ArticlePloS one2020
Socioeconomic differentials in hypertension based on JNC7 and ACC/AHA 2017 guidelines mediated by body mass index: Evidence from Nepal demographic and health survey.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 20 citations in OpenAlex.
- Article
- Municipal deprivation and cardiometabolic outcomes in Mexican adults: findings from ENSANUT 2021-2023.International journal for equity in health · 2026Article
- Mediating pathways between area-level deprivation and hypertension in Nepal: the role of nutritional status, food insecurity, and health behaviors.BMC public health · 2025Article
- Metal Mixtures Mediate the Socioeconomic Gradient in Blood Pressure: A Four-Way Decomposition in a Prospective Rural Bangladeshi Cohort.medRxiv : the preprint server for health sciences · 2025Article
- Is gender a factor in socioeconomic disparities in undiagnosed, and untreated hypertension in Bangladesh?Journal of clinical hypertension (Greenwich, Conn.) · 2024Article
- Mediating effect of BMI on the association of economic status and coexistence of hypertension and diabetes in Bangladesh: A counterfactual framework-based weighting approach.Health science reports · 2024Article
- Decomposing the Poor-Non-Poor Gap in the Prevalence of Undiagnosed and Untreated Hypertension Among Bangladeshi Population.Global heart · 2024Article
- Article
- BMI mediates the association of family medical history with self-reported hypertension and diabetes among older adults: Evidence from baseline wave of the longitudinal aging study in India.SSM - population health · 2022Article
- QALY losses for chronic diseases and its social distribution in the general population: results from the Belgian Health Interview Survey.BMC public health · 2022Article
- Need for HTA supported risk factor screening for hypertension and diabetes in Nepal: A systematic scoping review.Frontiers in cardiovascular medicine · 2022Article
- Prevalence, awareness, treatment, and control of hypertension in Bangladesh: Findings from National Demographic and Health Survey, 2017-2018.Journal of clinical hypertension (Greenwich, Conn.) · 2021Article
- Socioeconomic Status and Its Relation to Hypertension in Rural Nepal.International journal of hypertension · 2021Article
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Authors and funding
5 authors at 5 institutions in 4 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundUnlike developed countries, higher socioeconomic status (SES-education, and wealth) is associated with hypertension in low and middle-income countries (LMICs) with limited evidence. We examined the associations between SES and hypertension in Nepal and the extent to which these associations vary by sex and urbanity. The body mass index (BMI) was examined as a secondary outcome and assessed as a potential mediator. MATERIALS AND
methodsWe analyzed the latest Nepal Demographic and Health Survey data (N = 13,436) collected between June 2016 and January 2017, using a multistage stratified sampling technique. Participants aged 15 years or older from selected households were interviewed with an overall response rate of 97%. Primary outcomes were hypertension and normal blood pressure defined by the widely used Seventh Report of the Joint National Committee (JNC7) and the American College of Cardiology/American Heart Association (ACC/AHA) 2017.
resultsThe prevalence of hypertension was higher in Nepalese men than women. The likelihood of being hypertensive was significantly higher in the higher education group compared with the lowest or no education group for men (OR 1.89 95% CI: 1.36, 2.61) and for women (OR 1.20 95% CI: 0.79, 1.83). People in the richest group were more likely to be hypertensive compared with people in the poorest group for men (OR 1.66 95% CI: 1.26, 2.19) and for women (OR 1.60 95% CI: 1.20, 2.12). The associations between SES (education) and hypertension were partially modified by sex and fully modified by urbanity. BMI mediated these associations.
conclusionsThe higher SES was positively associated with the higher likelihood of having hypertension in Nepal according to both JNC7 and ACC/AHA 2017 guidelines. These associations were mediated by BMI, which may help to explain broader socioeconomic differentials in cardiovascular disease (CVD) and related risk factors, particularly in terms of education and wealth. Our study suggests that the mediating factor of BMI should be tackled to diminish the risk of CVD in people with higher SES in LMICs.
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