SEARCHCROSS-SECTIONALepidemiology, public health

cross-sectional·epidemiology, public health, cardiology, internal medicine, family medicine·PMC10021878

Prevalence and determinants of hypertension in underrepresented indigenous populations of Nepal

PLOS Global Public Health · 7 authors, 8 centres

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TL;DR

This cross-sectional survey of 311 individuals from 12 indigenous Nepali communities found a hypertension prevalence of 23.8%, associated with age, BMI, and tobacco use, while traditional risk factors like education and smoking were not individually significant.

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767 CHARS

This cross-sectional observational study assessed NCD risk factors in 311 individuals (mean age 43±15 years) from 12 indigenous Nepali communities in rural or semi-urban areas. Hypertension was significantly associated with age, BMI, and tobacco use in multivariable analysis, but these explained only 13.9% of the variation. Individually, factors like education, alcohol, and smoking were not significantly associated. Limitations include a small sample size and the inability to measure specific dietary factors like sodium intake. The findings suggest that hypertension is a significant burden in these underrepresented populations and that standard risk factors may not fully explain its prevalence, indicating a need to identify population-specific determinants.

STUDY TYPE

cross-sectional

SPECIALTY

epidemiology

SUMMARISED BY

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100% · A

ORIGINAL PAPER

PMC10021878

Prevalence and determinants of hypertension in underrepresented indigenous populations of Nepal

PLOS Global Public Health

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ABSTRACT

Indigenous populations residing in low- and middle-income countries (LMICs) are highly underrepresented in medicine and public health research. Specifically, data on non-communicable diseases (NCDs) from indigenous populations remains scarce. Despite the increasing burden of NCDs in the Himalayan region, their prevalence in many indigenous populations remains understudied. The nationally representative public health surveys often do not include the indigenous communities, especially those that reside in rural areas or exist in small numbers. This observational cross-sectional survey study aimed to assess the prevalence of three NCD risk factors namely obesity, hypertension, and tachycardia and identify dietary and lifestyle variables associated with them across underrepresented indigenous populations of Nepal. A total of 311 individuals (53.3% women, 46.7% men) with mean age 43±15 years from 12 indigenous Nepali communities residing in rural (47.9%) or semi-urban (52.1%) areas volunteered to participate in this study. Univariate tests and multivariable logistic regressions were used to analyze the survey data. The mean systolic and diastolic blood pressures were 121.3±19.5 mmHg and 81.3±11.8 mmHg respectively. Overall, the prevalence of obesity and tachycardia was low (0.64% and 3.22%, respectively) but hypertension was prevalent at 23.8%. Hypertension was not significantly different across populations, but it was associated with age, BMI, and tobacco use, and collectively, these variables explained 13.9% variation in hypertension prevalence. Although we were unable to detect direct associations between individual determinants of hypertension identified in non-indigenous Nepalis, such as education levels, alcohol consumption, and smoking in this study, having one or more determinants increased the odds of hypertension in the indigenous participants. Furthermore, ~14% of the hypertensive individuals had none of the universally identified hypertension risk factors. The lack of association between previously identified risk factors for hypertension in these individuals indicates that the additional determinants of hypertension remain to be identified in indigenous Nepali populations.

CITATION EXPORT

Tsedenia Workneh Denekew, Yoshina Gautam, Dinesh Bhandari et al.. Prevalence and determinants of hypertension in underrepresented indigenous populations of Nepal. PLOS Global Public Health. (2022). https://doi.org/10.1371/journal.pgph.0000133

AUTHORS

7 · 8 CENTRES

Tsedenia Workneh Denekew, Yoshina Gautam, Dinesh Bhandari, Guru Prasad Gautam, Jeevan Bahadur Sherchand, Amod K. Pokhrel, Aashish R. Jha

1 Genetic Heritage Group, Program in Biology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
2 Himalayan Diversity Project, Department of Biomedical Data Science, Stanford University, Stanford, Palo Alto, United States of America
3 School of Public Health, University of Adelaide, Adelaide, Australia
4 Public Health Research Lab, Tribhuvan University Institute of Medicine, Maharajgunj, Nepal
5 Department of Geography, Tribhuvan University, Nepalgunj, Nepal
6 Society for Legal and Environmental Analysis and Development Research, Kathmandu, Nepal
7 On-Campus/On-Line MPH program, School of Public Health, University of California, Berkeley, CA, United States of America
Augusta University, UNITED STATES

EDITOR / REVIEWER

Biplab Kumar Datta