Spatial patterning of hypertension and its association with comorbidities and risk factors: A cross-sectional study in South India.

INTRODUCTION: Non-communicable diseases (NCDs), particularly hypertension (HTN), pose a significant global health challenge, accounting for a substantial proportion of premature deaths worldwide. In India, HTN prevalence varies widely across states and districts and is influenced by demographic, socioeconomic, and lifestyle factors. This study aims to assess the spatial distribution of HTN and its correlates in South India. MATERIALS AND METHODS: This study utilized data from the 5th National Family Health Survey (NFHS-5), a nationally representative cross-sectional survey conducted across India between 2019 and 2021. For this analysis, data from five states and one union territory in South India were used. Bayesian spatial modelling was employed to analyse HTN prevalence at the district level, incorporating demographic, socioeconomic, and lifestyle covariates. RESULTS: The study included 304,420 adults, both male and female, aged >18 years. The overall prevalence of pre-HTN and HTN was 28.9% and 31.8%, respectively. HTN prevalence varied across states, with Kerala exhibiting the highest prevalence. Spatial clustering analysis identified districts with significantly higher HTN prevalence, often clustering with neighbouring districts showing similar patterns. Spatial autocorrelation analyses revealed a significant association between HTN and diabetes. Other comorbidities and risk factors were not significantly associated with HTN. CONCLUSION: The findings underscore the spatial heterogeneity of HTN prevalence within South Indian states and districts. The study highlights the need for targeted interventions tailored to local contexts to effectively mitigate the burden of HTN and associated comorbidities.