A 52-year-old man from rural India is enrolled in the NPCDCS cardiovascular disease screening program. Which of the following is the most common modifiable risk factor identified in the Indian population under this program?

Explanation

## NPCDCS Cardiovascular Disease Risk Factor Profile in India **Key Point:** Hypertension is the most common modifiable cardiovascular risk factor in the Indian population and is the primary target of NPCDCS screening and management at the primary care level. ### Epidemiology of CVD Risk Factors in India | Risk Factor | Prevalence (%) | NPCDCS Priority | Screening Tool | |---|---|---|---| | **Hypertension** | 25–30 | **Very High** | Blood pressure measurement | | Diabetes mellitus | 8–10 | High | Fasting/random blood glucose | | Dyslipidemia | 20–25 | Medium | Lipid profile (selective) | | Obesity (BMI ≥30) | 5–10 | Medium | BMI calculation | **High-Yield:** Hypertension accounts for approximately **25–30% prevalence** in the Indian adult population and is responsible for the largest attributable burden of cardiovascular disease and stroke mortality in India. The NPCDCS identifies hypertension as the **single most important modifiable risk factor** for prevention of CVD and stroke. ### NPCDCS Approach to Hypertension 1. **Screening:** Universal blood pressure measurement at all health encounters (PHC level). 2. **Diagnosis:** Confirmation on ≥2 occasions (systolic ≥140 mmHg or diastolic ≥90 mmHg). 3. **Management:** - Lifestyle modifications (salt restriction, weight loss, exercise). - Pharmacotherapy with ACE inhibitors or thiazide diuretics as first-line agents. 4. **Follow-up:** Regular monitoring and referral to CHC/district hospital for uncontrolled hypertension. **Clinical Pearl:** The NPCDCS emphasizes **opportunistic screening** for hypertension in all adults ≥30 years during routine health facility visits, maternal health programs, and community outreach. This strategy has significantly increased case detection in rural India. **Warning:** ~~Dyslipidemia~~ is often overestimated as a screening priority in resource-limited settings. The NPCDCS recommends selective lipid profiling only in high-risk individuals (age >40 years, family history of CVD, diabetes, or hypertension) due to cost constraints. **Mnemonic:** **HDBCO** — **H**ypertension is the **D**ominant, **B**iggest, **C**ommonest, **O**verarching CVD risk factor in NPCDCS.