title: A cross-sectional study of the prevalence and risk factors for hypertension in rural Nepali women.
abstract: BACKGROUND
  The prevalence of hypertension is increasing in much of the South Asian region, including Nepal. This paper reports the prevalence and risk factors of hypertension and pre-hypertension among adult women in a rural community of Nepal.
  
  
  METHODS
  Cross-sectional data on socioeconomic status (SES), lifestyle factors and blood pressure (BP) were collected from a cohort of 15,934 women in rural Nepal in 2006-08. Among a subsample (n = 1679), anthropometry and biomarkers of cardiovascular risk were measured.
  
  
  RESULTS
  The mean age of women was 34.2 years (range 16.4-71.2 years). More than three percent (3.3%) had hypertension and 14.4% had pre-hypertension. In an adjusted analysis, lower SES, especially lower household farm assets and storage of food for long term consumption, was associated with increased odds of hypertension (OR = 1.14 for mid-level SES and OR = 1.40 for low SES; p for trend < 0.01). Smoking, alcohol use and not working outside the home were also associated with higher risk. In a subsample, both systolic BP (SBP) and diastolic BP (DBP) were positively associated with high triglycerides (SBP β = 4.1 mm Hg; DBP β =3.6 mm Hg), high HbA1c (SBP β = 14.0; DBP β = 9.2), raised fasting glucose (SBP β = 10.0; DBP β = 6.9), high BMI (SBP β = 6.7; DBP β = 5.1) and high waist circumference (SBP β = 6.2; DBP β = 5.3) after adjusting for potential confounders (p for all <0.01).
  
  
  CONCLUSIONS
  Although the prevalence of hypertension was low in this cohort, it was more prevalent among the poorer women and was strongly associated with other cardiovascular risks. These associations at a relatively young age may confer greater risk for cardiovascular disease among women in later life, indicating the need for interventions to reduce the progression from pre-hypertension to hypertension.
authors: Program in Human Nutrition, Department of International Health Bloomberg, School of Public Health Johns Hopkins University, Baltimore, 21205 MD, USA.
authors: Rumana J
authors: RJ
authors: Khan
authors: Christine P
authors: CP
authors: Stewart
authors: Parul
authors: P
authors: Christian
authors: Kerry J
authors: KJ
authors: Schulze
authors: Lee
authors: L
authors: Wu
authors: Steven C
authors: SC
authors: Leclerq
authors: Subarna K
authors: SK
authors: Khatry
authors: Keith P
authors: KP
authors: West
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D054624:Health Status Disparities; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D058246:Prehypertension / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D055815:Young Adult