Article Text

Low levels of ideal cardiovascular health in a semi-urban population of Western Nepal: a population-based, cross-sectional study
  1. Bishal Gyawali1,
  2. Shiva Raj Mishra2,
  3. Salim S Virani3,
  4. Per Kallestrup1
  1. 1 Department of Public Health, Aarhus University, Aarhus, Denmark
  2. 2 Faculty of Medicine, The University of Queensland, Brisbane, Australia
  3. 3 Michael E DeBakey Veterans Affairs Medical Center and Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
  1. Correspondence to Mr Bishal Gyawali, Department of Public Health, Aarhus University, Aarhus, 8000 Aarhus C, Denmark; bishalforu{at}


Background The aim of this study was to assess the status of cardiovascular health among a semi-urban population of Nepal, and determine factors associated with ideal cardiovascular health.

Methods A population-based, cross-sectional study using a systematic random sample was conducted among 2310 adults aged ≥ 25 years in a semi-urban area of the Pokhara Metropolitan City previously named Lekthnath in Nepal. The ideal, intermediate and poor cardiovascular health were defined as the presence of 6–7, 4–5 or 1–3 health metrics, among a list of 7 health behaviours and healthfactors, namely smoking, body mass index, physical activity, fruits and vegetables intakes, harmful alcohol consumption, blood pressure, and fasting blood glucose. We used univariate and multivariate Poisson regression models adjusting for sex, age groups, ethnicity, educational level and socioeconomic status, and calculated the prevalence ratios with 95% CIs.

Results Only 14.3 % of the participants had ideal cardiovascular health, whereas 67.0% and 18.7% of the participants had intermediate and poor cardiovascular health, respectively. Age groups 45–54 years (prevalence ratio 0.88, 95% CI: 0.83 to 0.94, p<0.001) and 55–64 years (prevalence ratio 0.84, 95% CI: 0.79 to 0.90, p<0.001) were significantly associated with low prevalence of ideal cardiovascular health compared with the age group 35–44 years. Ethnic groups, including Janajati (prevalence ratio 0.89, 95% CI: 0.85 to 0.93, p<0.001) and Dalit (prevalence ratio 0.9, 95% CI: 0.84 to 0.95, p=0.001), were significantly associated with low prevalence of ideal cardiovascular health.

Conclusions Prevalence of ideal cardiovascular health is low in the semi-urban population in Nepal. Concerted efforts are needed to develop a population-based intervention to improve cardiovascular health in Nepal.

  • hypertension
  • epidemiology
  • primary care
  • public health
  • metabolic syndrome

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  • Contributors BG and SRM conceived the idea for this research publication. BG performed the experiments, analysed the data and interpreted the results. SRM, SSV and PK contributed to the revision of the manuscript. All authors have read and approved the final version for publication.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study complied with the Declaration of Helsinki and was reviewed and approved by the Ethics Committee of Nepal Health Research Council (NHRC) (Reg No 263/2016), Ramshah Path, Kathmandu, Nepal, PO Box 7626. Written informed consent was obtained from each study participant.

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

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