Prevalence and Role of Risk Factors for Hypertension in 18-70 Years of Age in Rural and Urban Areas of District Sahiwal, Punjab Pakistan

Globally, cardiovascular illnesses are believed to have hypertension as their primary cause and most important contributing factor. According to Pakistan's National Health Survey, 33% of adults over the age of 45 and 18% of adults generally have hypertension. Objective: To determine the prevalence of hypertension and its risk factors in both urban and rural District Sahiwal, Punjab, Pakistan. Methods: The population under consideration includes people from both urban and rural regions of three hospitals for identification of hypertension. Questions regarding behavior including food, cigarette, and alcohol intake were posed. The behavioral calculations followed the physical measurements. After the patient had been at ease for 20 minutes, blood pressure was taken, and the person's BMI. Results: With an increase in age, hypertension prevalence occurs suddenly. The frequency of hypertension was 4.27% in the age group of 20-29 years, rising to 59.72% up to the maximum frequency in the age group of 50-59 years, after which it significantly decreased to 56.79%. Out of 500 men, 162 (32.4%) and 170 (34%) of 500 females had hypertension. The percentage of hypertensive was 168 (33.6%) and 164 (32.8%) out of 500 respondents in rural and urban regions, respectively. Conclusions: In this study, the prevalence of hypertension suggests that it is becoming more prevalent. The key contributors to this emerging trend include urbanization, lifestyle modifications, and nutrient deficiencies

world is hypertension. The prevalence of hypertension in Pakistani society is still poorly understood [2]. One of the most notable examples of a disease's iceberg impact is hypertension. Worldwide, 7.5 million fatalities from high blood pressure are expected, or about 12.8% of all yearly deaths [3]. Adults aged 25 and older had a 40% global incidence of high blood pressure in 2008. Around 35% of adults in the South-East Asia region have hypertension, which is responsible for 9.4% of all deaths and nearly 1.5 million annual fatalities [4]. A signi cant public health concern in India is hypertension, which is straight liable for 51% of all stroke deaths and 45% of total deaths from coronary heart disease. According to World Health Hypertension In 18-70 Years of Age in Rural and Urban Areas of District Sahiwal

I N T R O D U C T I O N
Globally, cardiovascular illnesses are believed to have hypertension as their primary cause and most important contributing factor. According to Pakistan's National Health Survey, 33% of adults over the age of 45 and 18% of adults generally have hypertension. Objective: To determine the prevalence of hypertension and its risk factors in both urban and rural District Sahiwal, Punjab, Pakistan. Methods: The population under consideration includes people from both urban and rural regions of three hospitals for identi cation of hypertension. Questions regarding behavior including food, cigarette, and alcohol intake were posed. The behavioral calculations followed the physical measurements. After the patient had been at ease for 20 minutes, blood pressure was taken, and the person's BMI. Results: With an increase in age, hypertension prevalence occurs suddenly. The frequency of hypertension was 4.27% in the age group of 20-29 years, rising to 59.72% up to the maximum frequency in the age group of 50-59 years, after which it signi cantly decreased to 56.79%. Out of 500 men, 162 (32.4%) and 170 (34%) of 500 females had hypertension. The percentage of hypertensive was 168 (33.6%) and 164 (32.8%) out of 500 respondents in rural and urban regions, respectively. Conclusions: In this study, the prevalence of hypertension suggests that it is becoming more prevalent. The key contributors to this emerging trend include urbanization, lifestyle modi cations, and nutrient de ciencies.
Organization health data from 2012, the prevalence of hypertension in men and women aged 25 and older in Pakistan was 23.1% and 22.6%, respectively [5]. It is known that all lifestyle risk factors cause hypertension to develop early and worsen quickly. Social factors that negatively affect behavioral risk factors, such as urbanization, housing, and income, in uence the onset and course of hypertension. Some of the risk factors for hypertension include the following: 1) Physical inactivity; 2) consumption of a bad diet; 3) use of tobacco, etc. It frequently has linkages to co-morbid conditions including obesity and overweight [6]. By 2020, cardiovascular disease and stroke will be the primary causes of death globally, according to the "Global Burden of Disease research [7]. Thus, it is clear that the major public health issue of the twenty-rst century is hypertension. One of the most common cardiovascular diseases is hypertension [8]. The eating and drinking customs of the Punjabi people differ from those of the other states in Pakistan. Concerning the estimate of prevalence and contribution of risk factors for hypertension in individuals aged 20 to 70 in rural and urban areas of the district of Sahiwal, the current study was carried out.
Residents in the demographic under study come from both urban and rural areas. Data was gathered from three hospitals: THQ, DHQ Hospital Sahiwal, and Rai Ali Nawaz Hospital (Chichawatni) (teaching hospital of Sahiwal medical college). The patient's informed approval was acquired, and the study was carried out with the ethics committee of the Madina Medical College in Faisalabad approval. A one-year cross-sectional survey that lasted from January 1 to December 31, 2021, was conducted. There was a pre-planned performance made. The aforementioned hospitals' OPDs were used to gather patient information. The patients were told in their own language what the purpose of the study was. Patients were given the assurance that their information would be kept private and used only for research. It was granted with written informed permission. Ages 18 to 70 were believed to be the eligibility range. Participants were only excluded from the physical disability category if they had a serious physical impairment that prevented them from taking part. The pretested Performa was followed when conducting interviews with participants. Name, age, gender, and other socio-demographic details were included in the rst part. Then, behavioral measurements including food, cigarette, and alcohol intake were asked for. Physical calculations were done after the behavioral calculations. Once the subject had relaxed for 20 minutes, blood pressure was obtained, and the BMI was determined by dividing the subject's height by their weight in kilograms (m2). A

R E S U L T S
Proper trials were taken, and results were evaluated statistically using epi-info 7. The link between the de nite variables and ndings was observed with the help of Chi Square test. P values less than 0.05 were considered signi cant. The total occurrence of hypertension in the existing sample is 33.2%. Age-speci c distribution of hypertensive (Table 1) recommends that the prevalence of hypertension happens abruptly with increase in age. At age 20-29 years, the frequency of hypertension was 4.27% which increases to 59.72% up to age group of 50-59 years, which was the maximum frequency after which it decreases slightly to 56.79%. Out of 500 males, 162 (32.4%) and out of 500 females, 170 (34%) were hypertensive. Out of 500 respondents each in rural and urban areas, the percentage of hypertensive were 168 (33.6%) and 164 (32.8%) respectively.   Table 2 shows that when the BMI of respondents rises, the percentage of hypertensive grows. i.e., from 4 (5.2%) in respondents with BMI 30. Out of entire 1000 respondents, 72 were smokers, out of which 25 (34.72%) were hypertensive. As of 928 non -smokers, 307 (33.08%) were hypertensive ( Table 2). Out of 1000 respondents, 560 respondents were consuming vegetarian diet, out of which 206 (36.78%) were hypertensive. Out of 440 nonvegetarians, 126 (28.63%) were hypertensive.

AGE Age in years Hypertension
Pakistan's urban and rural areas, Punjab had the greatest weighted prevalence of hypertension at 49.2%, followed by Sindh at 46.3%, Baluchistan at 40.9%, and Khyber Pakhtunkhwa at 33.3%. Rural areas have a higher prevalence of hypertension than urban areas [16]. In a 2011 study, Mehmood et al., showed a statistically notable connection between hypertension and its risk variables (blood glucose, serum cholesterol, and body mass index [17]. Obesity is another risk factor for the development of hypertension. A linear development was observed between BMI and hypertension in our study, and a comparable discovery was made by Singh RB et al in his study on 25-64year-old grownup population of North India [18]. According to which, the prevalence of hypertension in smokers is just 1.64% higher than in nonsmokers. Kannan L and Satyamoorthy TS (2009) found that among hypertensive, smoking and tobacco chewers were key risk factors, and the dissimilarity was statistically signi cant when compared to nonsmokers and nontobacco chewers [19]. However, a study by Joseph C. Schoenenberger JC found no indication of a link between a change in smoking status and a change in blood pressure [20]. In this study, respondents who followed a non-vegetarian diet had a lower prevalence of hypertension than vegetarians, and comparable ndings were made by Das SK,Sanyal K,and Basu A [21]. Pakistan, a nation having a population of over 200 million people, has one of the poorest health indicators in South Asia, a region where cardiovascular disease and hypertension are on the rise. In hypertensive women, hypertension is also a major source of stress for the fetus.
[9]. The prevalence of hypertension (33.2%) in this study indicates that hypertension is on the rise. The main causes of this developing tendency include urbanization, lifestyle changes, and dietary changes. Similar ndings were reported in a research conducted in Punjab, which revealed a 46.2% prevalence of hypertension [10]. In this research, the prevalence of hypertension was 162 (32.4%) in males and 170 (34% in females). In a survey research conducted in 2017, Sha et al., reported that nearly one-third of the population in central Punjab had hypertension [11]. In a study conducted in 2000 in Punjab, Raza et al identi ed that the prevalence of hypertension in the adult inhabitants of Punjab is 18%. The current investigation discovered a substantial positive relationship among age and the prevalence of hypertension. According to a populationbased survey conducted by Raza et al., in 2000

C O N C L U S I O N S
Population expansion, ageing, and behavioral risk dynamics such as bad nutrition, less physical activity, excess weight gain, along with others are all contributing to the rising prevalence of the disease in rural and urban settings. Creating awareness, improving education levels, imparting healthy education, and adopting a lifestyle with consistent physical workout for at least 30 minutes per day, ve days a week are critical actions that should be supported early in life to combat the growing problem of hypertension.

C o n  i c t s o f I n t e r e s t
The authors declare no con ict of interest.

S o u r c e o f F u n d i n g
The author(s) received no nancial support for the research, authorship and/or publication of this article