Gender with marital status, cultural differences, and vulnerability to hypertension: Findings from the national survey for noncommunicable disease risk factors and mental health using WHO STEPS in Bhutan

Cardiovascular disease is the leading cause of death in the Kingdom of Bhutan. Thus, the early detection and prevention of hypertension is critical for reducing cardiovascular disease. However, the influence of sociocultural factors on vulnerability to hypertension needs further investigation. This study performed secondary data analysis on 1,909 individuals in a cross-sectional study (the National survey for noncommunicable disease risk factors and mental health using World Health Organization (WHO) STEPS approach in Bhutan– 2014). Multivariate logistic regression demonstrated a significant association between gender with marital status and hypertension. Women had a higher odds ratio than men (Ref) when married (AOR: 1.27, 95% confidence intervals (CI): 1.23–1.31), and when separated, divorced, or widowed (AOR: 1.18, 95% CI: 1.12–1.26). People who speak the Tshanglakha language scored the highest odds (AOR: 1.24, 95% CI: 1.20–1.27), followed by Lhotshamkha (AOR: 1.09, 95% CI: 1.06–1.12) and Dzongkha (Ref) after adjusting for various social and biomedical factors. Additionally, tobacco use displayed decreased odds for hypertension. To promote the early detection and prevention of hypertension, these cultural factors should be considered even within small geographic areas, such as Bhutan. It is necessary to strengthen hypertension preventive strategies for people who speak Tshanglakha and Lhotshamkha. Furthermore, careful consideration should be given to preventing hypertension among adults aged 40 years or more, women who are married, separated, divorced, or widowed, and men who never married in Bhutan.

Desigualdades étnicas y de género en la prevalencia de presión arterial elevada en población general de Cochabamba: un análisis interseccional de inequidades en salud en salud

Introducción: Las desigualdades en salud comúnmente son evaluadas en una sola dimensión de análisis y poco se conoce sobre el efecto sumativo o multiplicativo cuando se combinan 2 o más dimensiones sociales; representando un desafío para la prevención y control de la Presión Arterial Elevada (PAE). Objetivo. Analizar los factores involucrados en las desigualdades poblacionales de la prevalencia de PAE en el espacio inter seccional de los procesos de ventaja y desventaja social por referencia étnica y de género. Métodos. Estudio observacional, de corte transversal con enfoque interseccional. Participaron sujetos mayores de 18 años con residencia permanente en Cochabamba (n=10595), seleccionados mediante muestreo aleatorio trietápico. Se utilizó la encuesta WHO-STEPS para recopilar información sobre PAE y factores de riesgo asociados. Se construyeron cuatro posiciones interseccionales por la combinación de género y etnicidad. La descomposición de Oaxaca-Blinder se aplicó para estimar las contribuciones de los factores explicativos de las desigualdades. Resultados. La prevalencia de PAE fue mayor en los hombres-mestizos (10,76%); la disparidad por referencia de género fue más importante entre mestizos (3,74%) e indígenas (3,11%); la disparidad interseccional entre grupos extremos (3,53%) fue mayor a la disparidad entre grupos medios (3,32%). La edad, el tipo de trabajo y estilos de vida, contribuyeron más para explicar estas diferencias. Conclusiones. La PAE no se distribuye según los patrones esperados de desventaja social en el espacio interseccional de etnicidad y género. Una alta ventaja social se relacionó con prevalencias más altas de PAE, así como los factores de riesgo de comportamiento asociados.

Prevalence of Risk Factors of Noncommunicable Diseases in 12 Barangays of the AMIGA Municipalities of Cavite

Objective. This study aims to determine the prevalence of risk factors of non-communicable diseases (NCDs) in 16barangays of the AMIGA municipalities of Cavite. Methods. The research is a cross-sectional study. Randomly chosen participants were interviewed using a translatedversion of the WHO Steps questionnaire. Interviewees were then invited to participate in another session wheretheir anthropometric measurements were taken and their fasting blood sugar and cholesterol levels were determined. Results. The research was done in 12 out of the 16 targeted barangays. A total of 1,527 participants were interviewedand 1,123 of them completed the study. The most significant findings in all 12 barangays were a very high rate ofpassive smoking (range of 60-80%); a relatively high proportion of respondents with obesity by all 3 parameters(BMI 29-52%; waist circumference 42-78%; and waist-to-hip ratio 41-78%) despite sufficient intake of fruits andvegetables and more than adequate physical activity; and a high proportion of participants with hypertension (morethan 30% in 8 out of 12 barangays) and diabetes mellitus (more than 8% in 7 out of 12 barangays). Conclusion. A high prevalence of risk factors of NCDs, particularly obesity, hypertension, and diabetes was foundin the 12 barangays of AMIGA that participated in the study. Results of this study should provide the baseline dataagainst which the success of an ongoing program in the area can be measured.

Are risk factors for non-communicable diseases in adolescents a problem in senior high schools in Accra?

Background: We assessed risk factors of noncommunicable diseases (NCDs) among adolescents in a senior high schoolDesign: We conducted a cross-sectional study in 2016Setting: Senior High School in AccraParticipants: Adolescents in senior high schoolInterventions: Adolescents were interviewed with a structured questionnaire designed using the WHO STEPS framework. Data on tobacco use, alcohol consumption, physical activity and physical measurements of respondents were taken.Main outcome measures: risk factors of noncommunicable diseases among adolescentsResults: A total of 360 adolescents in the school were assessed. Mean age was (17±1.21) years with minimum age being 13 and maximum 19 years. Females were 51% (184/360). About 75% (271/360) reported low physical activity, 15% (55/360) were overweight or obese (95%CI: 0.0317-0.078), 7.0% (25/360) consumed alcohol (95%CI: 0.054-0.111) and 2.5% (9/360) smoked tobacco (95%CI: 0.013- 0.048). Majority of the respondents (346/360) were exposed or at risk of developing at least one risk factor. However, no one was found to be at risk of all five risk factors assessed. Females were three times more likely to be overweight or obese compared to their male counterparts (OR:3,95%CI:1.581-5.624)Conclusion: We found that majority of the children had low physical activity and more than 90% of the respondents had at least one NCD risk factor.Keywords: noncommunicable diseases, risk factors, physical activity, tobacco use, consumption of alcoholFunding: This work was funded by the authors

Descriptive profile of risk factors for cardiovascular diseases using WHO STEP wise approach in Madhya Pradesh

Background Periodic information on risk factor distribution is critical for public health response for reduction in non-communicable disease (NCDs). For this purpose, the WHO has developed STEPs wise approach. State representative population-based STEPS survey was last conducted in 2007–08 in seven states of In India. Since then no such work has been reported from low ETL states. This survey was carried out to assess the prevalence of risk factors associated with NCDs and the prevalence of NCDs in the low ETL state of Madhya Pradesh using the WHO STEPs approach. Methods A total of 5680 persons aged 18–69 years were selected from the state of Madhya Pradesh using multi-stage cluster random sampling. Using the WHO STEPs approach, details were collected on demographics, STEP 1 variables (tobacco consumption, alcohol consumption, physical activity, diet), STEP 2 variables (weight, height, waist circumference, blood pressure) and STEP 3 variables (fasting blood glucose, blood cholesterol). Results We found that 9.4% individuals smoked tobacco, 15.3% were overweight/obese, 22.3% had hypertension, and 6.8% have diabetes mellitus. As compared to women, men were less likely to be overweight or obese, but more likely to smoke tobacco, and have diabetes mellitus. Hypertension was also more common in men. Overall, about a fourth of all adults had three or more risk factors for cardiovascular disease. Conclusion The survey shows that a large section of the population from Madhya Pradesh is either suffering from NCDs or have risk factors which predispose them to acquire NCDs. This state representative survey provides benchmarking information for behavioural and biological risk factor distribution for recently scaled up National Programme for the Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS).

Prevalence and correlates of prehypertension and hypertension among adults in Delta State, Nigeria: a cross-sectional community-based study

Background: There are indications that prehypertension precedes hypertension. Like hypertension, it is associated with increased cardiovascular risk.Objective: To determine the prevalence, awareness and correlates of prehypertension and hypertension among adults in Delta State, Nigeria. Methods: This was a cross-sectional study. We recruited adults aged ≥18 years from two communities in Delta State, Nigeria, using the multi-stage sampling technique. The study instrument was a modified WHO-STEPS questionnaire.Prehypertension and hypertension were defined using the JNC-7 criteria. Ethical approval was obtained before the recruitment of participants. Results: Of the 852 adults studied, the mean (±SD) age was 42.64 (±16.07) years, females (55.9%) and urban dwellers (55.8%). The prevalence of prehypertension and hypertension were 42.5% and 29.3%, respectively; both were higheramong urban dwellers. The peak age-group for prehypertension and hypertension were 25-34 and 35-44 years, respectively. Awareness of hypertension was low; 12.0% (102/852). Blood pressure category significantly correlatedwith age, body mass index, place of residence, level of education, employment status and fruit intake. Conclusion: The prevalence of prehypertension and hypertension in this study were high. Based on the premise that prehypertension is a precursor of hypertension and occurred more among youths, the higher prevalence of prehypertensiongives an inkling to rising prevalence of hypertension. Keywords: Prehypertension, hypertension, adults, Nigeria, WHO STEPS Funding: Nil