Tobacco use and uncontrolled hypertension among Indian men: Insights from the National Family He alth Survey (NFHS-4), 2015-2016

BACKGROUND: Tobacco use is a modifiable risk factor for developing cardiovascular diseases, of which hypertension is a major killer. Uncontrolled hypertension (UHT) is a major public health concern that exerts a financial and service burden on the health system. AIM: The current analysis aimed to determine the association between tobacco use and UHT among Indian males. MATERIAL AND METHODS: Data from the 4(th) National Family Health Survey (NFHS) of 1,04,120 men aged 15–54 years were used. We estimated the adjusted prevalence ratio for having UHT among reported tobacco users and non-users. RESULTS: The prevalence of UHT was the lowest (41.02%) among those who did not consume tobacco in any form. Among tobacco users, those smoking tobacco had the highest prevalence (53.53%) of UHT followed by those using both smoked and smokeless forms of tobacco (43.84%) and those using only smokeless forms of tobacco (42.26%). Factors significantly associated with UHT were alcohol consumption (aPR: 1.30; 95% CI: 1.19–1.43), belonging to the richer wealth quintile (richest quintile- aPR: 1.27; 95% CI: 1.05–1.38), being overweight (aPR: 3.14, 95% CI: 2.35–4.21), and being obese (aPR: 2.89, 95% CI: 2.12–.94). Higher educational status was significantly protective against UHT (aPR: 0.75; 95% CI: 0.63–0.88). CONCLUSIONS: Tobacco use is significantly associated with hypertension in Indian men. Addressing tobacco control and prevention of UHT remain the cornerstones for achieving the SDG target 3.4 by 2030, which aims to reduce premature mortality from NCDs by a third by 2030 relative to 2015 levels.