Prevalence and Determinants of Hypertension in South-Asian Urban Communities: Findings from Demographic and Health Surveys (DHS) Data of South Asian Countries

Abstract

BackgroundHypertension increases risk of stroke and cardiovascular disease, however its prevalence and determinants in South Asian urban communities using standard datasets is lacking. This study evaluated prevalence of hypertension and determinants among urban residents of three South Asian countries.MethodsUrban population data from demographic and health surveys in Bangladesh, India, and Nepal were extracted. Hypertension prevalence was defined as systolic/diastolic blood pressure > 140/ 90 mmHg. Age, education, wealth, physical activity, alcohol, BMI were explanatory variables. We performed binary logistic regression and calculated adjusted Odds Ratios (AOR) with 95% confidence interval (CI) to assess factors related to hypertension.FindingsHypertension prevalence was highest in India (37.4%), then Bangladesh (25.1%) and Nepal (18.4%). Prevalence increased with age in all settings. Females had reduced odds of hypertension in Bangladesh (AOR 0.75; CI 0.69,0.81) and Nepal (AOR 0.62; CI 0.54,0.71), but higher risk in India (AOR 2.54; CI 2.45,2.63). Low education, caffeine consumption, obesity associated with higher prevalence of hypertension in all three countries. Smokers had increased odds of hypertension in India (AOR 1.11; CI 1.06, 1.15) and Nepal (AOR 1.23; 1.02, 1.47).InterpretationHypertension prevalence is high in all countries. Modifiable socioeconomic and lifestyle factors (education, wealth index, smoking status, caffeine consumption and BMI) associated with hypertension. Comprehensive hypertension-sensitive interventions (including behavioral modification treatments and timely screening and access to health care) are urgently needed to prevent and control hypertension urban populations in South Asia.

Keywords: Hypertension, South Asian Countries, Bangladesh, India, Nepal, Urban