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Background: Hypertension has remained an imperative risk factor for cardiovascular and cerebrovascular diseases, increasing the national burden of premature deaths over the decades. Purpose: There is limited data on the prevalence of hypertension and its distribution across all geographic regions in India. This nationwide survey was conducted in 2017 to assess the prevalence of hypertension and prehypertension among the Indian adults. Methods: A multilevel stratified cluster sampling technique, with a random selection among the urban and rural populations, was adopted to achieve a sample of 70,031 adults from 24 states and 4 union territories. Blood pressure was measured twice using automated oscillometric machines with a minimum of 3-min gap, and the average was recorded. This was later categorized into prehypertension (elevated blood pressure) and hypertension subgroups as defined by the new 2017 American Heart Association guidelines. Results: The prevalence of prehypertension and hypertension in our study population across all ages was found to be 18.2% and 24%, respectively. Prehypertension was common at a younger age, whereas the prevalence of hypertension was higher in the older age groups. The urban population (24.4%) and males (24.7%) were positively associated with prehypertension and hypertension. The western zone had the highest prevalence of hypertension, whereas the eastern population had the lowest. Conclusion: Our study revealed an alarmingly high prevalence of hypertension, accounting up to one hypertensive in every four adults in India. There is a need for more robust national strategies for identifying and treating hypertension to reduce the national and the global burden of hypertension by 25% before 2025. [ABSTRACT FROM AUTHOR]

Background: Hypertension has remained an imperative risk factor for cardiovascular and cerebrovascular diseases, increasing the national burden of premature deaths over the decades. Purpose: There is limited data on the prevalence of hypertension and its distribution across all geographic regions in India. This nationwide survey was conducted in 2017 to assess the prevalence of hypertension and prehypertension among the Indian adults. Methods: A multilevel stratified cluster sampling technique, with a random selection among the urban and rural populations, was adopted to achieve a sample of 70,031 adults from 24 states and 4 union territories. Blood pressure was measured twice using automated oscillometric machines with a minimum of 3-min gap, and the average was recorded. This was later categorized into prehypertension (elevated blood pressure) and hypertension subgroups as defined by the new 2017 American Heart Association guidelines. Results: The prevalence of prehypertension and hypertension in our study population across all ages was found to be 18.2% and 24%, respectively. Prehypertension was common at a younger age, whereas the prevalence of hypertension was higher in the older age groups. The urban population (24.4%) and males (24.7%) were positively associated with prehypertension and hypertension. The western zone had the highest prevalence of hypertension, whereas the eastern population had the lowest. Conclusion: Our study revealed an alarmingly high prevalence of hypertension, accounting up to one hypertensive in every four adults in India. There is a need for more robust national strategies for identifying and treating hypertension to reduce the national and the global burden of hypertension by 25% before 2025. [ABSTRACT FROM AUTHOR]

In recent years, environmental issues emerging from per- and polyfluoroalkyl substances (PFAS) have raised high concern worldwide. Levels of human exposure to PFAS remain unknown in India. Biomonitoring data obtained from hair analysis have been evidenced to provide insight into retrospective human exposure to PFAS. In this study, 25 PFAS, including perfluoroalkyl acids and their precursors, were measured in 39 human hair samples collected from 14 cities in India. The inuflence of gender on the PFAS levels was also examined. To our knowledge, this is the first attempt to provide preliminary indicative data (due to the limited sample size and variability in hair-length sampling) on the levels of PFAS in Indian hair. The concentrations of total PFAS in hair varied from below matrix-specific limit of quantification (<0.02 ng/g) to 3.78 ng/g. Among 9 PFAS quantified, perfluorohexanesulfonic acid (PFHxS), perfluorooctanesulfonic acid (PFOS), and perfluorooctanoic acid (PFOA) were the predominant compounds. Categorized into 4 regions, PFAS contamination exhibited certain regional difference where South India may show higher levels than the other regions. Highly significant positive correlation was observed between PFHxS and PFOS (p ≪ 0.001; r = 0.644), suggesting similar pathways of exposure to the two compounds. Higher PFAS occurrence was generally observed in the hair of females. Our results highlighted the urgent need to investigate the deposition mechanism of PFAS in hair. Image 1 • This is the first nationwide biomonitoring of PFAS in Indians. • PFHxS, PFOS, and PFOA were predominant in hair samples collected in India. • N -EtFOSA and 6:2 FTUCA were firstly detected in human hair samples. • Regional difference in PFAS levels was found in Indian hair. • Gender might influence PFAS accumulation in hair. [ABSTRACT FROM AUTHOR]