Population Attributable Risk of Elevated Fasting Plasma Glucose for Hypertension among Native Rural and Tea Garden Communities in Northeast India

Aim: Elevated fasting plasma glucose (eFPG) is associated with increased risk of hypertension, contributing cardiovascular risks. However, its population-level impact on hypertension remains insufficiently measured. This study aimed to estimate the population attributable risk (PAR) of eFPG for hypertension among native rural and tea garden communities of Assam, Northeast India. Methods: The participants of a cross-sectional study conducted in Dibrugarh Health and Demographic Surveillance Site, Assam, India were grouped into cases (hypertensive) and control (normotensive) based on European Society of Hypertension (ESH) guidelines 2023. A total of 1238 eligible adults (≥18 years) were consecutively recruited after obtaining informed consent. Sociodemographic, lifestyle, anthropometric, and biochemical data were collected using standardized protocols. eFPG was defined as FPG ≥100 mg/dL. Logistic regression used to estimate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Population attributable risk (PAR) was estimated using adjusted ORs and the prevalence of eFPG. Two-sided p <0.05 considered statistically significant. Results: eFPG was significantly associated with hypertension [AOR: 1.63 (1.24–2.14)]. Estimated PAR of hypertension attributable to eFPG was 18.49% (95% CI: 7.83–29.10), indicating that nearly one in five hypertension cases could be attributed to elevated blood glucose levels. Conclusion: eFPG contributes significantly to the burden of hypertension in these rural populations. Early detection and proper treatment of dysglycemia may decrease the risk of hypertension and associated risks.