Undertreated Hypertension and its Implications for Public Health in Nepal: Nationwide Population-Based Survey

Authors

  • R Koju Department of Internal Medicine, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre,
  • K Manandhar Department of Community Medicine, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Dhulikhel, Kavre
  • A Risal Department of Psychiatry, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre
  • TJ Steiner Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway 5Division of Brain Sciences, Imperial College London, London
  • A Holen Department of Neurology and Neurophysiology, St Olavs University Hospital, Trondheim
  • M Linde Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway and Department of Neurology and Neurophysiology, St Olavs University Hospital, Trondheim

DOI:

https://doi.org/10.3126/kumj.v13i1.13744

Keywords:

Cardiovascular disease, coronary artery disease, hypertension

Abstract

Background
Hypertension (HTN), a major risk factor for cardiovascular diseases (CVDs), is a substantial global public health problem. Occasional studies indicate a high prevalence of HTN in the Nepalese population, but no nationwide population-based data exist so far. We opportunistically used a survey of major disorders of the brain in Nepal to measure blood pressure (BP) in participants selected randomly from the adult general population.

Objective
To establish the prevalence of elevated BP (eBP), and factors associated with it, regardless of any antihypertensive therapy being taken. We took this to be indicative of unmet health-care need.

Method
This was a cross-sectional study, conducted by unannounced household visits, employing multistage random cluster sampling. To achieve representativeness, 15 districts out of 75 in the country were investigated: one district from each of the three physiographic divisions in each of the five development regions of Nepal. One adult aged 18-65 years was selected from each household and interviewed by structured questionnaire. BP was recorded in a standardised manner by digital device (Microlife 3BM1-3®).

Result
From 2,109 eligible households, 2,100 adults (99.6%) participated. The prevalence of eBP (>140/90 mmHg on ?2 readings) was found to be 15.1%. Multivariate logistic regression showed significant and independent associations with demographic variables (higher age, male gender), with life-style factors (daily alcohol consumption, BMI ?25), and with living at high altitude (?2000 m).

Conclusion
In the context of the survey we could not collect data on antihypertensive therapy being taken but, clearly, whatever this might have been, it was failing to meet treatment needs. Almost one in six adults met criteria for hypertension, carrying risk implications for CVDs and their substantial public-health consequences. Two remediable associated factors were identified, although in a cross-sectional survey we could not prove causation.

Kathmandu University Medical Journal Vol.13(1) 2015; 3-7

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Published

2015-10-20

How to Cite

Koju, R., Manandhar, K., Risal, A., Steiner, T., Holen, A., & Linde, M. (2015). Undertreated Hypertension and its Implications for Public Health in Nepal: Nationwide Population-Based Survey. Kathmandu University Medical Journal, 13(1), 3–7. https://doi.org/10.3126/kumj.v13i1.13744

Issue

Vol. 13 No. 1 (2015)

Section

Original Articles