Cardiovascular disease risk factors distribution and clustering across different geographic levels in Nepal

Abstract

Background: In an effort to reduce the burgeoning problem of cardiovascular diseases (CVD), it is imperative to understand the variation of risk factors across different geographic regions. This study aims to shed light on examining the leading risk factors of CVD and it's clustering across Nepal.Methods: Data from a nationally representative survey were analyzed to estimate the distribution of four major risk factors (high blood pressure, overweight, obesity, and smoking) of cardiovascular diseases. Similarly, this study also assessed the intra-cluster correlation coefficients (ICCs) of CVD risk factors at the household, community (urban/rural), district, and province level.Results: This study included 14 418 adult population with age of 15 years and above of which 41.7% were male and 58.3% were female. Higher prevalence of all four CVD risk factors was found in the richest quintile, people living in hilly region, most noticeably among residents of metropolitan city and in Gandaki, Bagmati, and Province 1. The ICC decreased as the socio-geographic clustering units decreased in size from province, district, and household level clustering. The ICC was highest at province level for "province 1" for raised blood pressure than other provinces. Conclusions: Risk factors of CVD in Nepal are concentrated prominent in highly urbanized areas and ICC is low as the level of geography decreased from province, district, and household. The findings can be applied in directing prevention activities at different levels to mitigate the higher burden of risk factors of CVD in Nepal.

Cardiovascular risk factors across different levels of urbanization in Brazilian Afro‐derived communities (quilombos)

“…Our results show different levels of urbanization are associated with differential chronic disease risk, as found elsewhere (Ghimire et al, 2022; Kidokoro et al, 2022). However, it is important to state that while we observed that rural and more isolated living was associated with overall better chronic disease risk profiles, quilombos —including those in more rural environments—historically and presently are facing hardships that continue to impact their health.…”

Ancestry, diversity, and genetics of health-related traits in African-derived communities (quilombos) from Brazil

“…In particular, the restrictions on hunting, fishing, and the reduction of their lands by predatory entrepreneurship have been forcing changes in the lifestyle of the quilombolas, who were traditionally involved in subsistence agriculture (Shiraishi Neto 2007;Nunes et al 2016;Silva et al 2016). It is worth noting that a higher level of urbanization, linked to a shift to a capitalist economy, is related to more sedentary lifestyles, higher stress, and a decrease in dietary quality, associated with increased chronic disease risk (Wells 2012; Ghimire et al 2022;Kidokoro et al 2022). Brazilian quilombos are not exempt from this pattern, with more urbanized quilombos showing higher chronic disease-related risk factors than their urban counterparts (Paiva et al 2022).…”