Background. Hypertension is a leading cause of morbidity and mortality worldwide. We aimed to evaluate the prevalence of hypertension in a population of male bus drivers in North Kerala, India. Methods. The study population included male bus drivers of Corporation Bus stand Kozhikode, Kerala. Blood pressure, height, and weight of subjects were measured, and relevance was obtained using a structured questionnaire. Results. Age varied from 21 to 60 years (mean ). Among 179 bus drivers studied, 16.8% (30/179) had normal BP, 41.9% (75/179) had prehypertension, and 41.3% (74/179) had hypertension. Isolated systolic HTN was seen in 6.70% (12/179) individuals. Out of 74 hypertensives, 9 (12.1%) were aware of their hypertension, while 3 (4.0%) were medicated and only 1 (1.3%) had BP adequately controlled. Age > 35 years (P = 0.015), BMI ≥ 23？kg/m2 (P = 0.007), supporting more than four family members (P = 0.011), and taking main meals from restaurants on most working days (P = 0.017) were independently associated with HTN in binary logistic regression. Conclusion. Prevalence of hypertension was high among bus drivers. Age > 35 years, elevated BMI, supporting a large family, and dietary habits associated with the job showed significant association with hypertension. Primary and secondary prevention strategies need to be emphasized in this occupational group. 1. Introduction Cardiovascular diseases (CVDs) account for nearly a third of all deaths worldwide. The prevalence of CVDs is increasing in developing countries like India. CVD is predicted to become the major cause of morbidity and mortality by 2020 [1]. The key intervention in CVDs is to identify risk factors early and initiate therapy to control them. An important modifiable risk factor for CVDs is systemic arterial hypertension (HTN). Hence, diagnosis of hypertension and appropriate treatment to optimize BP are important public health goals worldwide. All groups of professional drivers especially those carrying passengers are at excess risk of HTN, myocardial infarction, and hemorrhagic stroke [2–6]. Occupational bus drivers in a developing country like India deserve special concern. They have to be extremely careful in handling heavy vehicles laden with passengers. Traffic congestion, exposure to vehicle exhausts, constant whole body vibration, poor condition of roads, poor town planning and traffic regulation, over speeding due to competition between buses, and carelessness of pedestrians contribute to their misery. Besides, most of the drivers are in the habit of eating main meals from hotels and
References
[1]
World Health Organization and W. van Lerberghe, Primary Health Care: Now more than Ever, World Health Organization, Geneva, Switzerland, 2008.
[2]
L. Alfredsson, N. Hammar, and C. Hogstedt, “Incidence of myocardial infarction and mortality from specific causes among bus drivers in Sweden,” International Journal of Epidemiology, vol. 22, no. 1, pp. 57–61, 1993.
[3]
C. Bigert, P. Gustavsson, J. Hallqvist et al., “Myocardial infarction among professional drivers,” Epidemiology, vol. 14, no. 3, pp. 333–339, 2003.
[4]
H. Hannerz and F. Tüchsen, “Hospital admissions among male drivers in Denmark,” Occupational and Environmental Medicine, vol. 58, no. 4, pp. 253–260, 2001.
[5]
B. Netterstrom and K. Juel, “Impact of work-related and psychosocial factors on the development of ischemic heart disease among urban bus drivers in Denmark,” Scandinavian Journal of Work, Environment and Health, vol. 14, no. 4, pp. 231–238, 1988.
[6]
F. Tüchsen, H. Hannerz, C. Roepstorff, and N. Krause, “Stroke among male professional drivers in Denmark, 1994–2003,” Occupational and Environmental Medicine, vol. 63, no. 7, pp. 456–460, 2006.
[7]
K. R. Thankappan, S. Sivasankaran, S. Abdul Khader et al., “Prevalence, correlates, awareness, treatment, and control of hypertension in Kumarakom, Kerala: baseline results of a community-based intervention program,” Indian Heart Journal, vol. 58, no. 1, pp. 28–33, 2006.
[8]
M. G. Zachariah, K. R. Thankappan, S. C. Alex, P. S. Sarma, and R. S. Vasan, “Prevalence, correlates, awareness, treatment, and control of hypertension in a middle-aged urban population in Kerala,” Indian Heart Journal, vol. 55, no. 3, pp. 245–251, 2003.
[9]
T. S. Prasanth and K. Vijayakumar, “Prevalence of Systemic Hypertension among the rural residents of Kerala,” Calicut Medical Journal, vol. 6, no. 3, article e4, 2008.
[10]
A. V. Chobanian, G. L. Bakris, H. R. Black et al., “Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure,” Hypertension, vol. 42, no. 6, pp. 1206–1252, 2003.
[11]
S. S. Chaudhary, M. M. Nagargoje, S. S. Kubde, S. C. Gupta, and S. K. Misra, “Prevalence of cardiovascular diseases risk factors among auto-rickshaw drivers,” Indian Journal of Community Health, vol. 22, no. 1-2, pp. 32–34, 2011.
[12]
O. Kaewboonchoo and S. Kalampakorn, “Hypertension among bus drivers in Bangkok, Thailand,” 2011, http://www.nursinglibrary.org/vhl/handle/10755/166988.
[13]
S. Saleekul, A. Pauwattana, and O. Kaewboonchoo, “Hypertension among bus drivers in an urban area, Thailand,” Newport Beach, 2005, http://www.workhealth.org/2005%20ICOH/ICOH%20final%20program.html.
[14]
D. R. Ragland, M. A. Winkleby, and J. Schwalbe, “Prevalence of hypertension in bus drivers,” International Journal of Epidemiology, vol. 16, no. 2, pp. 208–214, 1987.
[15]
K. Belkic, R. Emdad, and T. Theorell, “Occupational profile and cardiac risk: possible mechanisms and implications for professional drivers,” International Journal of Occupational Medicine and Environmental Health, vol. 11, no. 1, pp. 37–57, 1998.
[16]
“3 in 4 taxi drivers have hypertension,” 2006, http://www.irishhealth.com/article.html?id=9510.
[17]
S. Guha, A. Ghosh, N. Chatterjee et al., “Risk factors for coronary heart disease in Indians: a case-control study from Eastern India,” Indian Heart Journal, vol. 57, no. 6, pp. 738–740, 2005.
[18]
R. Gupta, “Meta-analysis of prevalence of hypertension in India,” Indian Heart Journal, vol. 49, no. 4, p. 450, 1997.
[19]
S. K. Das, K. Sanyal, and A. Basu, “Study of urban community survey in India: growing trend of high prevalence of hypertension in a developing country,” International Journal of Medical Sciences, vol. 2, no. 2, pp. 70–78, 2005.
[20]
S. Markan, M. Sachdeva, B. S. Sehrawat, S. Kumari, S. Jain, and M. Khullar, “MTHFR 677 CT/MTHFR 1298？CC genotypes are associated with increased risk of hypertension in Indians,” Molecular and Cellular Biochemistry, vol. 302, no. 1-2, pp. 125–131, 2007.
[21]
K. Srivastava, R. Narang, V. Sreenivas, S. Das, and N. Das, “Association of eNOS Glu298Asp gene polymorphism with essential hypertension in Asian Indians,” Clinica Chimica Acta, vol. 387, no. 1-2, pp. 80–83, 2008.
[22]
T. Sathish, S. Kannan, P. S. Sarma, O. Razum, and K. R. Thankappan, “Incidence of hypertension and its risk factors in rural Kerala, India: a community-based cohort study,” Public Health, vol. 126, no. 1, pp. 25–32, 2012.
[23]
M. A. Winkleby, D. R. Ragland, and S. L. Syme, “Self-reported stressors and hypertension: evidence of an inverse association,” American Journal of Epidemiology, vol. 127, no. 1, pp. 124–134, 1988.
