Prevalence And Associated Factors of Hypertension Among the Tribal Populations Aged 15–49 Years in India: Evidence from the National Family Health Survey (NFHS–4)

Abstract

Introduction: Non-communicable diseases, particularly cardiovascular conditions, are a major global health challenge, with hypertension as a key risk factor. Unlike Western countries with stable rates, India shows rising hypertension, especially among vulnerable tribal populations with limited access to healthcare.

Objectives: Given the scarcity of data, this study aims to estimate the prevalence of hypertension and its associated factors among India’s tribal communities.

Methods: This study used secondary data from the National Family Health Survey (NFHS-4, 2015–2016), which employed a two-stage stratified random sampling across all Indian districts. A total of 136,400 scheduled tribe individuals aged 15–49 years (17,412 men and 118,988 women) were included for analysis. The prevalence of hypertension was estimated at national and state levels and factors associated with hypertension were obtained from logistic regression analysis.

Results: The overall sex-adjusted prevalence of hypertension among the Indian tribes was estimated at 13.9% (95% CI; 13.7–14.1). Men and women had a hypertension prevalence of 16.1% (95% CI; 15.6–16.6) and 11.4% (95% CI; 11.2–11.6) respectively. The prevalence of hypertension varied across the states, more among men than women. Among men, the highest and lowest prevalence was seen in Sikkim state (45.8%; 95% CI: 29.1–62.8) and Daman and Diu union territory (4.3%; 95% CI: 1.7–10.2) respectively and among women, in Arunachal Pradesh state (22.9%; 95% CI: 19.4–26.4) and union territory of Chandigarh (8.2%; 95% CI: 4.3–12.2) respectively. Increasing age, male gender, higher wealth index, high body mass index, tobacco use, alcohol consumption, nonvegetarian diet and daily fried food intake were independently associated with hypertension among the study participants.

Conclusions: Hypertension seems to be more prevalent among Indian tribes compared to the general population. Interventions directed towards changing lifestyle behaviour by controlling tobacco use, alcohol consumption and increasing body mass index may play a key role in reducing the burden of hypertension in tribal populations of India.