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Song M, Zheng L, Chen L, Zhang C, Chen X, Zhao C. Epidemiological characteristics of chronic non-communicable diseases in Dongfang, China, 2021: a cross-sectional survey. BMJ Open 2024; 14:e081710. [PMID: 38803260 PMCID: PMC11129020 DOI: 10.1136/bmjopen-2023-081710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 05/03/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVES The study aimed to understand the composition, epidemiological characteristics and disease burden of chronic non-communicable diseases and to evaluate the association between sociodemographic factors and chronic non-communicable diseases. DESIGN A cross-sectional study. SETTING AND PARTICIPANTS Medical records of 196 761 residents were collected from Dongfang disease surveillance system from January to December 2021. PRIMARY OUTCOME Prevalence and disability burden were recorded. Logistic regression was used to investigate the relationship between sociodemography factors and diseases. RESULTS Cardiovascular diseases, chronic lower respiratory diseases and other upper respiratory tract diseases were the main chronic non-communicable diseases. In multivariable analysis, men were associated with increased risk of cardiovascular diseases (OR=1.210, 95% CI 1.162 to 1.261) and chronic lower respiratory diseases (OR=1.128, 95% CI 1.079 to 1.180). Older age was associated with increased risk of cardiovascular diseases (OR=83.952, 95% CI 58.954 to 119.550), whereas was associated with decreased risk of chronic lower respiratory diseases (OR=0.442, 95% CI 0.415 to 0.471) and other upper respiratory tract diseases (OR=0.450, 95% CI 0.411 to 0.493). The unemployed and poor household were associated with decreased risk of cardiovascular diseases (OR=0.463, 95% CI 0.412 to 0.521 and OR=0.390, 95% CI 0.342 to 0.444, respectively), whereas were associated with increased risk of chronic lower respiratory diseases (OR=12.219, 95% CI 6.343 to 23.539 and OR=10.954, 95% CI 5.666 to 21.177, respectively) and other upper respiratory tract diseases (OR=2.246, 95% CI 1.719 to 2.936 and OR=3.035, 95% CI 2.308 to 3.991, respectively). Gender and age moderated the association between personnel category and major diseases. CONCLUSIONS The spectrum and epidemiological characteristics of chronic diseases observed in Dongfang is good evidence for developing prevention guides and health policies for region.
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Affiliation(s)
- Meixuan Song
- Department of Nursing, Tongji University School of Medicine, Shanghai, China
- Research Center for Translational Medicine, Tongji University Affilliated East Hospital, Shanghai, China
| | - Liang Zheng
- Research Center for Translational Medicine, Tongji University Affilliated East Hospital, Shanghai, China
| | - Lan Chen
- Department of Internal Medicine, Dongfang People's Hospital, Dongfang, Hainan, China
| | - Chunmei Zhang
- Dongfang Municipal Health Commission, Dongfang, Hainan, China
| | - Xingyi Chen
- Department of Medical, Tongji University Affilliated East Hospital, Shanghai, China
| | - Chunyan Zhao
- Department of Nursing, Tongji University Affilliated East Hospital, Shanghai, China
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Ma M, He L, Wang H, Tang M, Zhu D, Sikanha L, Darapiseth S, Lu J, Xia Y, Wang Z, Wu X, Zhu Q, Duo L, Pan X, Pang L. Prevalence and Clustering of Cardiovascular Disease Risk Factors among Adults Along the Lancang-Mekong River: A Cross-Sectional Study from Low- and Middle-Income Countries. Glob Heart 2024; 19:35. [PMID: 38638126 PMCID: PMC11025572 DOI: 10.5334/gh.1319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/20/2024] [Indexed: 04/20/2024] Open
Abstract
Background Progress in cardiovascular health is increasingly concentrated in high-income countries, while the burden of cardiovascular disease (CVD) is high in low- and middle-income countries, a clear health inequity that must be urgently addressed. Objective This study aims to evaluate the prevalence and clustering of CVD risk factors in the three Lancang-Mekong regions. Methods We conducted a population-based cross-sectional survey from January 2021 to March 2023 in China, Laos, and Cambodia. We compared the prevalence and clustering of CVD risk factors-including hypertension, dyslipidemia, diabetes mellitus, overweight/obesity, current smoking status, current drinking status, inadequate vegetable and fruit intake, and insufficient physical activity-across the three regions, further stratifying the data by gender and age. Multivariate logistic regression models were performed to explore factors influencing the aggregation of CVD risk factors (≥2, ≥3, ≥4). Results A total of 11,005 adults were included in the study. Hypertension emerged as the primary metabolic risk factor in Laos (36.8%) and Cambodia (23.5%), whereas overweight/obesity was the primary risk factor in China (37.6%). In terms of behavioral risk factors, participants in all three regions showed insufficient vegetable and fruit intake. The prevalence of individuals without CVD risk factors was 10% in China, 1.9% in Laos, and 5.2% in Cambodia. Meanwhile, the prevalence of two or more risk factors was 64.6% in China, 79.2% in Laos, and 76.0% in Cambodia. Multivariate logistic regression models revealed that the propensity for CVD risk factors clustering was higher in men and increased with age in all three countries. Conclusions CVD risk factors and multiple clustering are pressing health threats among adults in low- and middle-income areas along the Lancang-Mekong River Basin. This study highlights the urgent need for proactive tailored strategies to control CVD risk factors.
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Affiliation(s)
- Min Ma
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
- Kunming Medical University, Kunming, China
| | - Liping He
- Kunming Medical University, Kunming, China
| | | | - Mingjing Tang
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
| | - Da Zhu
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
| | - Labee Sikanha
- Saimangkorm International Hospital, Oudomxay province, Lao PDR
| | | | - Jiang Lu
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
| | - Yu Xia
- Kunming Medical University, Kunming, China
| | | | - Xia Wu
- Kunming Medical University, Kunming, China
| | - Qiuyan Zhu
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Lin Duo
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
| | - Xiangbin Pan
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
- Department of Structure Heart Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Linhong Pang
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
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Molefe-Baikai OJ, Kebotsamang K, Modisawakgomo P, Tlhakanelo JT, Motlhatlhedi K, Moshomo T, Youssouf NF, Masupe T, Gaolathe T, Tapela N, Lockman S, Mosepele M. Self-reported cardiovascular disease risk factor screening among people living with HIV vs. members of the general population in Botswana: a community-based study. BMC Public Health 2024; 24:198. [PMID: 38229024 PMCID: PMC10792864 DOI: 10.1186/s12889-024-17651-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 01/03/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Morbidity and mortality due to cardiovascular diseases (CVDs) are high and increasing in low- and middle-income countries. People living with HIV (PLWH) are more likely to experience CVD than members of the general population. Therefore, we aimed to assess whether PLWH were more likely to have previously been screened for cardiovascular disease risk factors (CVDRFs) than people without HIV. METHODS A population-based, cross-sectional study was conducted among individuals aged 16 to 68 years across 22 communities in Botswana from February to August 2017 as part of a larger community-based cluster randomized HIV treatment-as-prevention trial. Participants were asked if they had been screened for and counselled on cardiovascular disease risk factors (history of hypertension or blood pressure check, blood glucose and cholesterol measurements, weight check and weight control, tobacco smoking and cessation, alcohol use and physical activity) in the preceding 3 years. HIV testing was offered to those with an unknown HIV status. Multiple logistic regression analysis controlling for age and sex was used to assess the relationship between CVDRF screening and HIV status. RESULTS Of the 3981 participants enrolled, 2547 (64%) were female, and 1196 (30%) were PLWH (93% already on antiretroviral therapy [ART]). PLWH were more likely to report previous screening for diabetes (25% vs. 19%, p < 0.001), elevated cholesterol (17% vs. 12%, p < 0.001) and to have had their weight checked (76% vs. 55%, p < 0.001) than HIV-uninfected participants. PLWH were also more likely to have received counselling on salt intake (42% vs. 33%, p < 0.001), smoking cessation (66% vs. 46%, p < 0.001), weight control (38% vs. 29%, p < 0.001), physical activity (46% vs. 34%, p < 0.001) and alcohol consumption (35% vs. 23%, p < 0.001) than their HIV-uninfected counterparts. Overall, PLWH were more likely to have received screening for and/or counselling on CVDRFs (adjusted odds ratio 1.84, 95% CI: 1.46-2.32, p < 0.001). CONCLUSION PLWH were almost two times more likely to have been previously screened for CVDRFs than those without HIV, indicating a need for universal scale-up of integrated management and prevention of CVDs in the HIV-uninfected population.
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Affiliation(s)
- Onkabetse Julia Molefe-Baikai
- Faculty of Medicine, Department of Internal Medicine, University of Botswana, Princess Marina Hospital, Gaborone, Botswana.
| | - Kago Kebotsamang
- Faculty of Social Sciences, Department of Statistics, University of Botswana, Gaborone, Botswana
| | | | - John Thato Tlhakanelo
- Faculty of Medicine, Department of Family Medicine and Public Health, University of Botswana, Gaborone, Botswana
| | - Keneilwe Motlhatlhedi
- Faculty of Medicine, Department of Family Medicine and Public Health, University of Botswana, Gaborone, Botswana
| | - Thato Moshomo
- Faculty of Medicine, Department of Internal Medicine, University of Botswana, Princess Marina Hospital, Gaborone, Botswana
| | - Nabila Farah Youssouf
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- London School of Hygiene and Tropical Medicine, London, UK
| | - Tiny Masupe
- Faculty of Medicine, Department of Family Medicine and Public Health, University of Botswana, Gaborone, Botswana
| | - Tendani Gaolathe
- Faculty of Medicine, Department of Internal Medicine, University of Botswana, Princess Marina Hospital, Gaborone, Botswana
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Neo Tapela
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- International Consortium for Health Outcomes Measurement, Boston, USA
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, USA
| | - Shahin Lockman
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, USA
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, USA
| | - Mosepele Mosepele
- Faculty of Medicine, Department of Internal Medicine, University of Botswana, Princess Marina Hospital, Gaborone, Botswana
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, USA
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Sitaula D, Dhakal A, Mandal SK, Bhattarai N, Silwal A, Adhikari P, Gupta SR, Khatri D, Lageju N, Guragain B. Estimation of 10-year cardiovascular risk among adult population in western Nepal using nonlaboratory-based WHO/ISH chart, 2023: A cross-sectional study. Health Sci Rep 2023; 6:e1614. [PMID: 37818312 PMCID: PMC10560824 DOI: 10.1002/hsr2.1614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/19/2023] [Accepted: 09/25/2023] [Indexed: 10/12/2023] Open
Abstract
Background and Aims Noncommunicable diseases have emerged as a major cause of morbidity and mortality worldwide among which the majority of the deaths are caused by cardiovascular diseases. Estimating the risk of cardiovascular diseases helps eliminate the risk factors and prevent developing cardiovascular diseases in the future. The World Health Organization in association with the International Society of Hypertension has developed risk charts for the estimation of 10-year risk for cardiovascular diseases. This study aimed to estimate 10-year cardiovascular risk in the Nepalese population using nonlaboratory-based charts. Methods A hospital-based cross-sectional study was conducted among 314 adults aged 40-74 years visiting the outpatient departments of Shishuwa Hospital in western Nepal. Systematic random sampling was used to select the participants. Questionnaire-guided short interviews, physical examination, and anthropometric measurements were done. The χ 2 test was used to test the significance and a p < 0.05 was considered statistically significant. Results As per the risk estimation charts, high cardiovascular risk (20%-30%) was seen in 6.1% of total participants and moderate cardiovascular risk (10%-20%) was found in 29% of participants. The moderate-high risk was significantly higher among male participants compared to females (p < 0.01). Of all the participants, 22.0% were current smokers, 17.2% were alcohol users, 61.1% were hypertensive, and 35.7% were diabetics. Smoking tobacco, alcohol use, and hypertension were significantly more prevalent among the male participants. (p < 0.01) Adults in the 50-59 years age group had a significantly high prevalence of hypertension (p < 0.01), diabetes (p = 0.02), and alcohol abuse (p = 0.01). Conclusion This study shows high cardiovascular risk among adult population in western Nepal. The 10-year cardiovascular risk score and risk factors were significantly higher among males than females. There seems to be a prompt necessity of health promotion interventions to reduce cardiovascular risk factors and prevent the burden of cardiovascular diseases in Nepal.
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Affiliation(s)
| | - Aarati Dhakal
- Department of Community Programs, Dhulikhel HospitalKathmandu UniversityDhulikhelNepal
| | | | | | - Amisha Silwal
- Department of Medical OncologyNepal Cancer Hospital and Research CenterLalitpurNepal
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Bhandari P. Prevalence of cardiovascular risk factors among Asian migrant workers in South Korea. PLoS One 2023; 18:e0288375. [PMID: 37428813 DOI: 10.1371/journal.pone.0288375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 06/24/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND The burden of non-communicable diseases is rapidly increasing among young adults in middle- and low-income countries. Asian migrant workers continue to be a significant contributor to South Korea's economy; however, their cardiovascular health is neglected. We explored the prevalence of cardiovascular risk factors among Asian migrant workers in South Korea. METHODS Cross-sectional survey, anthropometric measurements, blood pressure measurements, and biochemical tests including triglyceride, high-density lipoprotein, low-density lipoprotein, total cholesterol, fasting blood sugar, HbA1c, and C-reactive protein levels were conducted in 141 Asian migrant workers in South Korea. RESULTS The mean age of the participants was 31.3 (5.6) years. Of the participants, 14.8% were current smokers, and 47.5% consumed alcohol. The prevalence of overweight/obesity was 32.4%. The prevalence of hypertension and dyslipidemia were 51.2% and 64.6%, respectively. Of the participants, 98.5% had an increased waist circumference; elevated HbA1C and C-reactive protein was seen in 20.9% and 4.3%, respectively. The prevalence of metabolic syndrome was 5.5%. Clustering of two or more risk factors was seen in 45% of the participants. Factors associated with a high risk of cardiovascular diseases (clustering of two or more risk factors) were age (odds ratio 1.16, p < 0.01) and smoking (4.98, p < 0.05). CONCLUSION The prevalence of cardiovascular risk factors was alarmingly high among Asian migrant workers employed in South Korea. Efforts to mitigate and eliminate those risk factors are urgently required.
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Affiliation(s)
- Pratibha Bhandari
- School of Nursing and Midwifery, University of Technology Sydney, Sydney, New South Wales, Australia
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Pandey AR, Dhimal M, Shrestha N, Sharma D, Maskey J, Dhungana RR, Bista B, Aryal KK. Burden of Cardiovascular Diseases in Nepal from 1990 to 2019: The Global Burden of Disease Study, 2019. Glob Health Epidemiol Genom 2023; 2023:3700094. [PMID: 37377984 PMCID: PMC10292936 DOI: 10.1155/2023/3700094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 05/08/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
Cardiovascular diseases (CVDs) have emerged as the leading cause of deaths worldwide in 2019. Globally, more than three-quarters of the total deaths due to CVDs occur in low- and middle-income countries like Nepal. Although increasing number of studies is available on the prevalence of CVDs, there is limited evidence presenting a complete picture on the burden of CVDs in Nepal. In this context, this study aims to provide comprehensive picture on the burden of CVDs in the country. This study is based on the Global Burden of Disease (GBD) study 2019, which is a multinational collaborative research covering 204 countries and territories across the world. The estimations made from the study are publicly available in the GBD Compare webpage operated by the Institute for Health Metrics and Evaluation (IHME), University of Washington. This article makes use of those data available on the GBD Compare page of IHME website to present the comprehensive picture of the burden of CVDs in Nepal. Overall, in 2019, there were an estimated 1,214,607 cases, 46,501 deaths, and 1,104,474 disability-adjusted life years (DALYs) due to CVDs in Nepal. The age-standardized mortality rates for CVDs witnessed a marginal reduction from 267.60 per 100,000 population in 1990 to 245.38 per 100,000 population in 2019. The proportion of deaths and DALYs attributable to CVDs increased from 9.77% to 24.04% and from 4.82% to 11.89%, respectively, between 1990 and 2019. Even though there are relatively stable rates of age-standardized prevalence, and mortality, the proportion of deaths and DALYs attributed to CVDs have risen sharply between 1990 and 2019. Besides implementing the preventive measures, the health system also needs to prepare itself for the delivery of long-term care of patients with CVDs which could have significant implications on resources and operations.
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Affiliation(s)
| | | | | | | | - Jasmine Maskey
- Oxford University Clinical Research Unit, Lalitpur, Nepal
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Khanal MK, Bhandari P, Dhungana RR, Gurung Y, Rawal LB, Pandey G, Bhandari M, Bhuiyan R, Devkota S, de Courten M, de Courten B. Electrocardiogram abnormalities and renal impairment in patients with type 2 diabetes mellitus: A healthcare facilities-based cross-sectional study in Dang district of Nepal. J Diabetes Investig 2023; 14:602-613. [PMID: 36747483 PMCID: PMC10034961 DOI: 10.1111/jdi.13985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/28/2022] [Accepted: 01/17/2023] [Indexed: 02/08/2023] Open
Abstract
AIMS/INTRODUCTION The global burden of diabetes mellitus is rising substantially, with a further increase in cardiovascular and kidney disease burden. These public health problems are highly prevalent in low- and middle-income countries, including Nepal. However, there is limited evidence on cardiac and renal conditions among patients with type 2 diabetes mellitus. We determined the status of electrocardiogram (ECG) abnormalities and renal impairment among patients with type 2 diabetes mellitus in Nepal. METHODS We carried out a cross-sectional study in Tulsipur Sub-Metropolitan City of Nepal using a multistage stratified sampling technique to recruit patients with type 2 diabetes mellitus. We used World Health Organization stepwise approach to surveillance (WHO STEPS) questionnaires and carried out resting ECG to collect data of 345 patients with type 2 diabetes mellitus. Logistic regression analysis assessed the factors associated with ECG abnormalities and renal impairment. RESULTS The study showed that 6.1% of participants had major ECG abnormalities (95% confidence interval [CI] 3.8-8.6%), which were associated with hypertension (P = 0.01%) and low socioeconomic status (P = 0.01). The proportion of major and/or minor ECG abnormalities was 47.8% (95% CI 40.5-51%), and were significantly associated with age (odds ratio [OR] 1.04, 95% CI 1.01-1.07), higher education (OR 3.50, 95% CI 1.31-9.33), unemployment (OR 3.02, 95% CI 1.08-8.48), body mass index (OR 1.09, 95% CI 1.02-1.17) and duration of type 2 diabetes mellitus >5 years (OR 2.42, 95% CI 1.19-4.93). The proportion of renal impairment was 3.5% (95% CI 1.5-4.5%) which was associated with older age (OR 1.08, 95% CI 1.00-1.17) and hypertension (OR 12.12, 95% CI 1.07-138.22). CONCLUSION A significant proportion of patients with type 2 diabetes mellitus had ECG abnormalities and renal impairment, which were significantly associated with hypertension. Therefore, hypertension management and early screening are essential to prevent future cardiorenal complications among patients with type 2 diabetes mellitus.
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Affiliation(s)
| | | | - Raja Ram Dhungana
- Center for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Yadav Gurung
- Child and Youth Health Research Center, Auckland University of Technology, Auckland, New Zealand
| | - Lal B Rawal
- School of Health, Medical and Applied Sciences, College of Science and Sustainability, Central Queensland University, Sydney, NSW, Australia
- Physical Activity Research Group, Appleton Institute, Central Queensland University, Sydney, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Sydney, NSW, Australia
| | - Gyanendra Pandey
- Dirghayu Polyclinic and Research Center Pvt. Ltd, Tulsipur, Dang, Nepal
| | - Madan Bhandari
- Ministry of Health, Provincial Ayurveda Hospital, Dang, Nepal
| | - Rijwan Bhuiyan
- Department of Health Promotion and Health Education, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
| | - Surya Devkota
- Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Center, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Maximilian de Courten
- Mitchell Institute for Education and Health Policy, Victoria University, Melbourne, Vic., Australia
| | - Barbora de Courten
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Vic., Australia
- School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, Vic., Australia
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He F, Liao Z, Li YM, Luo Y, Wu L, Lin L, Chen Y, Deng W, Huang J. Prevalence and clustering of cardiovascular risk factors among resident of coastal areas in Qinzhou, Guangxi, China. J Cardiothorac Surg 2023; 18:70. [PMID: 36765357 PMCID: PMC9912684 DOI: 10.1186/s13019-023-02137-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 01/04/2023] [Indexed: 02/12/2023] Open
Abstract
OBJECTIVE We aimed to estimate the prevalence of CRFs and investigate its associated social-economic factors among adults in coastal areas of Qinzhou, Guangxi. METHODS A representative sample of 1836 participants aged 20 to 70 years was included in Qinzhou, Guangxi in 2020. Data were collected by the questionnaire, anthropometric and laboratory measurements. The prevalence of CRFs, including hypertension, dyslipidemia, diabetes, overweight or obesity, alcohol consumption, and smoking were calculated by standardization. The multivariate logistic regression analysis was performed to explore the independent factors associated with the presence of CRFs. RESULTS The age-standardized prevalence of hypertension, dyslipidemia, diabetes, overweight or obesity alcohol consumption, and smoking was 42.7%, 39.5%, 0.9%, 38.5%, 18.4% and 15.7%, respectively. The prevalence of clustering of at least one and at least two cardiovascular disease risk factors were 82.2% and 45.3% in total. There were differences in the aggregation of cardiovascular risk factors among different age, education, and income levels. There appeared higher clustering of at least one and at least two CRFs among adults with lower education level, higher income level and those elderly. CONCLUSIONS Compared with other regions in China, a higher prevalence of CRFs exists among adults in Guangxi and several social-economic factors were associated with the presence of CRFs. These findings suggest that we should implement effective measures to control the CRFs, to reduce the risk of cardiovascular disease in adults.
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Affiliation(s)
- Fang He
- Department of Nursing, The Second People's Hospital of Qinzhou, No.219 of Wenfeng South Road, Qinzhou, 535000, China.
| | - Zhennan Liao
- Department of Nursing, The Second People’s Hospital of Qinzhou, No.219 of Wenfeng South Road, Qinzhou, 535000 China
| | - Yu-Mei Li
- Department of Nursing, The Second People's Hospital of Qinzhou, No.219 of Wenfeng South Road, Qinzhou, 535000, China.
| | - Yuanling Luo
- Department of Nursing, The Second People’s Hospital of Qinzhou, No.219 of Wenfeng South Road, Qinzhou, 535000 China
| | - Lili Wu
- Department of Nursing, The Second People’s Hospital of Qinzhou, No.219 of Wenfeng South Road, Qinzhou, 535000 China
| | - Liping Lin
- Department of Nursing, The Second People’s Hospital of Qinzhou, No.219 of Wenfeng South Road, Qinzhou, 535000 China
| | - Ying Chen
- Department of Nursing, The Second People’s Hospital of Qinzhou, No.219 of Wenfeng South Road, Qinzhou, 535000 China
| | - Weihong Deng
- Department of Nursing, The Second People’s Hospital of Qinzhou, No.219 of Wenfeng South Road, Qinzhou, 535000 China
| | - Junzhang Huang
- Department of Nursing, The Second People’s Hospital of Qinzhou, No.219 of Wenfeng South Road, Qinzhou, 535000 China
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Garanet F, Coulibaly A, Baguiya A, Kirakoya-Samadoulougou F, Kouanda S. Prevalence and Factors Associated with Cardiovascular Lifestyle Risk Factors among Pregnant Women in Burkina Faso: Evidence from a Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:102. [PMID: 36612424 PMCID: PMC9819095 DOI: 10.3390/ijerph20010102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/14/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
Data on lifestyle risk factors for cardiovascular diseases, such as smoking, alcohol consumption, inadequate physical activity, and insufficient consumption of fruits and vegetables, in pregnant women in Africa, are scarce. This study aimed to estimate the prevalence of cardiovascular lifestyle risk factors among pregnant women in Burkina Faso and identify their associated factors. Pregnant women who attended antenatal care services between December 2018 and March 2019 were included in this study. A modified Poisson regression model was used to estimate adjusted prevalence ratios (aPR) with a 95% confidence interval. A total of 1027 pregnant women participated in this study. The prevalence of alcohol consumption, tobacco use, inadequate physical activity, and insufficient consumption of fruits and vegetables were 10.2% [8.5-12.2], 3.0% [2.1-4.3], 79.4% [76.9-81.8], and 53.5% [50.5-56.6], respectively. The prevalence of more than one cardiovascular lifestyle risk factor in pregnant women was 50.9% [48.0-54.0]. The predictors significantly associated with more than one cardiovascular lifestyle risk factor were women over 30 years old aPR 1.26; 95% CI [1.03-1.53]), women living in fourth wealth index households (aPR 1.23; 95% CI [1.06-1.42]), in semi-urban areas (aPR 5.46; 95% CI [4.34-6.88]), and women with no occupation (aPR 1.31; 95% CI [1.18-1.44]). The prevalence of more than one cardiovascular lifestyle risk factor was high during pregnancy in Burkina Faso. Women of childbearing age should be advised on how healthy behaviors can lead to improved pregnancy outcomes.
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Affiliation(s)
- Franck Garanet
- Département Biomédical et Santé Publique, Institut de Recherche en Science de la Santé (IRSS), Centre National de la Recherche Scientifique et Technologique(CNRST), Ouagadougou 03 BP 7047, Burkina Faso
- Laboratoire de Santé Publique, Ecole Doctorale Science de la Santé (ED2S), Université Joseph Ki-Zerbo, Ouagadougou 03 BP 7021, Burkina Faso
- Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique Bruxelles, Ecole de Santé Publique, Université Libre de Bruxelles, 1070 Brussels, Belgium
| | - Abou Coulibaly
- Département Biomédical et Santé Publique, Institut de Recherche en Science de la Santé (IRSS), Centre National de la Recherche Scientifique et Technologique(CNRST), Ouagadougou 03 BP 7047, Burkina Faso
- Institut Africain de Santé Publique, Ouagadougou 12 BP 199, Burkina Faso
| | - Adama Baguiya
- Département Biomédical et Santé Publique, Institut de Recherche en Science de la Santé (IRSS), Centre National de la Recherche Scientifique et Technologique(CNRST), Ouagadougou 03 BP 7047, Burkina Faso
- Institut Africain de Santé Publique, Ouagadougou 12 BP 199, Burkina Faso
| | - Fati Kirakoya-Samadoulougou
- Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique Bruxelles, Ecole de Santé Publique, Université Libre de Bruxelles, 1070 Brussels, Belgium
| | - Seni Kouanda
- Département Biomédical et Santé Publique, Institut de Recherche en Science de la Santé (IRSS), Centre National de la Recherche Scientifique et Technologique(CNRST), Ouagadougou 03 BP 7047, Burkina Faso
- Institut Africain de Santé Publique, Ouagadougou 12 BP 199, Burkina Faso
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Xiao W, Wumaer A, Maimaitiwusiman Z, Liu J, Xuekelati S, Wang H. Heat maps of cardiovascular disease risk factor clustering among community-dwelling older people in Xinjiang: a cross-sectional study. BMJ Open 2022; 12:e058400. [PMID: 35981774 PMCID: PMC9394193 DOI: 10.1136/bmjopen-2021-058400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE The clustering of multiple cardiovascular disease (CVD) risk factors (CRFs) increases the risk of CVD prevalence and mortality. Little is known about CRF clustering among community-dwelling older people in Xinjiang. The objective of this study was to explore the prevalence of CRF clustering in this population. DESIGN Cross-sectional study. SETTING Xinjiang, China. PARTICIPANTS Multilevel random sampling was used to survey individuals aged ≥60 in six regions of Xinjiang. In total, 87 000 participants volunteered, with a response rate of 96.67%; 702 participants with incomplete data were excluded and data from 86 298 participants were analysed. OUTCOME MEASURES The prevalence of smoking, hypertension, diabetes, dyslipidaemia and overweight/obesity was 9.4%, 52.1%, 16.8%, 28.6% and 62.7%, respectively. The prevalence of CRF clusters among people of different ages, regions and ethnic groups differed significantly. The 85.7% of the participants presented at least one CRFs and 55.9% of the participants presented clustering of CRFs. The proportion of CRF clusters tended to be higher in men, 60-69-year-old group, northern Xinjiang and the Kazakh population. After adjusting for age and sex, logistic regression analysis revealed that men, 60-69-year-old group, northern Xinjiang and the Kazakh population were more likely to have clustering of CRFs, compared with their counterparts. CONCLUSIONS The prevalence of CRFs in the older Xinjiang population is high and their clustering differs by sex, age, region and ethnicity. CRF prevention and management should be active in this population, and strategies to reduce CVD risk based on sex, age, ethnic group and region are warranted.
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Affiliation(s)
- Wenwen Xiao
- Second Department of Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Aishanjiang Wumaer
- Second Department of Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Zhuoya Maimaitiwusiman
- Second Department of Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Jinling Liu
- Second Department of Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Saiyare Xuekelati
- Second Department of Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Hongmei Wang
- Second Department of Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
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Adhikari C, Dhakal R, Adhikari LM, Parajuli B, Subedi KR, Aryal Y, Thapa AK, Shah K. Need for HTA supported risk factor screening for hypertension and diabetes in Nepal: A systematic scoping review. Front Cardiovasc Med 2022; 9:898225. [PMID: 35979024 PMCID: PMC9376353 DOI: 10.3389/fcvm.2022.898225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Health Technology Assessment (HTA) is a comprehensive and important tool for assessment and decision-making in public health and healthcare practice. It is recommended by the WHO and has been applied in practice in many countries, mostly the developed ones. HTA might be an important tool to achieve universal health coverage (UHC), especially beneficial to low-and-middle-income countries (LMIC). Even though the Package for Essential Non-communicable Diseases (PEN) has already been initiated, there is a clear policy gap in the HTA of any health device, service, or procedure, including the assessment of cardiovascular risk factors (CVRFs) in Nepal. Hence, we carried out the review to document the HTA supported evidence of hypertension and diabetes screening, as CVRFs in Nepal. Materials and methods We searched in PubMed, Cochrane, and Google Scholar, along with some gray literature published in the last 6 years (2016–2021) in a systematic way with a controlled vocabulary using a well-designed and pilot tested search strategy, screened them, and a total of 53 articles and reports that matched the screening criteria were included for the review. We then, extracted the data in a pre-designed MS-Excel format, first in one, and then, from it, in two, with more specific data. Results Of 53 included studies, we reported the prevalence and/or proportion of hypertension and diabetes with various denominators. Furthermore, HTA-related findings such as cost, validity, alternative tool or technology, awareness, and intervention effectiveness have been documented and discussed further, however, not summarized due to their sparingness. Conclusion Overall, the prevalence of DM (4.4–18.8%) and HTN (17.2–70.0%) was reported in most studies, with a few, covering other aspects of HTA of DM/HTN. A national policy for establishing an HTA agency and some immediately implementable actions are highly recommended.
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Affiliation(s)
- Chiranjivi Adhikari
- Department of Public Health, SHAS, Pokhara University, Pokhara, Nepal
- Indian Institute of Public Health Gandhinagar, Gandhinagar, India
- *Correspondence: Chiranjivi Adhikari
| | - Rojana Dhakal
- Department of Nursing, School of Health and Allied Sciences, Pokhara University, Pokhara, Nepal
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - Lal Mani Adhikari
- Health Research and Social Development Forum International, Kathmandu, Nepal
| | - Bijaya Parajuli
- Ministry of Health and Population, Gandaki Province, Myagdi Health Office, Myagdi, Nepal
| | - Khem Raj Subedi
- Department of Economics, Far Western University, Tikapur Multiple Campus, Kailali, Nepal
| | | | - Arjun Kumar Thapa
- Department of Economics, School of Humanities and Social Sciences, Pokhara University, Pokhara, Nepal
| | - Komal Shah
- Indian Institute of Public Health Gandhinagar, Gandhinagar, India
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12
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Khanal MK, Bhandari P, Dhungana RR, Gurung Y, Rawal LB, Pandey G, Bhandari M, Devkota S, de Courten M, de Courten B. Poor glycemic control, cardiovascular disease risk factors and their clustering among patients with type 2 diabetes mellitus: A cross-sectional study from Nepal. PLoS One 2022; 17:e0271888. [PMID: 35877664 PMCID: PMC9312399 DOI: 10.1371/journal.pone.0271888] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/01/2022] [Indexed: 02/06/2023] Open
Abstract
Background Cardiovascular disease (CVD) is the most common complication of diabetes mellitus (DM). To prevent morbidity and mortality among patients with type 2 diabetes mellitus (T2DM), optimization of glycemic status and minimizing CVD risk factors is essential. As Nepal has limited data on these CVD risk parameters, we assessed the prevalence of poor glycemic control, CVD risk factors, and their clustering among patients with T2DM. Methods Using a cross-sectional study design, we collected data of 366 patients with T2DM. We applied a multistage cluster sampling technique and used the WHO STEPS tools. Binary logistic and Poisson regression was applied to calculate odds and prevalence ratio of clustering of risk factors, considering P< 0.05 statistically significant. Results The mean age of participants was 54.5±10.7 years and 208 (57%) were male. The prevalence of poor glycemic control was 66.4% (95% C.I: 61.5–71.2). The prevalence of smoking, alcohol users, inadequate fruit and vegetables intake and physical inactivity were 18% (95% C.I:14 to 21.9), 14.8% (95% C.I:11.1 to 18.4), 98.1% (95% C.I: 96.7–99.4), and 9.8% (95% C.I:6.7–12.8), respectively. Overall, 47.3% (95% C.I: 42.1–52.4) were overweight and obese, 59% (95% C.I: 52.9–63) were hypertensive, and 68% (95% C.I: 63.2–72.7) had dyslipidemia. Clustering of two, three, four, five and more than five risk factors was 12.6%, 30%, 30%,19%, and 8.7%, respectively. Four or more risk factors clustering was significantly associated with gender, age, level of education, T2DM duration, and use of medication. Risk factors clustering was significantly higher among males and users of anti-diabetic medications with prevalence ratio of 1.14 (95% C.I:1.05–1.23) and 1.09 (95% C.I: 1.09–1.18)], respectively. Conclusions The majority of the patients with T2DM had poor glycemic control and CVD risk factors. Policies and programs focused on the prevention and better management of T2DM and CVD risk factors should be implemented to reduce mortality in Nepal.
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Affiliation(s)
- Mahesh Kumar Khanal
- Provincial Ayurveda Hospital, Ministry of Health, Population and Family Welfare, Dang, Lumbini Province, Nepal
- * E-mail:
| | | | - Raja Ram Dhungana
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Yadav Gurung
- Child and Youth Health Research Center, Auckland University of Technology, Auckland, New Zealand
| | - Lal B. Rawal
- School of Health, Medical and Applied Sciences, College of Science and Sustainability, Central Queensland University, Sydney, Australia
- Physical Activity Research Group, Appleton Institute, Central Queensland University, Sydney, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Sydney, Australia
| | | | - Madan Bhandari
- Provincial Ayurveda Hospital, Ministry of Health, Population and Family Welfare, Dang, Lumbini Province, Nepal
| | - Surya Devkota
- Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Centre, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Maximilian de Courten
- Mitchell Institute for Education and Health Policy, Victoria University, Melbourne, Australia
| | - Barbora de Courten
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
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Gaudel P, Neupane S, Koivisto A, Kaunonen M, Rantanen A. Effects of intervention on lifestyle changes among coronary artery disease patients: A 6‐month follow‐up study. Nurs Open 2022; 9:2024-2036. [PMID: 35434911 PMCID: PMC9190674 DOI: 10.1002/nop2.1212] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/17/2022] [Accepted: 04/03/2022] [Indexed: 11/22/2022] Open
Abstract
Aim The main aim of the study was to investigate the effects of a nurse‐led lifestyle‐related risk factor modification intervention on multiple lifestyle behaviours among coronary artery disease patients over six months. Design A pre‐test post‐test control group design was conducted in a single clinical centre in Nepal. Methods A total of 224 eligible patients were randomly assigned to either the usual care group or the intervention group at baseline. The lifestyle intervention consisted of a brief counselling session supplemented with informational leaflets. Standard questionnaires were used to collect self‐reported data from patients on multiple lifestyle behaviours: diet, physical activity, adherence to medication, stress, body mass index, smoking and alcohol consumption. General linear model repeated measure analysis was used to estimate the effect of intervention. Results A statistically significant effect of study group‐by‐time interaction for diet, adherence to medication, physical activity, and perceived stress was found at 6‐month follow‐up. Overall, greater improvement in lifestyle habits was found in the intervention group compared with the control group at 6‐month follow‐up.
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Affiliation(s)
- Pramila Gaudel
- Unit of Health Sciences, Nursing Science Faculty of Social Sciences Tampere University Tampere Finland
| | - Subas Neupane
- Unit of Health Sciences, Epidemiology Faculty of Social Sciences Tampere University Tampere Finland
| | - Anna‐Maija Koivisto
- Unit of Health Sciences, Biostatistics Faculty of Social Sciences Tampere University Tampere Finland
| | - Marja Kaunonen
- Unit of Health Sciences, Nursing Science Faculty of Social Sciences Tampere University Tampere Finland
- General Administration Pirkanmaa Hospital District Tampere Finland
| | - Anja Rantanen
- Unit of Health Sciences, Nursing Science Faculty of Social Sciences Tampere University Tampere Finland
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Denekew TW, Gautam Y, Bhandari D, Gautam GP, Sherchand JB, Pokhrel AK, Jha AR. Prevalence and determinants of hypertension in underrepresented indigenous populations of Nepal. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000133. [PMID: 36962278 PMCID: PMC10021878 DOI: 10.1371/journal.pgph.0000133] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/29/2021] [Indexed: 11/19/2022]
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.
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Affiliation(s)
- Tsedenia Workneh Denekew
- Genetic Heritage Group, Program in Biology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Yoshina Gautam
- Genetic Heritage Group, Program in Biology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- Himalayan Diversity Project, Department of Biomedical Data Science, Stanford University, Stanford, Palo Alto, United States of America
| | - Dinesh Bhandari
- School of Public Health, University of Adelaide, Adelaide, Australia
- Public Health Research Lab, Tribhuvan University Institute of Medicine, Maharajgunj, Nepal
| | | | | | - Amod K Pokhrel
- Society for Legal and Environmental Analysis and Development Research, Kathmandu, Nepal
- On-Campus/On-Line MPH program, School of Public Health, University of California, Berkeley, CA, United States of America
| | - Aashish R Jha
- Genetic Heritage Group, Program in Biology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- Himalayan Diversity Project, Department of Biomedical Data Science, Stanford University, Stanford, Palo Alto, United States of America
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15
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Shrestha DB, Budhathoki P, Sedhai YR, Baniya A, Lamichhane S, Shahi M, Karki BJ, Baniya R, Patel N. Prevalence, awareness, risk factors and control of hypertension in Nepal from 2000 to 2020: A systematic review and meta-analysis. PUBLIC HEALTH IN PRACTICE 2021; 2:100119. [PMID: 36101638 PMCID: PMC9461174 DOI: 10.1016/j.puhip.2021.100119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/24/2021] [Accepted: 03/31/2021] [Indexed: 12/11/2022] Open
Abstract
Objective To analyse published literatures on prevalence, awareness, risk factors and control of hypertension in Nepal. Methods We used electronic databases to search relevant articles from January 2000 till October 2020. All relevant data from selected studies were extracted into a standardized form designed in Excel. Statistical analysis was conducted using Comprehensive Meta-Analysis Software (CMA) version 3. Proportions or Odds Ratio (OR) was used to estimate the outcome with 95% confidence interval (CI). The I-squared (I2) test was used for the assessment of heterogeneity. Results We identified a total of 3726 studies after comprehensive database searching. We performed qualitative and quantitative analysis of 40 studies. Pooling data showed 28.52% of patients with hypertension (CI: 26.40–30.75); 45.28% (CI: 38.89–51.83) aware of their high blood pressure; 31.66% (CI: 23.18–41.56) under treatment; 44.4% (CI: 36.17–53.04) had their blood pressure under optimum range. 27.4% (CI: 21.57–34.11) had pre-hypertensive range elevated blood pressure. 25.99% (CI: 21.81–30.65) of females and 34.25% (CI: 30.49–38.21) of male were hypertensive (p = 0.007). The pooling of data showed smokers have 1.43 times (CI: 1.1429–1.7889); and alcohol users have 2.073 times (CI: 1.7154–2.5050) higher risk of having hypertension. Individuals with normal BMI have 53.15% (OR: 0.4685 CI: 0.3543–0.6195); with formal educated have 37.27% (OR: 0.6273, CI: 0.5485–0.7175); and with adequate exercise have 31.6% (OR: 0.6839, CI: 0.5203–0.8991) lower chance of having hypertension. Conclusion Our study shows the prevalence of hypertension in Nepal is high. However, awareness, treatment and subsequently control of high blood pressure are found to be alarmingly low. Hypertension was associated with male gender, smoking, alcohol use, high BMI, no education and inadequate exercise. It calls for more attention to address the burden of hypertension and associated risk factors in Nepal. We did this systematic review and meta-analysis on prevalence, awareness, risk factors and control of hypertension in Nepal. The prevalence of hypertension in Nepal is high. Awareness, treatment and subsequently control of high blood pressure are alarmingly low. Male, smoker, alcoholics, with high BMI, no education and inadequate exercise were risk factors for hypertension.
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Prevalence and Clustering of Cardiovascular Risk Factors among Medical Staff in Northeast China. Healthcare (Basel) 2021; 9:healthcare9091227. [PMID: 34575001 PMCID: PMC8467224 DOI: 10.3390/healthcare9091227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/10/2021] [Accepted: 09/16/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The clustering of cardiovascular disease (CVD) risk factors has become a major public health challenge worldwide. Although many studies have investigated CVD risk factor clusters, little is known about their prevalence and clustering among medical staff in Northeast China. This study aimed to estimate the prevalence and clustering of CVD risk factors and to investigate the association between relevant characteristics and the clustering of CVD risk factors among medical staff in Northeast China. METHODS A cross-sectional survey of 3720 medical staff from 93 public hospitals in Jilin Province was used in this study. Categorical variables were presented as percentages and were compared using the χ2 test. Multiple logistic regression analysis was used to evaluate the association between relevant characteristics and the clustering of CVD risk factors. RESULTS The prevalence of hypertension, diabetes, dyslipidemia, being overweight, smoking, and drinking were 10.54%, 3.79%, 17.15%, 39.84%, 9.87%, and 21.75%, respectively. Working in a general hospital, male, and age group 18-44 years were more likely to have 1, 2, and ≥3 CVD risk factors, compared with their counterparts. In particular, compared with being a doctor, being a nurse or medical technician was less likely to have 1, 2, and ≥3 CVD risk factors only in general hospitals. CONCLUSIONS The findings suggest that medical staff of general hospitals, males, and older individuals have a high chance associated with CVD risk factor clustering and that more effective interventions should be undertaken to reduce the prevalence and clustering of CVD risk factors, especially among older male doctors who work in general hospitals.
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Paudel S, Subedi N, McLachlan CS, Smith BJ, Kallestrup P, Neupane D. Active commuting and leisure-time physical activity among adults in western Nepal: a cross-sectional study. BMJ Open 2021; 11:e051846. [PMID: 34385256 PMCID: PMC8362701 DOI: 10.1136/bmjopen-2021-051846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/28/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To determine the prevalence and sociodemographic factors associated with active commuting and leisure-time physical activity (LTPA) among adults in western Nepal. DESIGN Cross-sectional study. SETTING Adults from semiurban areas in western Nepal. PARTICIPANTS 2815 adults aged 25-65 years who participated in the 'Community-Based Management of Hypertension in Nepal (COBIN)' Study. Multiple logistic regression analysis was used to identify the sociodemographic factors associated with active commuting and LTPA. OUTCOME Self-reported participation in active commuting and LTPA. RESULTS Most study participants (96%) commuted actively (walked or cycled) from one place to another. Our results showed that only a small proportion (3.7%) of participants engaged in moderate or vigorous LTPA. Compared with those in paid employment, the odds of commuting actively were higher among people working in agriculture or as labourers (OR: 4.57, 95% CI: 2.46 to 8.48), those retired/unemployed (OR: 2.98, 95% CI: 1.42 to 6.25) and those in unpaid employment (OR: 1.85, 95% CI: 1.06 to 3.22). Adults who were overweight or had obesity were less likely to commute actively. Compared with adults aged 25-34 years, older adults were less likely (OR: 0.35, 95% CI: 0.17 to 0.72) to engage in LTPA. Women were 0.46 times less likely to engage in LTPA compared with men. CONCLUSION Most adults engaged in active commuting for work or travel. Less than 5% participated in any form of moderate or vigorous LTPA. Longitudinal studies incorporating objective assessment of physical activity and a range of individual, interpersonal, and environmental factors will help understand how to promote active commuting and LTPA among Nepalese adults.Trial registration number: ClinicalTrials.gov NCT02428075.
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Affiliation(s)
- Susan Paudel
- Nepal Development Society, Bharatpur, Bagmati, Nepal
| | - Narayan Subedi
- Nepal Development Society, Bharatpur, Bagmati, Nepal
- School of Exercise and Nutrition Sciences, Deakin University Faculty of Health, Burwood, Victoria, Australia
| | - Craig S McLachlan
- Torrens University Australia-Sydney Campus Pyrmont, Pyrmont, New South Wales, Australia
| | - Ben J Smith
- The University of Sydney, Sydney, New South Wales, Australia
| | - Per Kallestrup
- Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Dinesh Neupane
- Nepal Development Society, Bharatpur, Bagmati, Nepal
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA
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Health System Capacity and Access Barriers to Diagnosis and Treatment of CVD and Diabetes in Nepal. Glob Heart 2021; 16:38. [PMID: 34040951 PMCID: PMC8139299 DOI: 10.5334/gh.927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Universal access to essential medicines and routine diagnostics is required to combat the growing burden of cardiovascular disease (CVD) and diabetes. Evaluating health systems and various access dimensions availability, affordability, accessibility, acceptability, and quality is crucial yet rarely performed, especially in low- and middle-income countries. Objective: To evaluate health system capacity and barriers in accessing diagnostics and essential medicines for CVD and diabetes in Nepal. Methods: We conducted a WHO/HAI nationally-representative survey in 45 health-facilities (public-sector: 11; private-sector: 34) in Nepal to collect availability and price data for 21 essential medicines for treating CVD and diabetes, during MayJuly 2017. Data for 13 routine diagnostics was obtained in 12 health facilities. Medicines were considered unaffordable if the lowest paid worker spends >1 days wage to purchase a monthly supply. To evaluate accessibility, we conducted facility exit interviews among 636 CVD patients. Accessibility (e.g., private-public health facility mix, travel to hospital/pharmacy) and acceptability (i.e. Nepals adoption of WHO Essential Medicine List, and patient medication adherence) were summarized using descriptive statistics, and we conducted a systematic review of relevant literature. We did not evaluate medicine quality. Results: We found that mean availability of generic medicines is low (<50%) in both public and private sectors, and less than one-third medicines met WHOs availability target (80%). Mean (SD) availability of diagnostics was 73.1% (26.8%). Essential medicines appear locally unaffordable. On average, the lowest-paid worker would spend 1.03 (public-sector) and 1.26 (private-sector) days wages to purchase a monthly supply. For a person undergoing CVD secondary preventive-interventions in the private sector, the associated expenditure would be 7.511.2% of monthly household income. Exit-interviews suggest that a long/expensive commute to health-facilities and poor medicine affordability constrain access. Conclusions: This study highlights critical gaps in Nepals health system capacity to offer basic health services to CVD and diabetes patients, owing to low availability, poor affordability and accessibility of essential medicines and diagnostics. Research and policy initiatives are needed to ensure uninterrupted supply of affordable essential medicines and diagnostics.
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Shrestha N, Mishra SR, Ghimire S, Gyawali B, Mehata S. Burden of Diabetes and Prediabetes in Nepal: A Systematic Review and Meta-Analysis. Diabetes Ther 2020; 11:1935-1946. [PMID: 32712902 PMCID: PMC7434818 DOI: 10.1007/s13300-020-00884-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Unhealthy behaviors, such as energy-dense food choices and a sedentary lifestyle, both of which are established risk factors for diabetes, are common and increasing among Nepalese adults. Previous studies have reported a wide variation in the prevalence of prediabetes and diabetes in Nepal, and thus a more reliable pooled estimate is needed. Furthermore, Nepal underwent federalization in 2015, and the province-specific prevalence, which is necessary for the de novo provincial government to formulate local health policies, is lacking. This study aims to provide a comprehensive summary of the current literature on various aspects of diabetes in Nepal, i.e., the prevalence of prediabetes and diabetes as well as of the awareness, treatment, and control of diabetes in Nepal. METHODS This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched three electronic databases-PubMed, Scopus, and Web of Science-using a comprehensive search strategy to identify eligible studies published up to April 2, 2020. Data on prevalence estimates of prediabetes and diabetes were extracted and pooled in a meta-analysis using a random effect model. Subgroup analyses and meta-regression were conducted to assess heterogeneity across the studies. The quality of included studies was assessed using the New Castle-Ottawa scale. RESULTS We included 14 eligible studies that comprised a total of 44,129 participants and 3517 diabetes cases. Half of the included studies had good quality. Overall, the prevalence of prediabetes and diabetes was 9.2% (95% CI 6.6-12.6%) and 8.5% (95% CI 6.9-10.4%), respectively. Among the participants with diabetes, only 52.7% (95% CI 41.7-63.4%) were aware of their diabetes status, and 45.3% (95% CI 31.6-59.8%) were taking antidiabetic medications. Nearly one-third of those under antidiabetic treatment (36.7%; 95% CI 21.3-53.3%) had their blood glucose under control. The prevalence of prediabetes and diabetes gradually increased with increasing age and was more prevalent among males and urban residents. There was a wide variation in diabetes prevalence across the provinces in Nepal, the lowest 2% in Province 6 to the highest 10% in Province 3 and Province 4. CONCLUSIONS The prevalence of prediabetes and diabetes was high in Nepal, while its awareness, treatment, and control were low. Our findings call for urgent nationwide public health action in Nepal.
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Affiliation(s)
- Nipun Shrestha
- Institute for Health and Sport (IHeS), Victoria University, Melbourne, Australia
| | | | - Saruna Ghimire
- Department of Sociology and Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH, USA
| | - Bishal Gyawali
- Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Suresh Mehata
- Ministry of Health and Population, Government of Nepal, Kathmandu, Nepal
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Alsaud W, Tabbaa MJ, Kasabri VN, Suyagh MF, Abu Alsamen MA, Haddad HM, ALshweki AO. Prevalence of Cardiovascular Diseases Risk Factors among Jordanians. J Saudi Heart Assoc 2020; 32:324-333. [PMID: 33154938 PMCID: PMC7640553 DOI: 10.37616/2212-5043.1074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/25/2020] [Accepted: 05/30/2020] [Indexed: 12/13/2022] Open
Abstract
Background and aims One of the most common causes of death worldwide is cardiovascular diseases (CVDs). This study evaluated the prevalence of CVDs risk factors (RFs) and their constellation electively among the Jordanian population and, assessing the most prevalent RF interplay with the rest of CVDs RFs as well as the impact of age and gender dimorphism on the frequencies of coexistence of multiple CVDs risk factors (RFs) among the Jordanian population. Methods and results In this observational multicenter study, a total of 1449 subjects were enrolled. The mean age (±SD) was 44.35 ± 14.46 years; 796 (54.9%) of them were females and 801 (55.28%) of the whole study pool had no family history of premature CVDs. Only 5.9% of the population did not have any of these RFs. The prevalence of CVDs MRFs within-affected subjects was as follows: there were 1081 (74.6%) subjects with overall dyslipidemia, 471 (32.51%) with obesity, 456 (31.47%) were smokers, and at the first diagnostic encounter 541 (37.47%) were with elevated blood pressure and, 310 (21.51%) were with elevated random blood sugar. The coexistence of ≥ two, ≥ three and, ≥ four RFs was observed in 75.7%, 44.4%, and 21.4% of the subjects, respectively. The constellation of multiple RFs was more frequent in men than that in women, where the presence of ≥ two RFs for men was at 86.18% vs. 67.09% for women. Similarly, the appearance of multiple RFs increases with age, starting from the existence of ≥ three, and four RFs respectively. Most notably the clustering of ≥ five RFs in the age group of 45–59 years showed the greatest frequency vs. any other age group. Conclusions CVDs risk factors (RFs) and clusters of them are extremely prevalent in the Jordanian population. Overall dyslipidemia is the most prevalent MRF and the most favors clustering with other CVDs RFs. Combined two RFs had the highest proportional frequency between all six RFs clusters. The constellation of at least two, three, and four CVDs RFs presented at almost three-fourth, half, and around one-fourth; respectively, Middle-aged males presented significantly higher rates of ≥ five RFs occurrences than females.
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Affiliation(s)
- Wesam Alsaud
- Scientific Office, Jordanian Pharmaceutical Company, Amman, Jordan
| | | | | | | | | | | | - Anas O ALshweki
- Scientific Office, Jordanian Pharmaceutical Company, Amman, Jordan
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21
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Hui-Fang L, Cai L, Wang XM, Golden AR. Ethnic disparities in prevalence and clustering of cardiovascular disease risk factors in rural Southwest China. BMC Cardiovasc Disord 2019; 19:200. [PMID: 31426745 PMCID: PMC6701110 DOI: 10.1186/s12872-019-1185-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 08/14/2019] [Indexed: 01/19/2023] Open
Abstract
Background This study examines how prevalence and clustering of cardiovascular disease (CVD) risk factors differ by ethnicity and socioeconomic status (SES) among rural southwest Chinese adults. Methods A cross-sectional survey of 7027 adults aged ≥35 years of Han and four ethnic minority group descent (Na Xi, Li Shu, Dai, and Jing Po) was used to derive prevalence of tobacco smoking and exposure to secondhand smoke (SHS) as well as alcohol consumption and physical activity data. Anthropometric measurements were also taken, including height, weight, and waist and hip circumference, as well as blood pressure (BP) and fasting blood glucose (FBG) measurements. Results Current smoking and drinking status were the top two CVD risk factors in the study population. Dai ethnic minority participants had the highest prevalence of hypertension, obesity, and central obesity, whereas Jing Po ethnic minority participants had the highest prevalence of current smoking status, SHS exposure, and current drinking status (P < 0.01). Han participants had the highest prevalence of diabetes and physical inactivity (P < 0.01). 11.1% of all participants did not have any of the studied CVD risk factors, while 68.6% of Han, 60.2% of Na Xi, 50.7% of Li Shu, 82.2% of Dai, and 73.0% of Jing Po participants had clustering of two or more CVD risk factors. Prevalence of CVD risk factor clusters increased with age (P < 0.01). Males and individuals with lower education levels and lower annual household income were more likely to have CVD risk factors than their counterparts (P < 0.01). Conclusion Clustering of CVD risk factors is common in rural southwest China. Ethnicity and individual SES significantly impact prevalence of CVD risk factors and their clustering.
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Affiliation(s)
- Li Hui-Fang
- Cheng Gong New City, School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Kunming, 650500, China.,The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Le Cai
- Cheng Gong New City, School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Kunming, 650500, China.
| | - Xu-Ming Wang
- Cheng Gong New City, School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Kunming, 650500, China.,The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Allison Rabkin Golden
- Cheng Gong New City, School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Kunming, 650500, China
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Dhungana RR, Bista B, Pandey AR, de Courten M. Prevalence, clustering and sociodemographic distributions of non-communicable disease risk factors in Nepalese adolescents: secondary analysis of a nationwide school survey. BMJ Open 2019; 9:e028263. [PMID: 31110109 PMCID: PMC6530381 DOI: 10.1136/bmjopen-2018-028263] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES To assess the prevalence, clustering and sociodemographic distribution of non-communicable disease (NCD) risk factors in adolescents in Nepal. DESIGN Data originated from Global School Based Student Health Survey, Nepal conducted in 2015-2016. SETTING The study sites were the secondary schools in Nepal; 74 schools were selected based on the probability proportional to school enrolment size throughout Nepal. PARTICIPANTS 5795 school-going children aged 13-17 years were included in the study. PRIMARY OUTCOMES NCD risk factors: smoking, alcohol consumption, insufficient fruit and vegetable intake, insufficient physical activity and overweight/obesity were the primary outcomes. Sociodemographic distributions of the combined and individual NCD risk factors were determined by Poisson regression analysis. RESULTS Findings revealed the prevalence of smoking (6.04%; CI 4.62 to 7.88), alcohol consumption (5.29%; CI 4.03 to 6.92), insufficient fruit and vegetable intake (95.33%; CI 93.89 to 96.45), insufficiently physical activity (84.77%; CI 81.04 to 87.88) and overweight/obesity (6.66%; CI 4.65 to 9.45). One or more risk factors were present in 99.6%, ≥2 were in 83% and ≥3 were in 11.2%. Risk factors were more likely to cluster in male, 17 years of age and grade 7. Prevalence of smoking (adjusted prevalence ratio (aPR)=2.38; CI 1.6 to 3.51) and alcohol consumption (aPR=1.81; CI 1.29 to 2.53) was significantly high in male, and in 16 and 17 years of age. Prevalence of insufficient physical activity and overweight/obesity was significantly lower in higher grades. CONCLUSION Insufficient fruit and vegetable intake and insufficient physical activity were highly prevalent in the populations studied. Risk factors were disproportionately distributed and clustered in particular gender, age and grade. The study population requires an age and gender specific preventive public health intervention.
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Affiliation(s)
| | - Bihungum Bista
- Research, Nepal Health Research Council, Kathmandu, Nepal
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Ghimire S, Mishra SR, Baral BK, Dhimal M, Callahan KE, Bista B, Aryal KK. Noncommunicable disease risk factors among older adults aged 60-69 years in Nepal: findings from the STEPS survey 2013. J Hum Hypertens 2019; 33:602-612. [PMID: 30647463 DOI: 10.1038/s41371-019-0161-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/04/2018] [Accepted: 12/21/2018] [Indexed: 12/21/2022]
Abstract
Both the noncommunicable diseases (NCDs) burden and the population of older adults are increasing in Nepal. This study aims to estimate the prevalence of behavioral and biological risk factors of common NCDs among Nepali older adults aged 60-69 years. A subsample analysis of data from the 2013 Nepal STEPwise approach to Surveillance (STEPS) survey was conducted with 526 older adults aged 60-69 years. STEPS sample weighting and domain analyses were used to include the entire sample for variance estimation and to obtain prevalence estimates and corresponding 95% confidence intervals (CI) for our selected population of older adults. All participants had at least one risk factor for NCDs; about one-fourth had four. Of the eight examined risk factors, inadequate fruit/vegetable intake (98.6%, 95% CI: 96.9-100.0), hypertension (57.2%, 95% CI: 51.0-63.4), and hypercholesterolemia (37.9%, 95% CI: 30.8-44.9) were ranked the three most prevalent risk factors while physical inactivity (2.5%, 95% CI: 1.0-4.0) was least prevalent. Prevalence of smoking was 31% (95% CI: 24.9-37.2), overweight/obesity was 19% (95% CI: 13.1-25.2), alcohol use was 18% (95% CI: 12.2-23.5), diabetes was 15% (95% CI: 8.5-21.4), and 36% (95% CI: 30.9-42.0) of the older participants suffered discomfort due to oral health problems. Several risk factors, including current alcohol consumption, daily servings of fruit/vegetable intake, and overweight/obesity showed signficant variation in prevalence by gender, ethnicity, and place of residence, urban vs. rural. Epidemiological and demographic transitions are two emerging public health issues in Nepal. The baseline information provided by this study on the prevalence of NCD risk factors among Nepali older adults aged 60-69 years can inform policies and programs that focus on maximizing the health and well-being of older adults.
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Affiliation(s)
- Saruna Ghimire
- School of Community Health Sciences, University of Nevada, Las Vegas, NV, 89154, USA.
| | | | - Binaya Kumar Baral
- Department of Biochemistry, Nepal Medical College and Teaching Hospital, Kathmandu, Nepal
| | - Meghnath Dhimal
- Nepal Health Research Council (NHRC), Ramshah Path, Kathmandu, Nepal
| | - Karen E Callahan
- School of Community Health Sciences, University of Nevada, Las Vegas, NV, 89154, USA
| | - Bihungum Bista
- Nepal Health Research Council (NHRC), Ramshah Path, Kathmandu, Nepal
| | - Krishna Kumar Aryal
- Nepal Health Sector Programme 3 (NHSP3), Monitoring Evaluation and Operational Research Project, Abt Associates, Lalitpur, Nepal
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Gyawali B, Mishra SR, Virani SS, Kallestrup P. Low levels of ideal cardiovascular health in a semi-urban population of Western Nepal: a population-based, cross-sectional study. HEART ASIA 2019; 11:e011131. [PMID: 30728865 DOI: 10.1136/heartasia-2018-011131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 11/13/2018] [Accepted: 11/27/2018] [Indexed: 12/20/2022]
Abstract
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.
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Affiliation(s)
- Bishal Gyawali
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Shiva Raj Mishra
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Salim S Virani
- Michael E DeBakey Veterans Affairs Medical Center and Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Per Kallestrup
- Department of Public Health, Aarhus University, Aarhus, Denmark
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