BACKGROUND Lack of nationwide evidence on awareness, treatment, and control (ATC) of hypertension among older adults in India impeded targeted management of this condition. We aimed to estimate rates of hypertension ATC in the older population and to assess differences in these rates across sociodemographic groups and states in India. METHODS AND FINDINGS We used a nationally representative survey of individuals aged 45 years and over and their spouses in all Indian states (except one) in 2017 to 2018. We identified hypertension by blood pressure (BP) measurement ≥140/90 mm Hg or self-reported diagnosis if also taking medication or observing salt/diet restriction to control BP. We distinguished those who (i) reported diagnosis ("aware"); (ii) reported taking medication or being under salt/diet restriction to control BP ("treated"); and (iii) had measured systolic BP <140 and diastolic BP <90 ("controlled"). We estimated age-sex adjusted hypertension prevalence and rates of ATC by consumption quintile, education, age, sex, urban-rural, caste, religion, marital status, living arrangement, employment status, health insurance, and state. We used concentration indices to measure socioeconomic inequalities and multivariable logistic regression to estimate fully adjusted differences in these outcomes. Study limitations included reliance on BP measurement on a single occasion, missing measurements of BP for some participants, and lack of data on nonadherence to medication. The 64,427 participants in the analysis sample had a median age of 57 years: 58% were female, and 70% were rural dwellers. We estimated hypertension prevalence to be 41.9% (95% CI 41.0 to 42.9). Among those with hypertension, we estimated that 54.4% (95% CI 53.1 to 55.7), 50.8% (95% CI 49.5 to 52.0), and 28.8% (95% CI 27.4 to 30.1) were aware, treated, and controlled, respectively. Across states, adjusted rates of ATC ranged from 27.5% (95% CI 22.2 to 32.8) to 75.9% (95% CI 70.8 to 81.1), from 23.8% (95% CI 17.6 to 30.1) to 74.9% (95% CI 69.8 to 79.9), and from 4.6% (95% CI 1.1 to 8.1) to 41.9% (95% CI 36.8 to 46.9), respectively. Age-sex adjusted rates were lower (p < 0.001) in poorer, less educated, and socially disadvantaged groups, as well as for males, rural residents, and the employed. Among individuals with hypertension, the richest fifth were 8.5 percentage points (pp) (95% CI 5.3 to 11.7; p < 0.001), 8.9 pp (95% CI 5.7 to 12.0; p < 0.001), and 7.1 pp (95% CI 4.2 to 10.1; p < 0.001) more likely to be aware, treated, and controlled, respectively, than the poorest fifth. CONCLUSIONS Hypertension prevalence was high, and ATC of the condition were low among older adults in India. Inequalities in these indicators pointed to opportunities to target hypertension management more effectively and equitably on socially disadvantaged groups.

中文翻译：

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印度 45 岁及以上成年人及其配偶对高血压的认识、治疗和控制：一项具有全国代表性的横断面研究。

背景 缺乏关于印度老年人高血压认识、治疗和控制 (ATC) 的全国性证据阻碍了对这种情况的针对性管理。我们旨在估计老年人群中高血压 ATC 的发病率，并评估这些比率在印度社会人口群体和各邦之间的差异。方法和结果 我们对 2017 年至 2018 年印度所有州（一个州除外）的 45 岁及以上个人及其配偶进行了全国代表性调查。我们通过血压 (BP) 测量值≥140/90 mmHg 或自我- 如果还服用药物或观察盐/饮食限制以控制血压，则报告诊断。我们区分了那些 (i) 报告诊断（“知道”）；(ii) 报告服用药物或限制盐/饮食以控制血压（“ 9%（95% CI 41.0 至 42.9）。在高血压患者中，我们估计分别有 54.4%（95% CI 53.1 至 55.7）、50.8%（95% CI 49.5 至 52.0）和 28.8%（95% CI 27.4 至 30.1）知道、治疗和控制. 在各州，ATC 的调整率范围从 27.5%（95% CI 22.2 到 32.8）到 75.9%（95% CI 70.8 到 81.1），从 23.8%（95% CI 17.6 到 30.1）到 74.9%（95% CI）到 79.9），以及从 4.6%（95% CI 1.1 到 8.1）到 41.9%（95% CI 36.8 到 46.9）。在较贫穷、受教育程度较低和社会弱势群体以及男性、农村居民和就业人群中，年龄性别调整率较低 (p < 0.001)。在高血压患者中，最富有的五分之一是 8.5 个百分点 (pp)（95% CI 5.3 至 11.7；p < 0.001）、8.9 pp（95% CI 5.7 至 12.0；p < 0.001）和 7.1 pp（95% CI） 4.2 到 10.1；p < 0。001) 分别比最贫穷的五分之一更有可能意识到、治疗和控制。结论 印度老年人的高血压患病率很高，这种情况的 ATC 较低。这些指标中的不平等表明有机会更有效、更公平地针对社会弱势群体进行高血压管理。