Sociodemographic Determinants of Hypertension–Obesity–Diabetes (HOD) Complex among Adults in Central India

Abstract

Background: Hypertension, obesity, and diabetes mellitus are major non-communicable diseases that frequently coexist and substantially increase the risk of cardiovascular morbidity and mortality. The clustering of these conditions, referred to as the hypertension–obesity–diabetes (HOD) complex, reflects shared risk factors and underlying sociodemographic determinants. Understanding these determinants is essential for designing targeted and integrated public health interventions in rapidly transitioning populations such as those in Central India.
Aim and Objectives: To determine the association between sociodemographic factors and the HOD complex among adults in Central India. The study also aimed to estimate the prevalence of hypertension, obesity, diabetes, and their clustering, and to identify independent sociodemographic predictors of the HOD complex.
Methodology: A community-based cross-sectional study was conducted among 600 adults aged ≥18 years attending health camps under the Family Adoption Program in rural and urban field practice areas of R.D. Gardi Medical College, Ujjain. Data were collected using a pre-tested semi-structured questionnaire. Blood pressure, anthropometric measurements, and random capillary blood glucose were assessed using standardized procedures. Associations were evaluated using chi-square tests, and multivariable logistic regression was performed to determine independent predictors.
Results: Among the participants, 33.3% were overweight/obese, 23.7% were hypertensive, 8.5% were diabetic, and 45.0% had prehypertension. Overall, 5.3% had the HOD complex. Obesity was significantly associated with age (p = 0.0001) and gender (p <0.001). Diabetes was significantly associated with age (p = 0.031) and type of family (p = 0.003), while hypertension showed significant associations with age (p = 0.001), gender (p = 0.034), and family type (p = 0.016). On multivariable analysis, increasing age (AOR =2.05; 95% CI: 1.13–3.71), female gender (AOR=6.95; 95% CI: 2.10–23.03), and nuclear family type (AOR=6.38; 95% CI: 2.16–18.88) emerged as independent determinants of the HOD complex, whereas socioeconomic status was not significant.
Conclusion: A considerable burden of cardiometabolic conditions and their clustering was observed. Increasing age, female gender, and nuclear family structure were independent determinants of the HOD complex. These findings emphasize the need for integrated community-based screening and targeted preventive strategies focusing on high-risk sociodemographic groups to reduce the growing burden of cardiometabolic diseases.