Prevalence Of Hypertension In Nepal Research Articles

Association between height and hypertension in the adult Nepalese population: Findings from a nationally representative survey.

Background and aimsThe burden of hypertension is increasing in Nepal. Different studies have evaluated the relationship between height and blood pressure in different regions, with mixed results. The relationship between height and hypertension has not yet been explored in the Nepalese context. Given this knowledge gap, this study aims to determine the relationship between height and hypertension among Nepalese adults (aged ≥18 years).MethodsThis study utilized the dataset from the Nepal Demographic and Health Survey (NDHS) 2016. Hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or a diastolic blood pressure ≥ 90 mmHg. Height, measured in centimeters (cm), was analyzed as a continuous variable. Based on previous evidence, the following covariates were considered: age, sex, presence of overweight or obesity, educational status, household wealth status, and place, province, and ecological zone of residence. Multilevel multivariable logistic regression was done to evaluate the association between height and hypertension. Both crude odds ratio (COR) and adjusted odds ratio (AOR) are reported, along with a 95% confidence interval (CI). Sample weight of NDHS was adjusted during analysis.ResultsAmong 13 393 weighted individuals over the age of 18 years, the prevalence of hypertension in Nepal was found to be 21.1% (95% CI, 19.9%‐22.4%). In the final multivariable model, after adjusting for relevant covariates, it was found that height was inversely associated with hypertension. For a Nepalese adult, the odds of hypertension decreased by 10% with each 10‐cm increase in height (AOR 0.9; 95% CI 0.8‐0.9; P = 0.003).ConclusionAwareness should be raised among people with low stature for prevention of hypertension. Longitudinal studies are recommended to include genetic and social/environmental determinants of stature in the analyses.

Prevalence and Risk Factors of Hypertension Among Adults in Nagarjun Municipality of Kathamandu District

Hypertension plays a persistent role in the causation of coronary heart disease, stroke, and vascular problems. Many factors like dietary, behavioral, psychological, environmental, genetic, etc have a direct or indirect influence on hypertension. The available evidences shows a higher prevalence of hypertension in Nepal. The objective of this study was to assess the prevalence and risk factors associated with hypertension among adults of Nagarjun Municipality. A descriptive cross-sectional study was conducted among adults of age 18 and above in Nagarjun municipality. A structured questionnaire was used to assess the risk factors and observation was done to determine blood pressure and anthropometric measurement. The data were entered and analyzed by (SPSS) software version 20. Chi-square test was used to identify the association. The overall prevalence of hypertension was 22.8% and prehypertension was 14.5%. More males were found to have hypertension (28.09%) compared to females (16.67%). Age, sex, religion, socio-economic status, ciggrate smoking, alcohol consumption, BMI, diabetes, family history of hypertension and cardio vascular disease was found to be significantly associated with hypertension. The preventive and intervention measures should be adopted to reduce the behavioral and biological risk factors which are directly related with the causation of hypertension.

Estimated Change in Prevalence of Hypertension in Nepal Following Application of the 2017 ACC/AHA Guideline

The 2017 American College of Cardiology/American Heart Association (ACC/AHA) Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults lowered the systolic and diastolic blood pressure thresholds for hypertension to 130 and 80 mm Hg, respectively. This represents a reduction of 10 mm Hg in both systolic and diastolic blood pressure levels used to define hypertension compared with previous guidelines, such as the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). To estimate the prevalence of hypertension among adults aged 18 years or older in Nepal per the 2017 ACC/AHA guideline and to determine the absolute difference in hypertension prevalence comparing the 2017 ACC/AHA and JNC 7 guidelines. The cross-sectional analysis used data from the population-based 2016 Nepal Demographic and Health Survey. Data were collected from June 2016 to January 2017 using a multistage stratified sampling procedure that was applied in urban and rural areas, using wards as the primary sampling units. Individuals aged 15 years or older from selected households were interviewed. The survey had an overall response rate of approximately 97%. The primary outcome was the prevalence of hypertension. Blood pressure was measured 3 times for each participant with 5-minute intervals between. Hypertension was present if blood pressure was greater than or equal to 130/80 mm Hg for the 2017 ACC/AHA guideline, and greater than or equal to 140/90 mm Hg for the JNC 7 guideline. Among 13 519 participants (median [interquartile range] age, 38 [26-53] years; 7821 [57.9%] female), 44.2% (95% CI, 43.4%-45.0%; n = 5977) had hypertension according to the 2017 ACC/AHA guideline compared with 21.2% (95% CI, 20.5%-21.9%; n = 2869) by the JNC 7 guideline. The new prevalence was associated with an absolute increase of 23.0% (95% CI, 22.3%-23.7%) from the JNC 7 guideline. When estimating the proportion of hypertension by background characteristics, the new 2017 ACC/AHA guideline definition increased the prevalence to 50% or greater for some categories, with the highest prevalence among those with a body mass index (calculated as weight in kilograms divided by height in meters squared) greater than or equal to 30 (71.6%; 95% CI, 67.7%-75.3%) and between 25 and 29.9 (62.1%; 95% CI, 60.1%-64.1%). For adults in Nepal, the new 2017 ACC/AHA guideline reveals a greater estimated prevalence of hypertension compared with the JNC 7 guideline. Because of the public health significance of hypertension, higher prevalence rates confirm the importance of developing effective prevention and control methods in this country.

Prevalence and determinants of hypertension among adult population in Nepal: Data from Nepal Demographic and Health Survey 2016.

Like other developing countries, Nepal is currently going through epidemiological transition along with rising burden of Non-communicable Diseases. However, since 2013, no study investigated the prevalence and determinants of hypertension in Nepal involving nationally representative sample. Therefore, this study aimed to find out the current prevalence of hypertension in Nepal and its determinants using the latest nationally representative data obtained from Nepal Demographic and Health Survey (NDHS) 2016. The NDHS 2016 collected data on hypertension from 13,304 men and women aged 18 years and above from 5,520 urban and 5,970 rural households covering seven administrative provinces and three ecological zones. Participants were considered as hypertensive when their systolic blood pressure was ≥140 mmHg and/or diastolic blood pressure was ≥90 mmHg and/or they reported taking antihypertensive medication. A total of 19.9% study participants were diagnosed as hypertensive of which majority were male (male-24.3%, female-16.9%), ever married (ever married-21.7%, unmarried-6.1%) and residents of urban area (urban-20.9%, rural-18.3%). Hypertension prevalence has shown growing trend with the increase of age. This prevalence was also higher among rich and overweight/obese individuals. In multivariable logistic regression analysis, older age, male gender, better education, residence at urban area and province 4 and 5 and being overweight/obese were found positive association with having hypertension. When the determinants of hypertension were stratified by sex of the participants, difference was observed in case of age group, education and place of residence. As one out of every five individuals in Nepal are hypertensive, public health initiatives are immediately required for prevention and control of hypertension to reduce mortality and morbidity associated with this progressive disease.

Awareness, treatment and control of hypertension in Nepal: findings from the Dhulikhel Heart Study

ObjectivesAlthough previous studies have suggested alarming rise in the prevalence of hypertension in Nepal, there is dearth of information on its awareness, treatment and control. In this cross-sectional study, we...

PS 06-05 PREVALENCE, AWARENESS, TREATMENT, CONTROL AND BEHAVIORAL RISK FACTORS OF HYPERTENSION IN NEPAL

Objective: Hypertension is an established risk factor for cardiovascular and renal disease. There are few studies detailing the prevalence of hypertension in Nepal. Thus, the purpose was to determine prevalence, awareness, treatment and control of hypertension in Nepal. Design and Method: A door-to-door survey was conducted in Lekhnath municipality, Nepal among randomly selected participants, aged between 25–65 years. The WHO STEPS Survey questionnaire was administered. Data collected included socio-demographic characteristics, behavioral risk factors, BMI and blood pressure. The subjects were classified as having hypertension if the blood pressure is ≥ 140/90 mmHg or if currently on antihypertensive medication. Results: Study population included 2816 subjects’ aged 25–64 years, 1844 (65.5%) were males. The mean age was 46.0 ± 10.1 years and body mass index was 25.0 ± 4.39 kg/m2. Mean blood pressures for men systolic 129.4 ± 18.4 mmHg and diastolic 84.1 ± 11.7 mmHg. In women mean systolic 121.6 ± 18.0 mmHg and mean diastolic 79.7 ± 10.7 mmHg. The prevalence of hypertension was 29.8%. Thirty-nine percent of them were found during the survey. Overall 30.3% were on treatment and 50% (128/257) met blood pressure control targets. Of the study population, 16.0% were daily smokers, 12.0% drinking alcohol harmful to health (women >12 standard drinks/week and men >15 standard drinks/week), 90% eating less than 5 servings of fruit and/or vegetable on a day and 6.6% reported having low physical activity (<3000 Metabolic Equivalents). Eighty-two percent consumed > = 5 gram salt per day. Multivariate analysis revealed that increasing age, higher body mass index (obesity), male, alcohol and family history of hypertension were independently associated with hypertension. Conclusions: Hypertension is an emerging challenge in Nepal with a number of risk factors identified as possible drivers of the epidemic. A significant proportion of the Nepali population has undiagnosed hypertension. This suggests a primary care need to target prevention, screening and control measures for blood pressure and associated risk factors.