High blood pressure, hypothyroidism high among tribal Kashmiris: Study

Known to consume excess salt which is directly linked to hypertension

A large proportion of the tribal population from Kashmir has high blood pressure and underactive thyroid gland, shows a field study done by doctors from All India Institute of Medical Sciences, Delhi, and the Sher-i-Kashmir Institute of Medical Sciences (SKIMS).

The study found a higher proportion of overweight and obese individuals. Of the 2,410 men, 23.7% were either overweight or obese and so were 30.8% of the 3,431 women surveyed.

At the national level, 18.9% adult men and 20.6% adult women are overweight or obese, according to the National Family Health Survey (NFHS) data.

“If you look at the percentage of obese people (with BMI over 30) it is lower; just 6.1% among men and 11.2% among women.

The number of overweight individuals is higher than the national average because we have considered 23 to be the cutoff mark and not 25,” said Dr Ashraf Ganie, lead author of the study that is under review at the Indian Council of Medical Research (ICMR) for publication in its journal.

HIGHER THAN THE NATIONAL AVERAGE

A high 24.4% of men and 14.4% women from two tribal groups in Kashmir have high blood pressure despite low socioeconomic status. This is higher than the national average of 13.8% men suffering from hypertension and 8.8% women, according to the NFHS (2015-16).

The study found pre-hypertension, or elevated blood pressure but not high enough to be considered hypertension, in 22.5% of men and 20.6% of women.

“India has 8.9% tribal population and these marginalised groups have a worse health status than the general population. This is supported by our study that looks at the prevalence of non-communicable diseases (NCDs) and the socio-economic status of two marginalised tribal communities of Gujjars and Bakerwals,” said Dr Ganie.

“95% of the people interviewed and tested for the study earn less than Rs 25,000 per annum. They have a high prevalence of hypertension and hypothyroid,” he said. This could be attributed to the dietary habits of the people.

“The people in the area are known to consume a lot of salt, even in their tea. High salt consumption is directly linked to high blood pressure. The high altitude at which they live may have an impact,” said Dr Ganie.

“The high blood pressure puts the population at high risk for cardiovascular diseases and stroke. It is no longer true that the NCDs are the diseases of the rich. The poor are at a higher risk because they do not have easy access to health information about good diet and exercise and the lack of health facilities mean that the diseases do not get caught or treated early,” said Dr D Prabhakaran, director of the Centre for Chronic Disease Control, a Public Health Foundation of India institute.

The population suffers from hypothyroidism or an underactive thyroid gland that can lead to weight gain, fatigue, and increased sensitivity to cold. The study found 8% of people had hypothyroidism with symptoms, while 26% had subclinical hypothyroidism. “In children, it can lead to impaired cognitive functions. Hypothyroidism in people living in the Himalayan foothills is associated with iodine deficiency,” said Dr Prabhakaran.

But that might not be the case, the authors of the study have found. “Despite high prevalence of hypothyroidism, there is low prevalence of goitre or the swelling of the neck from an enlarged gland associated with thyroid dysfunction due to iodine deficiency. We cannot say what the reason is but urinary iodine data is being analysed,” Dr Ganie said.

The study shows that just over 65% of the tribal people had Vitamin D deficiency. This is better than the national average of 80% to 90%.