Koju R, Manandhar K, Risal A, Steiner T J, Holen A, Linde M
Department of Internal Medicine, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal.
Department of Community Medicine, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Dhulikhel, Kavre, Nepal.
Kathmandu Univ Med J (KUMJ). 2015 Jan-Mar;13(49):3-7. doi: 10.3126/kumj.v13i1.13744.
Hypertension (HTN), a major risk factor for cardiovascular diseases (CVDs), is a substantial global public health problem. Occasional studies indicate a high prevalence of HTN in the Nepalese population, but no nationwide population-based data exist so far. We opportunistically used a survey of major disorders of the brain in Nepal to measure blood pressure (BP) in participants selected randomly from the adult general population.
To establish the prevalence of elevated BP (eBP), and factors associated with it, regardless of any antihypertensive therapy being taken. We took this to be indicative of unmet health-care need.
This was a cross-sectional study, conducted by unannounced household visits, employing multistage random cluster sampling. To achieve representativeness, 15 districts out of 75 in the country were investigated: one district from each of the three physiographic divisions in each of the five development regions of Nepal. One adult aged 18-65 years was selected from each household and interviewed by structured questionnaire. BP was recorded in a standardised manner by digital device (Microlife 3BM1-3®).
From 2,109 eligible households, 2,100 adults (99.6%) participated. The prevalence of eBP (>140/90 mmHg on ≥2 readings) was found to be 15.1%. Multivariate logistic regression showed significant and independent associations with demographic variables (higher age, male gender), with life-style factors (daily alcohol consumption, BMI ≥25), and with living at high altitude (≥2000 m).
In the context of the survey we could not collect data on antihypertensive therapy being taken but, clearly, whatever this might have been, it was failing to meet treatment needs. Almost one in six adults met criteria for hypertension, carrying risk implications for CVDs and their substantial public-health consequences. Two remediable associated factors were identified, although in a cross-sectional survey we could not prove causation.
高血压（HTN）是心血管疾病（CVDs）的主要危险因素，是一个重大的全球公共卫生问题。偶尔有研究表明尼泊尔人群中高血压患病率较高，但目前尚无全国性的基于人群的数据。我们利用尼泊尔一项关于大脑主要疾病的调查，对从成年普通人群中随机选取的参与者测量血压（BP）。
确定血压升高（eBP）的患病率及其相关因素，无论是否正在接受任何抗高血压治疗。我们认为这表明未满足的医疗保健需求。
这是一项横断面研究，通过不事先通知的家庭访视进行，采用多阶段随机整群抽样。为了实现代表性，对该国75个区中的15个区进行了调查：尼泊尔五个发展区域中每个区域的三个自然地理分区各选一个区。从每个家庭中选取一名18 - 65岁的成年人，并通过结构化问卷进行访谈。使用数字设备（Microlife 3BM1 - 3®）以标准化方式记录血压。
从2109户符合条件的家庭中，有2100名成年人（99.6%）参与。发现血压升高（≥2次测量时收缩压>140/舒张压>90 mmHg）的患病率为15.1%。多变量逻辑回归显示与人口统计学变量（年龄较大、男性）、生活方式因素（每日饮酒、BMI≥25）以及居住在高海拔地区（≥2000米）存在显著且独立的关联。
在本次调查中，我们无法收集关于正在接受的抗高血压治疗的数据，但显然，无论治疗情况如何，治疗需求都未得到满足。几乎六分之一的成年人符合高血压标准，这对心血管疾病及其重大的公共卫生后果具有风险影响。确定了两个可纠正的相关因素，尽管在横断面调查中我们无法证明因果关系。
