Prevalence of hypertension in Nepalese community triples in 25 years: a repeat cross-sectional study in rural Kathmandu.

AIM/OBJECTIVES: The objective of the study was to examine if there has been any change in the prevalence of hypertension (HTN) in the Nepalese population in the last two and half decades. METHODS: A population-based cross-sectional study was done in Bhadrabas village area of Kathmandu valley to estimate the prevalence of HTN and the findings were compared to the study done in the same location 25 years ago. FINDINGS: The study shows that there has been a three-fold increment in the prevalence of HTN in the same location. The major causes behind this increment appear to be increased salt intake and increased body mass index (BMI). CONCLUSION: This is the first repeat cross-sectional study on blood pressure (BP) in a Nepalese population. There is a very high prevalence as well as a sharp rise in HTN prevalence in this society largely because of changing lifestyle which is most likely because of socio-economic transition.

Risk factors for early myocardial infarction in South Asians compared with individuals in other countries.

CONTEXT: South Asians have high rates of acute myocardial infarction (AMI) at younger ages compared with individuals from other countries but the reasons for this are unclear. OBJECTIVE: To evaluate the association of risk factors for AMI in native South Asians, especially at younger ages, compared with individuals from other countries. DESIGN, SETTING, AND PARTICIPANTS: Standardized case-control study of 1732 cases with first AMI and 2204 controls matched by age and sex from 15 medical centers in 5 South Asian countries and 10,728 cases and 12,431 controls from other countries. Individuals were recruited to the study between February 1999 and March 2003. MAIN OUTCOME MEASURE: Association of risk factors for AMI. RESULTS: The mean (SD) age for first AMI was lower in South Asian countries (53.0 [11.4] years) than in other countries (58.8 [12.2] years; P<.001). Protective factors were lower in South Asian controls than in controls from other countries (moderate- or high-intensity exercise, 6.1% vs 21.6%; daily intake of fruits and vegetables, 26.5% vs 45.2%; alcohol consumption > or =once/wk, 10.7% vs 26.9%). However, some harmful factors were more common in native South Asians than in individuals from other countries (elevated apolipoprotein B(100) /apolipoprotein A-I ratio, 43.8% vs 31.8%; history of diabetes, 9.5% vs 7.2%). Similar relative associations were found in South Asians compared with individuals from other countries for the risk factors of current and former smoking, apolipoprotein B100/apolipoprotein A-I ratio for the top vs lowest tertile, waist-to-hip ratio for the top vs lowest tertile, history of hypertension, history of diabetes, psychosocial factors such as depression and stress at work or home, regular moderate- or high-intensity exercise, and daily intake of fruits and vegetables. Alcohol consumption was not found to be a risk factor for AMI in South Asians. The combined odds ratio for all 9 risk factors was similar in South Asians (123.3; 95% confidence interval [CI], 38.7-400.2] and in individuals from other countries (125.7; 95% CI, 88.5-178.4). The similarities in the odds ratios for the risk factors explained a high and similar degree of population attributable risk in both groups (85.8% [95% CI, 78.0%-93.7%] vs 88.2% [95% CI, 86.3%-89.9%], respectively). When stratified by age, South Asians had more risk factors at ages younger than 60 years. After adjusting for all 9 risk factors, the predictive probability of classifying an AMI case as being younger than 40 years was similar in individuals from South Asian countries and those from other countries. CONCLUSION: The earlier age of AMI in South Asians can be largely explained by higher risk factor levels at younger ages.