Determinants of hypertension in Nepal using odds ratios and prevalence ratios: an analysis of the Demographic and Health Survey 2016

Abstract

<jats:title>Abstract</jats:title> <jats:p>This cross-sectional study investigated the factors associated with hypertension among Nepalese adults aged 18 years or above using data from the Nepal Demographic and Health Survey 2016. Prevalence ratios (PRs) and odds ratios (ORs) were obtained using log-binomial regression and logistic regression, respectively. Initially, unadjusted PRs and ORs were obtained. The variables that yielded a significance level below 0.2 in unadjusted analyses were included in the multivariable analysis. The overall prevalence of hypertension among the 13,393 participants (58% male and 61.2% urban) was 21.1% (<jats:italic>n</jats:italic> = 2827). In the adjusted analysis, those aged 30–49 years (adjusted PR [APR]: 3.1, 95% Confidence Interval (CI): 2.6, 3.7; adjusted OR [AOR]: 3.6, 95% CI: 2.9, 4.5), 50–69 years (APR: 5.3, 95% CI: 4.4, 6.6; AOR: 8.2, 95% CI: 6.4, 10.4) and ≥70 years (APR: 7.3, 95% CI: 5.8, 9.2; AOR: 13.6, 95% CI: 10.1, 18.3) were more likely to be hypertensive than younger participants aged 18–29 years. Males (APR: 1.3, 95% CI: 1.2, 1.4; AOR: 1.5, 95% CI: 1.3, 1.7), overweight/obese participants (APR: 1.8, 95% CI: 1.7, 2.0; AOR: 2.4, 95% CI: 2.2, 2.8) and those in the richest wealth quintile (APR: 1.3, 95% CI: 1.1, 1.5; AOR: 1.5, 95% CI: 1.1, 1.9) had higher prevalences and odds of hypertension than their female, normal weight/underweight and poorest wealth quintile counterparts, respectively. Those residing in Province 4 (APR: 1.2, 95% CI: 1.0, 1.5; AOR: 1.4, 95% CI: 1.1, 1.8) and Province 5 (APR: 1.2, 95% CI: 1.0, 1.4; AOR: 1.3, 95% CI: 1.1, 1.7) were more likely to be hypertensive than those residing in Province 1. The point estimate was inflated more in magnitude by ORs than by PRs, but the direction of association remained the same. Public health programmes in Nepal aimed at preventing hypertension should raise awareness among the elderly, males, individuals in the richest wealth quintile and the residents of Provinces 4 and 5.</jats:p>

Area of residence and hypertension risk: need more evidence from low- and middle-income countries

“…The reason of higher odds of hypertension in the least to moderate deprived areas compared to highest deprived areas is probably related to wealth index. In low-and-middleincome countries (LMICs) like Nepal, the prevalence of non-communicable diseases including hypertension and overweight and obesity is higher among the higher wealth quintiles [4]. Similar findings were observed in neighboring India [5] and Bangladesh [6].…”