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Awareness, treatment and control of hypertension in Nepal: findings from the Dhulikhel Heart Study
  1. Biraj M Karmacharya1,2,3,4,5,
  2. Rajendra P Koju3,6,
  3. James P LoGerfo3,7,
  4. Kwun Chuen Gary Chan8,9,
  5. Ali H Mokdad1,3,9,10,
  6. Archana Shrestha1,5,11,
  7. Nona Sotoodehnia2,12,
  8. Annette L Fitzpatrick1,3,13
  1. 1Department of Epidemiology, University of Washington, Seattle, WA, USA
  2. 2Division of Cardiology, University of Washington, Seattle, WA, USA
  3. 3Department of Global Health, University of Washington, Seattle, WA, USA
  4. 4Department of Community Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
  5. 5Department of Community Programs, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
  6. 6Department of Cardiology, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
  7. 7Department of Medicine, University of Washington, Seattle, WA, USA
  8. 8Department of Biostatistics, University of Washington, Seattle, WA, USA
  9. 9Department of Health Services, University of Washington, Seattle, WA, USA
  10. 10Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
  11. 11Department of Epidemiology, Harvard T.H. Chan School of Public Health, MA, USA
  12. 12Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
  13. 13Department of Family Medicine, University of Washington, Seattle, WA, USA
  1. Correspondence to Dr Biraj M Karmacharya, Division of Cardiology, University of Washington, Seattle, WA 98195, USA; birajmk{at}gmail.com

Abstract

Objectives Although previous studies have suggested alarming rise in the prevalence of hypertension in Nepal, there is dearth of information on its awareness, treatment and control. In this cross-sectional study, we assessed awareness, treatment and control of hypertension among 298 hypertensive adults from the suburban town of Dhulikhel, Nepal.

Methods This cross-sectional study is based on Dhulikhel Heart Study, which included 1073 adults, aged ≥18 years, recruited from randomly selected households. Comprehensive health interviews and blood pressure measurements were completed during home interviews. Hypertensives (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or receiving antihypertensive medication) were further evaluated for awareness, treatment and control of hypertension. Multivariate regression model quantified the association of the sociodemographic characteristics and the cardiovascular disease (CVD) risk factors with hypertension awareness. Differences between sociodemographic characteristics and CVD risk factors with treatment and control of hypertension were tested using χ2 tests.

Results A total of 43.6% of all hypertensives (n=298) were aware of their hypertension status. In multivariate analyses, hypertension awareness was associated with increasing age (p<0.001). More than three-fourth (76.1%) of those who were aware of their hypertension status (n=130) were currently on treatment. There were significant differences in treatment status by sex, occupation, age, income quartiles and body mass index. Only 35.3% of those on treatment (n=99) had blood pressure control.

Conclusions The levels of awareness, treatment and control of hypertension in this sample of Nepalese adults were low.

  • HYPERTENSION

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Footnotes

  • Contributors BMK conceived the study. BMK, RPK, ALF, AS and JPL elaborated the study design, developed the protocol and the data collection tool. AS and ALF trained the data collectors. RPK oversaw the data collection in the field. KCGC and AM provided inputs in the data analysis. NS helped improvise the manuscript. All authors contributed to refinement and approved the final manuscript.

  • Funding NS is supported by the endowed fund from Laughlin family.

  • Competing interests None declared.

  • Ethics approval Dhulikhel Hospital Institutional Review Committee, University of Washington Human Subjects Division.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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