Prevalence of White Coat Hypertension among the Patients Visiting in a Tertiary Care Center, Kathmandu, Nepal.

Background Hypertension is a major cardiovascular risk factor. White coat hypertension refers to elevated office blood pressure but normal out of office blood pressure. White-coat hypertension has a risk of cardiovascular events more than normotensives. Objective To identify the prevalence of white coat hypertension among patients presented in the cardiology department. Method The descriptive cross-sectional study was conducted among 165 patients who visited the cardiology outpatient department of Kathmandu Medical College and Teaching Hospital from December 2017 to November 2018. Blood pressure was measured at the hospital, and ambulatory blood pressure device was used to monitor 24hrs pattern. Hypertension is classified as per recent guideline. Data were entered and analysed using Statistical Package for social sciences version 20. Result Out of 165 ambulatory blood pressure monitoring conducted patients, 140 participants were enrolled in the study based on inclusion criteria. Among them 55% (77) were male, and 45% (63) were female. Age ranged from 18-78 years with a mean of 43.82 ± 12.31 years. Overall among 140 participants 14.28% had white coat hypertension, however, after excluding twenty-two high normal group, among 118 participants who were hypertensive according to office BP, 16.9% (20) had white coat hypertension, and 33.57% of patients did not have nocturnal dipping of blood pressure. Conclusion The white coat hypertension is prevalent among around one-sixth of hypertensive patients visiting tertiary care centre, and one third have non-dipping which needs to be considered in the management of hypertension.

Screening for Hypertension and Obesity in Rural Population of Nepal.

Background Hypertension is a major non-communicable disease and obesity is a risk factor for non-communicable diseases around the globe. The prevalence of hypertension and obesity is gradually increasing in Nepal. Most cases in the rural population of Nepal remain undiagnosed due to lack of routine screening and awareness. Objective To screen the cases of hypertension and obesity in a rural population of Nepal and also to depict the association between them. Method A cross sectional study was used to collect data on age, sex, height, weight and blood pressure through a screening health camp. Only the respondents who were not already taking antihypertensive drugs were included in this study. The measurement of blood pressure and body mass index was done using standard instruments. Joint National Committee VII classification was used to classify hypertension and World Health Organization classification was used for Body Mass Index. Analysis was done in IBM SPSS version 20. Result Out of the total respondents, 69.8% were female and 30.2% were male, and mean age was 48.73 (±16.25) years. Among them, 375 (30.17%) respondents were found to be hypertensive and 137 (11.02%) were pre-hypertensive. Similarly, 27% male participants and 72 % female participants were obese. Almost three-fifths of the obese participants were hypertensive. Conclusion Pre-hypertension and hypertension were seen in 11.02% and 30.17% of the study population respectively. As routine screening of hypertension and obesity is not done in our country, most of them remain undiagnosed.