Prevalence and Risk Factors of Elevated Blood Pressure, Overweight, and Dyslipidemia in Adolescent and Young Adults in Rural Nepal

Background: Chronic disease begins early in life, yet population data are sparse on potential causal factors in children and young adults in South Asia. Methods: We assessed risk factors for chronic disease in two population cohorts, aged 9-23 years, in rural Nepal. Assessed variables included short height (less than -2 z), high body mass index (BMI) (z>0.42), waist circumference (WC) >90cm (male) or 80cm (female) or age-adjusted child cutoff], high blood pressure (>120/80mmHg), fasting glucose (100mg/dL), glycosylated hemoglobin (HbA1c) (>7%), blood lipids [triglyceride, high-density lipoprotein cholesterol (HDL-C), and total cholesterol], diet, smoking, alcohol, and socioeconomic status (SES) factors. Results: The population was stunted (46%) and few were overweight (approximate to 2%-4% with high BMI or WC). Twelve percent had high blood pressure. Plasma hypertriglyceridemia (150mg/dL) affected approximate to 8.5%, and 78% had low HDL-C concentrations <40mg/dL (male) or <50mg/dL (female)], while few (3%) had elevated total cholesterol (180mg/dL), glucose, and HbA1c. Females were at higher risk than males for high blood pressure [odds ratio (OR) 1.9; 95% confidence interval (CI) 1.6-2.3] and overweight (4.2; 3.0-5.8), but had lower risk of dyslipidemia (0.7; 0.6-0.9). Ethnic plains Madheshi were less likely to be overweight (0.3; 0.2-0.4), but had greater risk of dyslipidemia (1.4; 1.1-1.7) versus those of Hill origin. Some dietary factors were significantly associated with high blood pressure or dyslipidemia, but not overweight. Conclusions: Dyslipidemia and high blood pressure are emerging health concerns among young adults in rural Nepal.