Urban-Rural Disparities in Hypertension Awareness, Treatment, and Control: A Cross-Sectional Population Study from Rajasthan
Abstract
Background
Hypertension is the leading modifiable cardiovascular risk factor in India. Despite high prevalence, awareness and control rates remain low, particularly in rural populations. This study characterizes the hypertension cascade across urban and rural Rajasthan.
Methods
Cross-sectional household survey of 4,200 adults aged 30–70 years across 12 urban wards and 24 rural villages in Rajasthan (2023). Blood pressure was measured using standardized oscillometric devices. The hypertension care cascade was assessed: awareness among hypertensives, treatment among aware, and control among treated (BP <140/90 mmHg).
Results
Hypertension prevalence was 38.2% urban vs. 29.7% rural (p<0.001). Awareness was 64.3% urban vs. 41.8% rural. Among aware, treatment uptake was 78.9% urban vs. 59.4% rural. Controlled BP was achieved in 52.1% of treated urban vs. 31.7% of treated rural patients. Key barriers in rural areas: distance to health facilities (OR 2.4), medication cost (OR 1.9), and low health literacy (OR 3.1).
Conclusion
A substantial urban-rural gap exists across all stages of the hypertension care cascade in Rajasthan. Targeted community health worker interventions and subsidized antihypertensive access are needed to reduce this disparity.
Conflict of Interest
No conflicts of interest. Funded by Indian Council of Medical Research (ICMR) Short-Term Studentship Grant.