Cargando…

Association of altitude and urbanization with hypertension and obesity: analysis of the Nepal Demographic and Health Survey 2016

BACKGROUND: Nepal's Himalayan range attracts mountaineers, climbers and tourists from all across the globe. Limited recent evidence suggests that exposure to hypoxia at a higher altitude may be a risk factor for hypertension and a protective factor for obesity. The existing urban–rural disparit...

Descripción completa

Detalles Bibliográficos
Autores principales: Mehata, Suresh, Shrestha, Nipun, Ghimire, Saruna, Atkins, Emily, Karki, Deepak Kumar, Mishra, Shiva Raj
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7902681/
https://www.ncbi.nlm.nih.gov/pubmed/32623453
http://dx.doi.org/10.1093/inthealth/ihaa034
_version_ 1783654579053789184
author Mehata, Suresh
Shrestha, Nipun
Ghimire, Saruna
Atkins, Emily
Karki, Deepak Kumar
Mishra, Shiva Raj
author_facet Mehata, Suresh
Shrestha, Nipun
Ghimire, Saruna
Atkins, Emily
Karki, Deepak Kumar
Mishra, Shiva Raj
author_sort Mehata, Suresh
collection PubMed
description BACKGROUND: Nepal's Himalayan range attracts mountaineers, climbers and tourists from all across the globe. Limited recent evidence suggests that exposure to hypoxia at a higher altitude may be a risk factor for hypertension and a protective factor for obesity. The existing urban–rural disparities in Nepal in health and economic resources may be anticipated in the burden of hypertension and obesity, two rapidly growing public health issues, but they remain largely unstudied. Therefore this study aims to assess the association of altitude and urbanization with hypertension and overweight/obesity in Nepal. METHODS: Data on 10 473 participants from a nationally representative survey, the 2016 Nepal Demographic and Health Survey (NDHS), was used. The NDHS assessed/measured blood pressure, height, weight, urbanization and the altitude of participants’ households by following standard procedures. Logistic and linear regression models were used to study the association of altitude (per 100 m increases) and urbanization with hypertension and obesity, or their continuous measurements (i.e. systolic and diastolic blood pressure [SBP and DBP, respectively] and body mass index [BMI]). RESULTS: The prevalence of hypertension, overweight and obesity was 25.6%, 19.6% and 4.8%, respectively. After controlling for covariates, residents of metropolitan cities had a 30% higher prevalence of overweight/obesity (adjusted prevalence ratio 1.30 [95% confidence interval {CI} 1.11 to 1.52]) than their rural counterparts. For altitude, there was a marginally increased odds of hypertension and overweight/obesity with elevation. Consistently, DBP (β = 0.18 [95% CI 0.09 to 0.27]) and BMI increased with altitude (β = 0.11 [95% CI 0.08 to 0.13]). CONCLUSION: Urbanization was positively associated with BMI, while altitude showed a marginally positive association with hypertension and overweight/obesity. Given the role of obesity and hypertension in the aetiology of other chronic diseases and subsequently associated mortality and health care costs, residents in urban areas and at higher altitudes may benefit from weight control interventions and BP monitoring, respectively.
format Online
Article
Text
id pubmed-7902681
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-79026812021-03-01 Association of altitude and urbanization with hypertension and obesity: analysis of the Nepal Demographic and Health Survey 2016 Mehata, Suresh Shrestha, Nipun Ghimire, Saruna Atkins, Emily Karki, Deepak Kumar Mishra, Shiva Raj Int Health Original Article BACKGROUND: Nepal's Himalayan range attracts mountaineers, climbers and tourists from all across the globe. Limited recent evidence suggests that exposure to hypoxia at a higher altitude may be a risk factor for hypertension and a protective factor for obesity. The existing urban–rural disparities in Nepal in health and economic resources may be anticipated in the burden of hypertension and obesity, two rapidly growing public health issues, but they remain largely unstudied. Therefore this study aims to assess the association of altitude and urbanization with hypertension and overweight/obesity in Nepal. METHODS: Data on 10 473 participants from a nationally representative survey, the 2016 Nepal Demographic and Health Survey (NDHS), was used. The NDHS assessed/measured blood pressure, height, weight, urbanization and the altitude of participants’ households by following standard procedures. Logistic and linear regression models were used to study the association of altitude (per 100 m increases) and urbanization with hypertension and obesity, or their continuous measurements (i.e. systolic and diastolic blood pressure [SBP and DBP, respectively] and body mass index [BMI]). RESULTS: The prevalence of hypertension, overweight and obesity was 25.6%, 19.6% and 4.8%, respectively. After controlling for covariates, residents of metropolitan cities had a 30% higher prevalence of overweight/obesity (adjusted prevalence ratio 1.30 [95% confidence interval {CI} 1.11 to 1.52]) than their rural counterparts. For altitude, there was a marginally increased odds of hypertension and overweight/obesity with elevation. Consistently, DBP (β = 0.18 [95% CI 0.09 to 0.27]) and BMI increased with altitude (β = 0.11 [95% CI 0.08 to 0.13]). CONCLUSION: Urbanization was positively associated with BMI, while altitude showed a marginally positive association with hypertension and overweight/obesity. Given the role of obesity and hypertension in the aetiology of other chronic diseases and subsequently associated mortality and health care costs, residents in urban areas and at higher altitudes may benefit from weight control interventions and BP monitoring, respectively. Oxford University Press 2020-07-04 /pmc/articles/PMC7902681/ /pubmed/32623453 http://dx.doi.org/10.1093/inthealth/ihaa034 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Article
Mehata, Suresh
Shrestha, Nipun
Ghimire, Saruna
Atkins, Emily
Karki, Deepak Kumar
Mishra, Shiva Raj
Association of altitude and urbanization with hypertension and obesity: analysis of the Nepal Demographic and Health Survey 2016
title Association of altitude and urbanization with hypertension and obesity: analysis of the Nepal Demographic and Health Survey 2016
title_full Association of altitude and urbanization with hypertension and obesity: analysis of the Nepal Demographic and Health Survey 2016
title_fullStr Association of altitude and urbanization with hypertension and obesity: analysis of the Nepal Demographic and Health Survey 2016
title_full_unstemmed Association of altitude and urbanization with hypertension and obesity: analysis of the Nepal Demographic and Health Survey 2016
title_short Association of altitude and urbanization with hypertension and obesity: analysis of the Nepal Demographic and Health Survey 2016
title_sort association of altitude and urbanization with hypertension and obesity: analysis of the nepal demographic and health survey 2016
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7902681/
https://www.ncbi.nlm.nih.gov/pubmed/32623453
http://dx.doi.org/10.1093/inthealth/ihaa034
work_keys_str_mv AT mehatasuresh associationofaltitudeandurbanizationwithhypertensionandobesityanalysisofthenepaldemographicandhealthsurvey2016
AT shresthanipun associationofaltitudeandurbanizationwithhypertensionandobesityanalysisofthenepaldemographicandhealthsurvey2016
AT ghimiresaruna associationofaltitudeandurbanizationwithhypertensionandobesityanalysisofthenepaldemographicandhealthsurvey2016
AT atkinsemily associationofaltitudeandurbanizationwithhypertensionandobesityanalysisofthenepaldemographicandhealthsurvey2016
AT karkideepakkumar associationofaltitudeandurbanizationwithhypertensionandobesityanalysisofthenepaldemographicandhealthsurvey2016
AT mishrashivaraj associationofaltitudeandurbanizationwithhypertensionandobesityanalysisofthenepaldemographicandhealthsurvey2016