Abstract P314: High Prevalence of Behavioural Cardiovascular Risk Factors in a Nepalese Community undergoing Socio-epidemiological Transition

Abstract

Behavioral risk factors, particularly the major four- tobacco consumption, harmful use of alcohol, unhealthy diet and physical inactivity- are accountable for a major proportion of cardiovascular disease burden. Driven by urbanization and globalization, these risk factors are rising in many of the low- income countries including Nepal. Population-based surveys and hospital reports indicate cardiovascular diseases are rising in Nepal. The first countrywide WHO-STEPS risk factor survey conducted in 2007-2008 showed that 23.8% are daily smokers, 28.5% are current drinkers, and 61.9% consumed less than five servings of fruits and vegetables, while 5.5% had low physical activity. Risk factors are generally more prevalent in urban areas than rural. We aimed to study the status of these behavioural risk factors in a community that is rapidly undergoing transition from a village to an urban community. We conducted the study in Duwakot and Jhaukhel, two urbanizing villages 13 kilometers from the capital Kathmandu. Six clusters were randomly selected. Altogether 777 adults aged 25-59 years consented to participate. Questions were based on the WHO-STEPS survey. Current smokers included those who affirmed to the question ‘Do you smoke?’ Current drinkers had ‘consumed alcohol in the previous one month’. Inadequate fruit and vegetable intake indicated those who were taking less than five servings of combined fruit and vegetable in a day. Physical activity was subjectively measured by asking about the respondent’s activities at work, travel and leisure. Having low physical activity meant not meeting any of the GPAQ (Global Physical Activity Questionnaire) criteria of adequate physical activity. Prevalence of the four major behavioral risk factors was high in the community. Addictive behavioural risk factors were particularly higher in the males than in the females: current smoking (33.5% vs. 14.7%), current smokeless tobacco consumption (20.2% vs. 3.3%), and current alcohol drinking (34.5 % vs. 12.6%). Only 2% of the study population fulfilled the recommended minimum five servings of fruits and vegetables. Low physical activity was present in 43.3% of the respondents, with a higher prevalence seen among the females, elderly, more educated and those on non-agro works. In conclusion, there is particularly high physical inactivity and low fruit and vegetable intake in the community indicating negative effects of urbanization such as changing dietary habit and escalating sedentary lifestyle. Because the community is still beginning to urbanize, it is important that timely population-based health promotional strategies and favourable environmental modifications are implemented to counteract the effects of urbanization.