Incident hypertension in urban slums of central India: a prospective cohort study

Task-sharing with community health workers to treat hypertension: a scoping review

Many studies have implemented and evaluated task-sharing interventions with community health workers (CHWs) to manage hypertension. To identify gaps in research, we conducted a scoping review. We searched original articles published in PubMed and EMBASE between 2010 and 2022 and found 122 articles meeting our inclusion criteria. Only seven articles were from low-income countries (LICs), most of which were qualitative studies or mixed methods studies. In the identified 122 articles, CHWs often performed health education (61.3%) and measured blood pressure (60.4%). Whereas CHWs carried out pharmacological treatment in only three studies. Participant homes (75.0%) were the most common setting for receiving interventions. Our study identified specific needs for future research, specifically, studies in LICs that are experimental in design and that collect relevant qualitative information, and studies in which CHWs do advanced task. In addition, publications of CHW studies should provide a more comprehensive list of intervention features.

Trends in hypertension prevalence, awareness, treatment, and control: an 8-year follow-up study from rural North India

Hypertension is a major contributor to global CVD burden. LMICs including India is challenged with rising hypertension prevalence, yet limited studies are available on temporal change and incidence among community-cohorts. This study aimed to describe trends in hypertension prevalence, awareness, treatment, and control over 8 years among a rural community-cohort from Haryana, India. The study also lends towards an analysis of incidence. Adults ≥ 30 years (N = 1542) recruited during baseline cross-sectional study between 2011 and 2014 were followed up after a median 8.1 years. At endline, demographic/lifestyle characteristics and blood pressure were re-examined. Overall median SBP significantly increased from 120 mmHg at baseline to 125.5 mmHg at endline (p < 0.001), while hypertension prevalence increased from 34.4% (95% CI 32.0-36.9) to 40.4% (95% CI 37.5-43.4) (p = 0.002). Age-standardized hypertension incidence was 30.2% (95% CI 26.7-35.2) over 8 years. Among hypertensive group, awareness, treatment, and control increased from 9.6, 8.8 and 5.0% to 31.8, 27.3 and 9.6% (p < 0.05), respectively. Increasing trend in SBP and hypertension prevalence was observed as the cohort ages. This increase is supported by the high incidence of hypertension. Nevertheless, our study highlights positive trends in hypertension care cascade but poor control, suggesting that this trend may not be adequately impactful to reduce hypertension burden.