Gender differences in factors associated with prehypertension and hypertension in Nepal: A nationwide survey

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.

Examining the prevalence, correlates and inequalities of undiagnosed hypertension in Nepal: a population-based cross-sectional study

“…Several studies have reported higher risks of hypertension among people who are older in age, male, urban dwellers, have higher education level, regularly consume tobacco and/or alcohol, or are overweight. 6 8 28 29 We found that patients aged ≥65 years and who were overweight/obese were at lower risk of remaining undiagnosed from hypertension. Our findings depicted a greater proportion of undiagnosed hypertensive patients among those who were young and those with lower BMI.…”

“…Similar to risk factors of hypertension, undiagnosed hypertension was also more prevalent among males and tobacco users. 6 29 The higher rate of undiagnosed hypertension among males might be due to their lack of awareness and lower treatment rates than females. 32 Smoking, a main source of using tobacco, is well recognised to be associated with an increased risk of hypertension in many settings, including Nepal.…”

“…In Nepal, despite the detection of risk factors 6 8 29 and inequalities, 28 the prevalence of hypertension has been well investigated nationally, resulting in the implementation of new policies to mitigate the rising number of patients with hypertension. 47 However, these policy reform efforts will fail to effectively achieve intended hypertension reduction targets if patients remain undiagnosed, undetected and untreated.…”

“…5 Nepal has one of the highest prevalence rates of hypertension among South-East Asian countries. 6 Currently, Nepal is facing an epidemiological transition with an increasing prevalence of hypertension. 7 A study based on the Nepal Demographic and Health Survey (NDHS) 2016 reported about 20% of Nepalese adults (aged ≥18 years) had hypertension.…”

Association between osteosarcopenic obesity and hypertension among four minority populations in China: a cross-sectional study

“…According to Regitz-Zagrosek’s report, hypertension is more common in women than men in the elderly population 9. However, one study conducted in Nepal showed that prehypertension and hypertension occurred more frequently in males than famales 10…”