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Cardiovascular disease is the leading global cause of death, 1 and hypertension is one of the major risk factors for cardiovascular disease. 2 Approximately 80% of the attributable burden of hypertension is in low-and middle-income countries. 3 The health systems in these countries are often under strain because of limited financial resources and historically have prioritized maternal and child health and infectious diseases over noncommunicable diseases and their risk factors, such as hypertension. 4

Data from low-and middle-income countries on trends in population blood pressure distribution and on hypertension prevalence, awareness, treatment and control in representative populations over time are scarce owing to a lack of active surveillance and to poor follow-up mechanisms. 5 A metaanalysis estimates that about 33% of urban and 25% of rural Indians have hypertension, and that only 25% of rural and 42 …