PMID- 31401611
OWN - NLM
STAT- MEDLINE
DCOM- 20200828
LR  - 20200828
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 9
IP  - 8
DP  - 2019 Aug 10
TI  - Factors associated with hypertension among adults in Nepal as per the Joint 
      National Committee 7 and 2017 American College of Cardiology/American Heart 
      Association hypertension guidelines: a cross-sectional analysis of the 
      demographic and health survey 2016.
PG  - e030206
LID - 10.1136/bmjopen-2019-030206 [doi]
LID - e030206
AB  - OBJECTIVES: This study investigated the determinants of hypertension in Nepal 
      according to both the Joint National Committee 7 (JNC7) and the American College 
      of Cardiology/American Heart Association (2017 ACC/AHA) guidelines. DESIGN: 
      Cross-sectional study. SETTING: This study used data collected from the 2016 
      Nepal Demographic and Health Survey data. PARTICIPANTS: 13 393 weighted adults 
      aged >/=18 years enrolled by a stratified cluster sampling strategy were included 
      in our analysis. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was 
      hypertension, which was defined according to JNC7 (systolic blood pressure (SBP) 
      >/=140 mm Hg and/or diastolic blood pressure (DBP) >/=90 mm Hg) and 2017 ACC/AHA 
      guidelines (SBP >/=130 mm Hg and/or DBP >/=80 mm Hg). Antihypertensive medication 
      users were also classified as hypertensive. After descriptive analysis, 
      multilevel logistic regression was applied to obtain ORs. RESULTS: About 21% 
      (n=2827) and 44% (n=5918) of the individuals aged >/=18 years were classified as 
      hypertensive according to the JNC7 and 2017 ACC/AHA guidelines, respectively. 
      Following factors were found to be significantly associated with hypertension 
      according to the 2017 ACC/AHA guideline: >/=70 years (adjusted OR (AOR) 5.2; 95% CI 
      4.3 to 6.2), 50-69 years (AOR 3.9; 95% CI 3.4 to 4.4) and 30-49 years (AOR 2.7; 
      95% CI 2.4 to 3.0) age groups, male gender (AOR 1.7; 95% CI 1.6 to 1.9), being 
      overweight/obese (AOR 3.0; 95% CI 2.7 to 3.3), residence in provinces 4 (AOR 1.5; 
      95% CI 1.2 to 2.0) and 5 (AOR 1.5; 95% CI 1.2 to 1.9). No significant association 
      was identified with household wealth status and ecological regions of residence 
      using the 2017 ACC/AHA guideline. CONCLUSIONS: Per both guidelines, multiple 
      factors were associated with hypertension. Public health programme aiming to 
      prevent and control hypertension in Nepal should prioritise these factors and 
      focus on individuals with a higher likelihood of hypertension irrespective of 
      educational level, household wealth status and ecological regions of residence.
CI  - (c) Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Das Gupta, Rajat
AU  - Das Gupta R
AUID- ORCID: 0000-0002-7680-676X
AD  - Centre for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of 
      Public Health, BRAC University, Dhaka, Bangladesh rajat89.dasgupta@gmail.com.
AD  - Centre for Science of Implementation and Scale-Up, BRAC James P Grant School of 
      Public Health, BRAC University, Dhaka, Bangladesh.
FAU - Bin Zaman, Sojib
AU  - Bin Zaman S
AD  - Maternal and Child Health Division, International Centre for Diarrhoeal Disease 
      Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
FAU - Wagle, Kusum
AU  - Wagle K
AD  - Research Division, Center for Research on Environment Health and Population 
      Activities, Kathmandu, Nepal.
AD  - Department of Public Health, Om Health Campus Pvt. Ltd, Kathmandu, Nepal.
FAU - Crispen, Reese
AU  - Crispen R
AD  - Department of Epidemiology and Public Health, University of Maryland, Baltimore, 
      Maryland, USA.
FAU - Hashan, Mohammad Rashidul
AU  - Hashan MR
AUID- ORCID: 0000-0002-1627-4976
AD  - Department of Medicine, Dhaka Medical College and Hospital, Dhaka, Bangladesh.
FAU - Al Kibria, Gulam Muhammed
AU  - Al Kibria GM
AD  - Department of Epidemiology and Public Health, University of Maryland, Baltimore, 
      Maryland, USA.
LA  - eng
PT  - Journal Article
DEP - 20190810
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Cross-Sectional Studies
MH  - Female
MH  - Health Surveys
MH  - Humans
MH  - Hypertension/epidemiology/*etiology
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Nepal/epidemiology
MH  - Obesity/complications
MH  - Practice Guidelines as Topic
MH  - Risk Factors
MH  - Sex Factors
MH  - Socioeconomic Factors
PMC - PMC6701821
OTO - NOTNLM
OT  - key-words:2017 acc/aha
OT  - JNC7
OT  - determinants
OT  - hypertension
OT  - nepal
COIS- Competing interests: None declared.
EDAT- 2019/08/12 06:00
MHDA- 2020/08/29 06:00
PMCR- 2019/08/10
CRDT- 2019/08/12 06:00
PHST- 2019/08/12 06:00 [entrez]
PHST- 2019/08/12 06:00 [pubmed]
PHST- 2020/08/29 06:00 [medline]
PHST- 2019/08/10 00:00 [pmc-release]
AID - bmjopen-2019-030206 [pii]
AID - 10.1136/bmjopen-2019-030206 [doi]
PST - epublish
SO  - BMJ Open. 2019 Aug 10;9(8):e030206. doi: 10.1136/bmjopen-2019-030206.