Modelling the Impact of Obesity Reduction on the Prevalence of Hypertension in India: A Discrete-Event Microsimulation Approach

Obesity is one of the most significant risk factors of non-communicable diseases, disability, and premature death. Due to its profound impact on health, researchers have started classifying it as a disease rather than a mere abnormality. India, following the global trend, is experiencing a surge in obesity prevalence, posing a critical research question about the potential impact of obesity reduction on NCD incidence and related disorders. This study employs discrete-event dynamic microsimulation modelling to investigate how changes in BMI distribution in early years of life can influence the prevalence of hypertension, one of the most prevalent diseases in India. The microsimulation modelling approach enables the simulation of individual-level real-life behaviors and interactions within a given population. The model simulated the lives of 100,000 individuals aged 20 over the next 50 years till age 70. Baseline characteristics, prevalence rates, and transition probabilities were derived from diverse data sources, including Census 2011, the National Family Health Survey - V (NFHS-5), and the Longitudinal Aging Study in India (LASI, 2017-18). The study explores the impact of two scenarios on hypertension prevalence: (i) a one-unit reduction in mean BMI level at baseline, and (ii) a one-unit reduction in the standard deviation of BMI distribution at baseline. Results indicate that a one-unit reduction in mean BMI level at baseline could lead to a 5% reduction in hypertension prevalence at age 70, while a one-unit reduction in the standard deviation of BMI distribution at baseline could result in a 7.5% reduction. These findings underscore the importance of targeting children and adolescents with elevated BMI values to mitigate the later-life prevalence of hypertension. Additionally, the study highlights the significance of promoting the use of microsimulation modelling in health research in the Indian context.