Control of Blood Pressure in District Dehradun, India: is Rule of Halves Still Valid?
Keywords:Hypertension, Rule of Halves, Awareness, Treatment, Controlled
Background: Hypertension is one of the most important causes for cardiovascular disease (CVD) which
poses a major public health challenge. Rule of Halves in hypertension has long been used as a standard
referral point for level of awareness, treatment& control of blood pressure in general population considering
it to be 50 percent at each level.
Aim and Objectives: To validate “Rule of Halves”, for updated teaching to medical and nursing students
and formulation of appropriate strategies for prevention and control of Hypertension at community level.
Methodology: A cross section survey was conducted covering all households in the randomly selected 30
villages of district Dehradun, Uttarakhand by house-to-house visit. A pre-validated, structured questionnaire
was used for capturing data.Hypertension was defined as Systolic Blood pressure -140mmHg or greater &/
or Diastolic Blood pressure of 90mm Hg or greater or both or treatment with antihypertensives.
Result: Out of 1946 screened, 39 percent (749) were found hypertensive. Out of them, less than half (43.5%)
were aware,more than 2/3rd(87.1%) were under treatment and approximately one third were well controlled
(36.2%) with given treatment.Age more than 40 years, female gender and self-employment were found
significant factors after adjusting the confounding factors for hypertension in binary logistic regression
Conclusion: Hypertension was more among younger age group and females had better control of
Hypertension. Awareness regarding hypertensive status is still less than fifty percent, but those who are
aware, majority of them are on treatment, but control on given treatment is far from optimal.
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