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. 2018 Sep 13;13(9):e0203278.
doi: 10.1371/journal.pone.0203278. eCollection 2018.

Gender differences in factors associated with prehypertension and hypertension in Nepal: A nationwide survey

Kingsley Emwinyore Agho  1 , Uchechukwu L Osuagwu  2 , Osita K Ezeh  1 , Pramesh Raj Ghimire  1 , Stanley Chitekwe  3 , Felix Akpojene Ogbo  4   5
Affiliations

Gender differences in factors associated with prehypertension and hypertension in Nepal: A nationwide survey

Kingsley Emwinyore Agho et al. PLoS One. .

Abstract

Background: Nepal has one of the highest prevalence of hypertension in South Asia. However, no national studies have examined the gender differences in the determinants of prehypertension and hypertension in the country to inform targeted interventions. This study aimed to investigate gender differences in factors associated with prehypertension and hypertension in Nepal using the 2016 Nepal Demographic and Health Survey (NDHS).

Methods: Sociodemographic, behavioural, anthropometric and health status data and information on hypertension were obtained from 14,857 (males: 6,245 and females: 8,612) individuals aged 15 years or above from the biomarker sample of the 2016 NDHS. Factors associated with prehypertension and hypertension by gender were investigated using generalized linear latent and mixed models (GLLAM) with the mlogit link and binomial family that adjusted for clustering and sampling weights.

Results: The overall prevalence of prehypertension and hypertension was 26.9% [95% confidence interval (CI): 25.7, 28.1] and 17.2% (95% CI 16.1, 18.3), respectively. Prehypertension was present in 30.4% (95%CI: 28.7, 32.2) of males and 24.3% (95% CI: 23.1, 25.6) of females, while hypertension was present in 20.4%, (95% CI 18.9, 22.0) of males and 14.8% (95% CI: 13.7, 16.0) of females. Key modifiable factors that were strongly associated with prehypertension and hypertension in both genders included overweight and obesity, caffeine intake, tobacco use, no schooling, previously informed of hypertension in a health facility, and alcohol consumption (for males). Other significant factors associated with prehypertension and hypertension included increasing age (> 30 years), ecological zone (Hill), Developmental zone (Western) and being married.

Conclusion: Our results suggest that prehypertension and hypertension were higher in males compared to females. Interventions to improve awareness, screening, treatment and control of prehypertension and hypertension in Nepal are warranted and should target key modifiable factors, as well as people aged 30 years and above.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Contextual framework for analysing factors associated with prehypertension and hypertension among males and females aged 15 years and over in Nepal.
Fig 2
Fig 2. Prevalence of prehypertension and hypertension by gender in Nepal (NDHS, 2016).
(A) Males; (B) Females; (C) Both genders.
Fig 3
Fig 3. Prehypertension and hypertension among males and females aged 15 years and over in seven states in Nepal.
£ Independent variables adjusted for: type of residence, ecological zone, developmental region, household wealth index, education level, current age, marital status, alcohol use, tobacco use, caffeine use, BMI (kg/m2), and previously informed of hypertension.
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Grants and funding

The author(s) received no specific funding for this work.