Prevalence of cardiovascular disease risk factors: A community-based cross-sectional study in a peri-urban community of Kathmandu, Nepal

Raja Ram Dhungana, Puspa Thapa, Surya Devkota, Palash Chandra Banik, Yadav Gurung, Shirin Jahan Mumu, Arun Shayami, Liaquat Ali
2018 Indian Heart Journal  
This study assessed the burden and correlates of three cardiometabolic risk factors, (hypertension, diabetes, and overweight/obesity), and their possible clustering patterns in a semi-urban population of Nepal. Data were obtained from a community-based management of non-communicable disease in Nepal (COBIN) Wave II study, which included 2,310 adults aged 25-64 years in a semi-urban area of Pokhara Metropolitan City of Nepal, using the World Health Organization-STEPS questionnaire. Unadjusted
more » ... aire. Unadjusted and adjusted binary logistic regression models were used to study the correlates of the individual risk factors and their clustering. The prevalence of hypertension, diabetes, and overweight/ obesity was 34.5%, 11.7%, and 52.9%, respectively. In total, 68.2% of the participants had at least one risk factor and many participants had two risks in combination: 6.8% for 'hypertension and diabetes', 7.4% for 'diabetes and overweight/obesity' and 21.4% for 'hypertension and overweight/obesity'. In total, 4.7% had all three risk factors. Janajati ethnicity (1.4-2.1 times), male gender (1.5 times) and family history of diabetes (1.4-3.4 times) were associated with presence of individual risk factors. Similarly, Janajati ethnicity (aOR: 4.31, 95% CI: 2.53-7.32), current smoking (aOR: 4.81, 95% CI: 2.27-10.21), and family history of diabetes (aOR: 4.60, 95% CI: 2.67-7.91) were associated with presence of all three risk factors. Our study found a high prevalence of all single and combined cardiometabolic risk factors in Nepal. It underlines the need to manage risk factors in aggregate and plan prevention activities targeting multiple risk factors. Cardiovascular disease (CVD), a leading cause of global morbidity and mortality, accounts for 17.9 million deaths worldwide annually 1 . In 2012, it was estimated that 7.4 million died due to coronary heart diseases and 6.7 million died due to stroke 2 . Over 75% of cardiovascular deaths take place in low-and middle-income countries (LMICs) 1 . Additionally, CVD contributes to the global economic burden by increasing health-care expenditures, lower productivity at work, increasing the number of sick days, causing permanent disability 3 . Nepal, a low-income country in South Asia, is experiencing a similar increasing trend in CVD morbidity and mortality. The mortality attributed to CVD in Nepal has increased rapidly from 22% to 25% between 2004 and 2008 4,5 . The public health care spending in Nepal is still focused on infectious diseases, and the resources allocated to fighting CVD have not kept up with its increasing burden. As is common in poor resource settings,
doi:10.1016/j.ihj.2018.03.003 fatcat:5adpsritf5fi7iuhn2sxdlrgiy