Prevalence and associated factors of pre-hypertension and hypertension in Nepal: Analysis of the Nepal Demographic and Health Survey 2016.

Gulam Muhammed Al Kibria,Muhammad Nazmus Sakib,Vanessa Burrowes,Krystal Swasey,Atia Sharmeen

doi:10.1002/hsr2.83

Abstract

ObjectivesHypertension is the leading risk factor for cardiovascular diseases and develops faster among pre‐hypertensive individuals. However, there is a lack of nationally representative studies that investigate the prevalence and determinants of these two conditions in many developing countries, including Nepal. This study investigates the prevalence and determinants of pre‐hypertension and hypertension in Nepal.MethodsThe present cross‐sectional analysis used data from the 2016 Nepal Demographic and Health Survey, collected from June 2016 to January 2017. After calculating the weighted prevalence (with 95% confidence interval [CI]), simple and multivariable analyses were performed to estimate odds ratios.ResultsA total of 14 857 individuals (6247 males and 8610 females) aged ≥15 years who had their blood pressure measured during the survey were included in this study. The prevalence for pre‐hypertension and hypertension were 26.0% (95% CI: 25.3‐26.3, n = 3856) and 19.5% (95% CI: 18.8‐20.2, n = 2899), respectively. The prevalence of both conditions was greater among males. In multivariable analyses, older age, male sex, higher body mass index, and residents of Provinces 4 and 5 had significantly increased odds of pre‐hypertension and hypertension (P < .05). Additionally, higher education level was found to be positively associated with hypertension.ConclusionsThe combined higher prevalence of pre‐hypertension and hypertension indicates that nearly half (45.5%) of the respondents are at a greater risk of cardiovascular and other non‐communicable diseases due to these two conditions. Older people, males, obese people, and individuals living in Provinces 4 and 5 require more awareness to control blood pressure levels.

Highlights

Cardiovascular diseases are currently the leading causes of global deaths or disability‐adjusted life years.[1-3]
We considered the hierarchical structure of the 2016 Nepal Demographic and Health Survey (NDHS) dataset after accounting for cluster sampling design of the 2016 NDHS to estimate the prevalence and determinants in this study.[14]
Of the total 14 857 participants included in this study, 8102, 3856, and 2899 had normal blood pressure, pre‐hypertension, and hypertension, respectively

Summary

Introduction

Cardiovascular diseases are currently the leading causes of global deaths or disability‐adjusted life years.[1-3]. Many developing countries are currently dealing with a problem that is known as “twin” or “double” disease burden, where there is a concomitant higher incidence and prevalence of communicable and non‐communicable diseases.[7-9]. Among the regions of the World Health Organization (WHO), hypertension and other cardiovascular disorders are increasing at a faster rate in South Asian countries compared with other regions.[7-9]. Previous studies reported that prevalence and likelihood of pre‐hypertension and hypertension vary according to several characteristics, including age, sex, body mass index (BMI), socioeconomic status, and place of residence.[10-12]. These characteristics affect awareness, treatment, and control of hypertension.[11,12]

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