High Hypertension Prevalence in Kerala Linked to Sleep, Caffeine, and Dyslipidemia, Study Finds

The findings, published in Cureus, identified key risk factors contributing to the condition, including dyslipidemia (aOR: 12.804), frequent consumption of caffeinated beverages (aOR: 11.43), poor sleep quality (aOR: 2.14), and higher socioeconomic status (aOR: 2.14). Given the high prevalence of hypertension, the study underscores the importance of preventive strategies focused on modifiable risk factors to effectively reduce its burden on the population.

Hypertension poses a significant public health challenge, driving the risk of cardiovascular diseases, stroke, and chronic kidney disease. Its growing prevalence, especially in low- and middle-income countries, is largely attributed to lifestyle shifts, urbanization, and dietary modifications. Despite Kerala’s strong health indicators, the state reports a higher-than-average prevalence of hypertension, highlighting the need for targeted research and intervention strategies. Against this backdrop, Aparna Ajay, Community Medicine, Amrita Institute of Medical Sciences and Research Center, Kochi, IND, and colleagues explored the prevalence of hypertension among adults in the Ernakulam district, Kerala, while also examining its association with sleep quality and other contributing risk factors.

For this purpose, the researchers conducted a community-based cross-sectional study in the Ernakulam district, Kerala, from September 2021 to March 2022, involving 1,110 adults aged 30 years and above. Using cluster sampling, they selected 30 clusters with 37 participants each. Data on sociodemographic factors, lifestyle habits, comorbidities, and sleep quality were collected via a structured questionnaire. Hypertension was defined per JNC 8 guidelines. Sleep quality was assessed using the PSQI, and caffeine intake was categorized based on self-reported consumption. Statistical analysis was performed using IBM SPSS, with multivariable logistic regression to determine risk factor associations.

The study revealed the following findings:

• The average age of the participants was 54.46 ± 14.22 years.
• Hypertension prevalence was 49.8%.
• Poor sleep quality increased the risk of hypertension (aOR = 2.14).
• Higher caffeine consumption was significantly associated with hypertension (aOR = 11.43).
• Individuals with higher socioeconomic status had an elevated risk (aOR = 2.14).
• Dyslipidemia was a strong predictor of hypertension (aOR = 12.804).

The authors highlight that nearly half of the adult population in the Ernakulam district is affected by hypertension, underscoring the need for proactive prevention strategies.

"This study emphasizes the significant role of lifestyle and socioeconomic factors, including poor sleep quality, caffeine consumption, higher socioeconomic status, and dyslipidemia, in increasing hypertension risk," they wrote.

They further noted that "effective management requires a multifaceted approach that extends beyond clinical care to include public health interventions promoting balanced nutrition, physical activity, and sleep hygiene."

In conclusion, they stated, "Community-based initiatives for early detection and risk reduction, alongside policy-driven efforts to enhance awareness and access to preventive healthcare, are essential in curbing the long-term burden of hypertension."

Reference:

Ajay A, Francis P T, Sreedevi A, et al. (March 24, 2025) Prevalence and Risk Factors of Hypertension Among Adults in Ernakulam District, Kerala: A Cross-Sectional Study. Cureus 17(3): e81117. doi:10.7759/cureus.81117