Abstract
BackgroundNepal has one of the highest prevalence of hypertension in South Asia. However, no national studies have examined the gender differences in the determinants of prehypertension and hypertension in the country to inform targeted interventions. This study aimed to investigate gender differences in factors associated with prehypertension and hypertension in Nepal using the 2016 Nepal Demographic and Health Survey (NDHS).MethodsSociodemographic, behavioural, anthropometric and health status data and information on hypertension were obtained from 14,857 (males: 6,245 and females: 8,612) individuals aged 15 years or above from the biomarker sample of the 2016 NDHS. Factors associated with prehypertension and hypertension by gender were investigated using generalized linear latent and mixed models (GLLAM) with the mlogit link and binomial family that adjusted for clustering and sampling weights.ResultsThe overall prevalence of prehypertension and hypertension was 26.9% [95% confidence interval (CI): 25.7, 28.1] and 17.2% (95% CI 16.1, 18.3), respectively. Prehypertension was present in 30.4% (95%CI: 28.7, 32.2) of males and 24.3% (95% CI: 23.1, 25.6) of females, while hypertension was present in 20.4%, (95% CI 18.9, 22.0) of males and 14.8% (95% CI: 13.7, 16.0) of females. Key modifiable factors that were strongly associated with prehypertension and hypertension in both genders included overweight and obesity, caffeine intake, tobacco use, no schooling, previously informed of hypertension in a health facility, and alcohol consumption (for males). Other significant factors associated with prehypertension and hypertension included increasing age (> 30 years), ecological zone (Hill), Developmental zone (Western) and being married.ConclusionOur results suggest that prehypertension and hypertension were higher in males compared to females. Interventions to improve awareness, screening, treatment and control of prehypertension and hypertension in Nepal are warranted and should target key modifiable factors, as well as people aged 30 years and above.
Highlights
Hypertension is a global public health issue that accounted for an estimated 141 deaths and 2,869 disability-adjusted life years (DALYs) per 100,000 population in 2016 [1,2,3,4]
The overall prevalence of prehypertension and hypertension was 26.9% [95% confidence interval (CI): 25.7, 28.1] and 17.2%, respectively
Prehypertension was present in 30.4% (95%CI: 28.7, 32.2) of males and 24.3% of females, while hypertension was present in 20.4%, of males and 14.8% of females
Summary
Hypertension is a global public health issue that accounted for an estimated 141 deaths and 2,869 disability-adjusted life years (DALYs) per 100,000 population in 2016 [1,2,3,4]. The main aim of this strategic plan is to galvanise a multi-sectoral collaboration at the national, regional and global levels to reduce the avoidable burden of morbidity, mortality and disability due to NCDs. Achieving reductions in hypertension and its complications would require high-quality research to promote and support preventive programs. The assessment of determinants of hypertension by gender is warranted to guide targeted and high-impact initiatives [5]. No national studies have examined the gender differences in the determinants of prehypertension and hypertension in the country to inform targeted interventions. This study aimed to investigate gender differences in factors associated with prehypertension and hypertension in Nepal using the 2016 Nepal Demographic and Health Survey (NDHS)
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