Factors associated with hypertension among adults in Nepal as per the Joint National Committee 7 and 2017 American College of Cardiology/American Heart Association hypertension guidelines: a cross-sectional analysis of the demographic and health survey 2016
Objectives This study investigated the determinants of hypertension in Nepal according to both the Joint National Committee 7 (JNC7) and the American College of Cardiology/American Heart Association (2017 ACC/AHA) guidelines.Design Cross-sectional study.Setting This study used data collected from th...
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BMJ Publishing Group
2019-08-01
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| author | Rajat Das Gupta Mohammad Rashidul Hashan Gulam Muhammed Al Kibria Sojib Bin Zaman Kusum Wagle Reese Crispen |
| author_facet | Rajat Das Gupta Mohammad Rashidul Hashan Gulam Muhammed Al Kibria Sojib Bin Zaman Kusum Wagle Reese Crispen |
| author_sort | Rajat Das Gupta |
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| description | Objectives This study investigated the determinants of hypertension in Nepal according to both the Joint National Committee 7 (JNC7) and the American College of Cardiology/American Heart Association (2017 ACC/AHA) guidelines.Design Cross-sectional study.Setting This study used data collected from the 2016 Nepal Demographic and Health Survey data.Participants 13 393 weighted adults aged ≥18 years enrolled by a stratified cluster sampling strategy were included in our analysis.Primary and secondary outcome measures The primary outcome was hypertension, which was defined according to JNC7 (systolic blood pressure (SBP) ≥140 mm Hg and/or diastolic blood pressure (DBP) ≥90 mm Hg) and 2017 ACC/AHA guidelines (SBP ≥130 mm Hg and/or DBP ≥80 mm Hg). Antihypertensive medication users were also classified as hypertensive. After descriptive analysis, multilevel logistic regression was applied to obtain ORs.Results About 21% (n=2827) and 44% (n=5918) of the individuals aged ≥18 years were classified as hypertensive according to the JNC7 and 2017 ACC/AHA guidelines, respectively. Following factors were found to be significantly associated with hypertension according to the 2017 ACC/AHA guideline: ≥70 years (adjusted OR (AOR) 5.2; 95% CI 4.3 to 6.2), 50–69 years (AOR 3.9; 95% CI 3.4 to 4.4) and 30–49 years (AOR 2.7; 95% CI 2.4 to 3.0) age groups, male gender (AOR 1.7; 95% CI 1.6 to 1.9), being overweight/obese (AOR 3.0; 95% CI 2.7 to 3.3), residence in provinces 4 (AOR 1.5; 95% CI 1.2 to 2.0) and 5 (AOR 1.5; 95% CI 1.2 to 1.9). No significant association was identified with household wealth status and ecological regions of residence using the 2017 ACC/AHA guideline.Conclusions Per both guidelines, multiple factors were associated with hypertension. Public health programme aiming to prevent and control hypertension in Nepal should prioritise these factors and focus on individuals with a higher likelihood of hypertension irrespective of educational level, household wealth status and ecological regions of residence. |
| format | Article |
| id | doaj-art-39c18c47854f40cdafc3b94f90b964dc |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-08-01 |
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| series | BMJ Open |
| spelling | doaj-art-39c18c47854f40cdafc3b94f90b964dc2024-11-26T20:30:10ZengBMJ Publishing GroupBMJ Open2044-60552019-08-019810.1136/bmjopen-2019-030206Factors associated with hypertension among adults in Nepal as per the Joint National Committee 7 and 2017 American College of Cardiology/American Heart Association hypertension guidelines: a cross-sectional analysis of the demographic and health survey 2016Rajat Das Gupta0Mohammad Rashidul Hashan1Gulam Muhammed Al Kibria2Sojib Bin Zaman3Kusum Wagle4Reese Crispen5BRAC James P Grant School of Public Health, BRAC University, Dhaka, BangladeshCentral Queensland University, Rockhampton, Queensland, Australia6 Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland, USA3 Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh4 Research Division, Center for Research on Environment Health and Population Activities, Kathmandu, Nepal6 Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland, USAObjectives This study investigated the determinants of hypertension in Nepal according to both the Joint National Committee 7 (JNC7) and the American College of Cardiology/American Heart Association (2017 ACC/AHA) guidelines.Design Cross-sectional study.Setting This study used data collected from the 2016 Nepal Demographic and Health Survey data.Participants 13 393 weighted adults aged ≥18 years enrolled by a stratified cluster sampling strategy were included in our analysis.Primary and secondary outcome measures The primary outcome was hypertension, which was defined according to JNC7 (systolic blood pressure (SBP) ≥140 mm Hg and/or diastolic blood pressure (DBP) ≥90 mm Hg) and 2017 ACC/AHA guidelines (SBP ≥130 mm Hg and/or DBP ≥80 mm Hg). Antihypertensive medication users were also classified as hypertensive. After descriptive analysis, multilevel logistic regression was applied to obtain ORs.Results About 21% (n=2827) and 44% (n=5918) of the individuals aged ≥18 years were classified as hypertensive according to the JNC7 and 2017 ACC/AHA guidelines, respectively. Following factors were found to be significantly associated with hypertension according to the 2017 ACC/AHA guideline: ≥70 years (adjusted OR (AOR) 5.2; 95% CI 4.3 to 6.2), 50–69 years (AOR 3.9; 95% CI 3.4 to 4.4) and 30–49 years (AOR 2.7; 95% CI 2.4 to 3.0) age groups, male gender (AOR 1.7; 95% CI 1.6 to 1.9), being overweight/obese (AOR 3.0; 95% CI 2.7 to 3.3), residence in provinces 4 (AOR 1.5; 95% CI 1.2 to 2.0) and 5 (AOR 1.5; 95% CI 1.2 to 1.9). No significant association was identified with household wealth status and ecological regions of residence using the 2017 ACC/AHA guideline.Conclusions Per both guidelines, multiple factors were associated with hypertension. Public health programme aiming to prevent and control hypertension in Nepal should prioritise these factors and focus on individuals with a higher likelihood of hypertension irrespective of educational level, household wealth status and ecological regions of residence.https://bmjopen.bmj.com/content/9/8/e030206.full |
| spellingShingle | Rajat Das Gupta Mohammad Rashidul Hashan Gulam Muhammed Al Kibria Sojib Bin Zaman Kusum Wagle Reese Crispen Factors associated with hypertension among adults in Nepal as per the Joint National Committee 7 and 2017 American College of Cardiology/American Heart Association hypertension guidelines: a cross-sectional analysis of the demographic and health survey 2016 BMJ Open |
| title | Factors associated with hypertension among adults in Nepal as per the Joint National Committee 7 and 2017 American College of Cardiology/American Heart Association hypertension guidelines: a cross-sectional analysis of the demographic and health survey 2016 |
| title_full | Factors associated with hypertension among adults in Nepal as per the Joint National Committee 7 and 2017 American College of Cardiology/American Heart Association hypertension guidelines: a cross-sectional analysis of the demographic and health survey 2016 |
| title_fullStr | Factors associated with hypertension among adults in Nepal as per the Joint National Committee 7 and 2017 American College of Cardiology/American Heart Association hypertension guidelines: a cross-sectional analysis of the demographic and health survey 2016 |
| title_full_unstemmed | Factors associated with hypertension among adults in Nepal as per the Joint National Committee 7 and 2017 American College of Cardiology/American Heart Association hypertension guidelines: a cross-sectional analysis of the demographic and health survey 2016 |
| title_short | Factors associated with hypertension among adults in Nepal as per the Joint National Committee 7 and 2017 American College of Cardiology/American Heart Association hypertension guidelines: a cross-sectional analysis of the demographic and health survey 2016 |
| title_sort | factors associated with hypertension among adults in nepal as per the joint national committee 7 and 2017 american college of cardiology american heart association hypertension guidelines a cross sectional analysis of the demographic and health survey 2016 |
| url | https://bmjopen.bmj.com/content/9/8/e030206.full |
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