29, 2025.

International Institute for Population Sciences (IIPS). National Family Health Survey (NFHS-V), 2019–21: India: Volume I. Mumbai, India: IIPS; 2021. https://www.nfhsiips.in/nfhsuser/index.php. Accessed March 30, 2025.

International Society of Hypertension. May Measurement Month 2017–2019: global hypertension screening initiative. https://www.maymeasurementmonth.com. Accessed April 29, 2025.

Gupta R. Trends in hypertension epidemiology in India. J Hum Hypertens. 2019;33(8):575-577. doi:10.1038/s41371-019-0204-0

Chockalingam A, Balaguer-Vinto I, Ganesan N. Impact of hypertension in India: strategies for prevention and control. Curr Hypertens Rep. 2019;21(4):33. doi:10.1007/s11906-019-0942-x

Geldsetzer P, Manne-Goehler J, Theilmann M, et al. Diabetes and hypertension in India: a nationally representative study of 1.3 million adults. JAMA Intern Med. 2018;178(3):363-372. doi:10.1001/jamainternmed.2017.8094

Patel SA, Winkel M, Ali MK, et al. Cardiovascular disease risk factors in India: a systematic review of the literature. Glob Health. 2021;17(1):1-20. doi:10.1186/s12992-021-00687-7

Kaur J, Singh A, Kumar R. Dietary factors and hypertension risk in India: a systematic review. Nutr Metab Cardiovasc Dis. 2020;30(7):987-994. doi:10.1016/j.numecd.2020.02.001

Venkataraman R, Kulothungan V, Vasudevan S, et al. Urban-rural disparities in hypertension prevalence and control in India. J Hum Hypertens. 2021;35(2):153-163. doi:10.1038/s41371-020-00427-9

Gul S, Sharma R, Gupta M. Educational disparities in hypertension awareness and management among Indian adults. J Community Health. 2019;44(1):45-53. doi:10.1007/s10900-018-0565-6

Piano MR. Effects of cigarette smoking on cardiovascular disease and hypertension. Crit Care Nurs Clin North Am. 2011;23(1):111-120. doi:10.1016/j.ccell.2010.12.006

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Published

2025-07-18

How to Cite

Prasad, J. B., Sabhahit, G., & Biradar, R. A. (2025). Sex differences in hypertension prevalence and risk factors in India ‒ a comparative study based on National Family Health Survey IV and V . European Journal of Clinical and Experimental Medicine. https://doi.org/10.15584/ejcem.2025.4.22

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ORIGINAL PAPERS