Prevalence of undiagnosed depression among persons with hypertension and associated risk factors: a cross-sectional study in urban Nepal.
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ABSTRACT:
SUBMITTER: Neupane D
PROVIDER: S-EPMC4324992 | biostudies-other | 2015
REPOSITORIES: biostudies-other
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Project description:ObjectiveTo examine the prevalence, correlates and sociodemographic inequalities of undiagnosed hypertension in Nepal.DesignThis study used cross-sectional 2016 Nepal Demographic and Health Survey (NDHS) data. Undiagnosed patients with hypertension were defined as an NDHS respondent who was diagnosed as hypertensive (systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg) during the survey, but never took any prescribed anti-hypertensive medicine to lower/control blood pressure and was never identified as having hypertension by a health professional prior the survey. Multiple binary logistic regression analysis was performed, and Concentration Index was measured.SettingNepal.ParticipantsAdult patients with hypertension.ResultsAmong 3334 patients with hypertension, 50.4% remained undiagnosed during the survey in Nepal. Adjusted model reveals that patients who were male, belonged to households other than the highest wealth quintile, and lived in province 4 and province 5 were at higher risk of remaining undiagnosed for hypertension. Patients who were ≥65 years of age and were overweight/obese were at lower risk of remaining undiagnosed for hypertension. The poor-rich gap was 24.6 percentage points (Q1=64.1% vs Q5=39.6%) and poor:rich ratio was 1.6 (Q1/Q5=1.6) in the prevalence of undiagnosed hypertension. Undiagnosed hypertension was disproportionately higher among lower socioeconomic status groups (Concentration Index, C=-0.18). Inequalities in the prevalence of undiagnosed hypertension further varied across other geographic locations, including place of residence, ecological zones and administrative provinces.ConclusionsUndiagnosed hypertension was highly prevalent in Nepal and there were substantial inequalities by sociodemographics and subnational levels. Increasing awareness, strengthening routine screening to diagnose hypertension at primary health service facilities and enactment of social health insurance policy may help Nepal to prevent and control this burden.
| S-EPMC7534699 | biostudies-literature
Project description:BackgroundHypertension is responsible for many premature deaths worldwide. However, many individuals with hypertension remain undiagnosed. Tonga is one of the countries that has had a steep increase in hypertension, thus undiagnosed hypertension could also be increasing. Purpose of this study was to assess the prevalence and factors associated with undiagnosed hypertension among Tongan adults.MethodsThis cross-sectional study used data collected from conveniently sampled 473 participants using electronic questionnaire and digital sphygmomanometer through household visits between February and March 2023. Inclusion criteria were age of 18-65 years, residence in the villages for at least six months, and not being pregnant. Fisher's exact test and mixed-effect logistic regression were performed using the EZR software to assess the association between undiagnosed hypertension and predictor variables.ResultsThe prevalence of undiagnosed hypertension was 22.4% (106/473). Five variables that were significantly associated with undiagnosed hypertension in Fisher's exact test were included in the multivariate logistic regression. Overall, only three variables remained significant. First, participants who never had their blood pressure measured had higher prevalence compared to those who had it checked recently (33.3% vs. 19.1%); odds ratio: 2.24). Secondly, participants who were not aware of the risk of developing hypertension were significantly more likely to have undiagnosed hypertension compared to those who were aware (27.9% vs. 16.7%; odds ratio: 1.81). Lastly, middle-aged participants (30-49 years) and older (50-65 years), were significantly more likely to have undiagnosed hypertension compared to those who were 18-29 years old (30.0% and 23.7% vs. 11.8%; odds ratio: 3.58 and 3.38 vs. 1.00).ConclusionThe prevalence of undiagnosed hypertension could be substantial among Tongan adults, implicating a need to address this issue by doing further research and review current public health work to address hypertension in Tonga. Undiagnosed hypertension was associated with having no experience of blood pressure measurement, lack of awareness about hypertension, and age. Tongan government should provide people with more opportunities to have their blood pressure measured and to improve their awareness.
| S-EPMC10759494 | biostudies-literature
Project description:ObjectivesThis study estimated the prevalence of hypertension, in accordance with the American College of Cardiology and American Heart Association's 2017 guidelines, and examined the association between various socioeconomic factors and systolic blood pressure (SBP), diastolic blood pressure (DBP) and hypertension.Setting and designWe used nationally representative data from the 2016 Nepal Demographic and Health Survey. Multivariate analysis was used to study the association of hypertension with socioeconomic factors: logistic regression was used for hypertension and linear regression was used for DBP and SBP.ParticipantsOur sample consisted of 9827 adults between the ages of 15 and 49 years.ResultsThe prevalence of hypertension was 36%. The mean DBP and SBP were 76.4 and 111.5, respectively. Janjatis (adjusted OR (AOR): 1.34, CI: 1.12 to 1.59), Other Terai castes (AOR: 1.38, CI: 1.03 to 1.84), Muslim and other ethnicities (AOR: 1.64, CI: 1.15 to 2.33) and Dalits (AOR: 1.26, CI: 1.00 to 1.58) had higher odds of hypertension. Individuals employed in professional, technical and managerial professions collectively (AOR: 1.62; CI: 1.18 to 2.21) also had higher odds of hypertension. Moderately food insecure household had lower odds of hypertension (AOR: 0.84; CI: 0.72 to 0.99) compared with households with no issue of food insecurity. Results were similar for SBP and DBP. When stratified by sex, there were differences mainly in terms of occupation and ethnicity.ConclusionThere are substantial disparities in hypertension prevalence in Nepal. These disparities extend across ethnic groups, occupational status and food security status. Differences also persist across different provinces. As hypertension continues to be increasingly more significant, more research is needed to better understand the disparities and gradients that exist across various socioeconomic factors.
| S-EPMC9161073 | biostudies-literature
Project description:BackgroundHypertension is a major cause of morbidity and mortality. In community populations the prevalence of hypertension, both in diagnosed and undiagnosed states, has been widely reported. However, estimates for the prevalence of hospitalized patients with average blood pressures (BPs) that meet criteria for the diagnosis of hypertension are lacking. We aimed to estimate the prevalence of patients in a UK hospital setting, whose average BPs meet current international guidelines for hypertension diagnosis.MethodsWe performed a retrospective cross-sectional observational study of patients admitted to adult wards in 4 acute hospitals in Oxford, United Kingdom, between March 2014 and April 2018.ResultsWe identified 41,455 eligible admitted patients with a total of 1.7 million BP measurements recorded during their hospital admissions. According to European ESC/ESH diagnostic criteria for hypertension, 21.4% (respectively 47% according to American ACC/AHA diagnostic criteria) of patients had a mean BP exceeding the diagnostic threshold for either Stage 1, 2, or 3 hypertension. Similarly, 5% had a mean BP exceeding the ESC/ESH (respectively 13% had a mean BP exceeding the ACC/AHA) diagnostic criteria for hypertension, but no preexisting diagnostic code for hypertension or a prescribed antihypertensive medication during their hospital stay.ConclusionsLarge numbers of hospital inpatients have mean in-hospital BPs exceeding diagnostic thresholds for hypertension, with no evidence of diagnosis or treatment in the electronic record. Whether opportunistic screening for in-hospital high BP is a useful way of detecting people with undiagnosed hypertension needs evaluation.
| S-EPMC8457434 | biostudies-literature
Project description:ObjectivesThis is the first attempt to provide estimates on the prevalence of hypertension at the national, state and district level, a prerequisite for designing effective interventions. Besides, the study aims to identify the risk factors of hypertension.DesignWe analysed cross-sectional survey data from the fourth round (2015-2016) of National Family Health Survey (NFHS). NFHS was conducted between January 2015 and December 2016, gathering information on a range of indicators including blood pressure. The age adjusted prevalence of hypertension was calculated for state comparison, while multilevel logistic regression analysis was done to assess the correlates of hypertension.Setting and participantsIndia (2015-2016; n=811 917) aged 15-49.Primary and secondary outcome measuresThe primary outcome is hypertension, which has been defined as systolic blood pressure ?140 mm Hg and/or diastolic blood pressure ?90 mm Hg.ResultsThe age-adjusted prevalence of hypertension in India was 11.3% (95% CI 11.16% to 11.43%) among persons aged between 15 and 49 and was four percentage points higher among males 13.8% (95% CI 13.46% to 14.19%) than among females 10.9% (95% CI 10.79% to 11.06%). Persons in the urban location (12.5%, 95% CI 12.25% to 12.80%) had a marginally higher prevalence than persons in rural location (10.6%, 95% CI 10.50% to 10.78%). The proportion of population suffering from hypertension varied greatly between states, with a prevalence of 8.2% (95% CI 7.58% to 8.85%) in Kerala to 20.3% (95% CI 18.81% to 21.77%) in Sikkim. Advancing age, obesity/overweight, male sex, socioeconomic status and consumption of alcohol were found to be the major predictors of hypertension.ConclusionsHypertension prevalence is now becoming more concentrated among the poor. Policy measures should be taken to improve the hazardous working conditions and growing social pressures of survival responsible for 'life-style' changes such as consumption of high calorie food and alcohol.
| S-EPMC6937064 | biostudies-literature
Project description:Objective:The increased blood pressure level in children and adolescents is recognized as an essential predictor of adulthood cardiovascular disease. This study aimed to ascertain the prevalence and the urban-rural disparity of childhood hypertension in the southwest of China. Methods:Using stratified cluster sampling in urban and rural areas, a total of 13597 primary school children aged 6?12 years living in the Southwest of China were included. The prevalence of hypertension was analyzed. The risk factors were collected by questionnaires, and the risk factors of childhood hypertension were analyzed by the logistic regression model. Results:The prevalence of hypertension was 13.75%, 9.02%, and 17.47% in total, urban, and rural children, respectively, and the urban-rural difference was 8.44% (95%CI: 7.32%, 9.56%). Children with obesity, maternal gestational hypertension, >10 months of breastfeeding, or low family income had a significantly increased prevalence of hypertension (29.4%, 20.00%, 16.31%, and 16.25%, respectively). Rural residence, intake of more pickle (in rural), maternal gestational hypertension (in urban), low birth weight (in rural), obesity, increased heart rate, and red blood cell counts were the risk factors of childhood hypertension. The adjusted R 2 values were 13.61%, 23.25%, 10.88%, 11.12%, 12.23%, and 25.04% in the full models excluding and including serum indexes for total, urban, and rural children, respectively. Conclusions:The prevalence of childhood hypertension is significant in the Southwest of China and alarming in rural areas, which requires community intervention. Children living in rural areas combined with obesity, low social economic status, dietary imbalance, and abnormal lipid metabolism were associated with an increased risk of hypertension, and routine care programs should be conducted to prevent childhood hypertension.
| S-EPMC7240786 | biostudies-literature
Project description:ObjectiveThis study examined the prevalence and factors associated with depression among adolescents attending higher secondary schools in the Pokhara Metropolitan City of Nepal.DesignA cross-sectional study design was adopted.SettingFour randomly selected higher secondary schools of Pokhara Metropolitan, Nepal.Participants312 randomly sampled higher secondary school students.MethodsThe Center for Epidemiologic Studies Depression Scale was used to assess the level of depression among students. The data collected through a self-administered questionnaire were analysed using descriptive statistical methods such as frequency and percentage. χ2 test and unadjusted OR (UOR) were calculated to assess the statistical relationship between depression and various variables at 95% CI, with level of significance at p<0.05.ResultsThe study found a high prevalence of depression among high school students, with more than two-fifths (44.2%) of students having depression. Furthermore, almost a quarter (25.3%) of the students were noted to have mild depression and 18.9% of the students expressed major depression. Students who had low perceived social support (UOR: 3.604; 95% CI 2.088 to 6.220), did not share their problems with anyone (UOR: 1.931; 95% CI 1.228 to 3.038) and had low self-esteem (UOR: 5.282; 95% CI 2.994 to 9.319) were at higher odds of being depressed.ConclusionA high prevalence of depression was observed among high school students. It was also observed that students' level of perceived social support, self-esteem and help-seeking behaviour are somehow related to their mental well-being. Hence, improving social support and self-esteem may alleviate depression and mental distress among these adolescents.
| S-EPMC7780534 | biostudies-literature
Project description:The prevalence of non-communicable diseases is increasing in Nepal. Overweight and obesity are the major risk factors of many non-communicable diseases. Adolescence is a critical phase for development of overweight and obesity. Risk factors associated with overweight and obesity are not well understood in Nepal. The objective of the study was to identify the factors associated with overweight and obesity among adolescent students.A cross-sectional descriptive study was carried out on higher secondary school students in the Lalitpur sub-metropolitan city, Nepal.A random sample of 360 students aged 16-19 years from eight schools was included in the study.The prevalence of overweight among adolescent students was 12.2% (95% CI 8.9 to 15.5). Factors associated with being overweight included being male (adjusted OR (AOR) 2.64, 95% CI 1.18 to 4.88), studying in private school (AOR 2.10, 95% CI 1.03 to 4.28), high socioeconomic status family (AOR 4.77, 95% CI 1.36 to 16.72), watching television for more than 2 h per day (AOR 8.86, 95% CI 3.90 to 20.11), and consuming fruit four times or less per week (AOR 3.13, 95% CI 1.39 to 7.01). There was no statistically significant association between adolescent overweight and age, ethnicity, mother's education level, mother's occupation, number of siblings or family type.Socioeconomic status, watching television for a longer time and consuming less fruit are major risk factors for overweight among adolescents in Nepal. Interventions are needed to increase awareness about the risk factors of adolescent overweight and obesity to decrease prevalence of overweight-associated non-communicable diseases.
| S-EPMC4885275 | biostudies-other
Project description:BACKGROUND:The increasing elderly population worldwide is likely to increase mental health problems such as geriatric depression, which has mostly been studied in high-income countries. Similar studies are scarce in low-and-middle-income-countries like Nepal. METHODS:A cross-sectional, population-based, door-to-door survey was conducted in randomly selected rural and urban population clusters of the Kavre district, Nepal. Trained nurses (field interviewers) administered structured questionnaires that included a validated Nepali version of the Geriatric Depression Scale short form (GDS-15) for identifying geriatric depression among the elderly (?60?years) participants (N?=?460). Those scoring ?6 on GDS-15 were considered depressed. Logistic regression analysis explored the associations of geriatric depression with regard to socio-demographic information, life style, family support and physical well-being. RESULTS:Of the total 460 selected elderly participants, 439 (95.4%) took part in the study. More than half of them were females (54.2%). The mean age was 70.9 (± 8.6) years. Approximately half (50.6%) were rural inhabitants, the majority (86.1%) were illiterate, and about three-fifths (60.1%) were living with their spouses. The gender-and-age adjusted prevalence of geriatric depression was 53.1%. Geriatric depression was significantly associated with rural habitation (AOR 1.6), illiteracy (AOR 2.1), limited time provided by families (AOR 1.8), and exposure to verbal and/or physical abuse (AOR 2.6). CONCLUSION:Geriatric depression is highly prevalent in Kavre, Nepal. The findings call for urgent prioritization of delivery of elderly mental health care services in the country.
| S-EPMC6724336 | biostudies-literature
Project description:ObjectiveThis study aimed to assess the prevalence of depression, anxiety and stress, associated factors and stress-coping strategies among traffic police officers in Kathmandu, Nepal.DesignCross-sectional survey.SettingKathmandu Valley, Nepal.ParticipantsA total of 300 traffic police officers working under the different traffic units of Kathmandu Valley for at least 6 months were recruited via a simple random sampling procedure.Primary outcome measuresState of depression, anxiety and stress among traffic police officers based on the Depression, Anxiety and Stress Scale.Secondary outcome measuresCoping strategies under stressful conditions based on the Coping Orientation to Problems Experienced Inventory (Brief-COPE) tool.ResultsAltogether 124 (41.3%) traffic police officers had symptoms of depression, 141 (47%) had anxiety symptoms and 132 (44%) had symptoms of stress. Smoking was significantly associated with an increased likelihood of experiencing symptoms of depression (adjusted OR (AOR): 10.7, 95% CI: 4.8 to 23.6), anxiety (AOR: 7.1, 95% CI: 3.4 to 14.9) and stress (AOR: 6.8, 95% CI: 3.3 to 14.1). Similarly, longer working hours was significantly associated with higher odds of experiencing symptoms of depression (AOR: 3.4, 95% CI: 1.8 to 6.4), anxiety (AOR: 2.3, 95% CI: 1.3 to 3.9) and stress (AOR: 1.9, 95% CI: 1.1 to 3.4), and lack of physical exercise was associated with an increased likelihood of exhibiting depressive symptoms (AOR: 2.3, 95% CI: 1.1 to 4.7). Participants in this study used positive coping strategies more than negative coping strategies.ConclusionOur study found a high prevalence of depression, anxiety and stress symptoms among traffic police officers in Kathmandu Valley, Nepal. Smoking and longer working hours were associated with an increased likelihood of experiencing symptoms of depression, anxiety and stress, and lack of physical exercise was associated with an increased likelihood of depressive symptoms.
| S-EPMC9174765 | biostudies-literature