Prevalence, awareness, treatment and control of hypertension in Nepal: data from nationally representative population-based cross-sectional study

Abstract

Background
Previous studies in Nepal noted an alarming increase in prevalence of hypertension. However, these studies were geographically sparse and coverage of population, mostly limited to single site. The current study fills this gap by examining the current status of prevalence, awareness, treatment and control of hypertension, using recently collected population-based data.

Methods
We used the Nepal Demographic Health Survey 2016 data. Sample selection was based on stratified two-stage cluster sampling in rural areas and three stages in urban areas. Blood pressure was measured in all women and men aged 15 and above.

Results
A total of 13 598 participants: 5593 men and 8005 women aged 15–69 had their blood pressures measured. Overall, 18% (95% CI 16.7–19.2) of the participants aged 15–69 years were hypertensive. Prevalence of hypertension was more among men (22%; 95% CI 21.1–23.5), aged 45–69 years (34%), with no formal education (22%), richest quintile (25%), formerly/ever married (32%), urban dwellers (19%), residents of Province 4 (24%), residents of hills (21%), and obese (41.6%). Among the total hypertensive individuals, only 38% were aware of their hypertensive status and 18% were taking antihypertensive medication. Only half of the hypertensive participants on treatment (52%) had their blood pressure under control.

Conclusion
This nationally representative survey data showed that the prevalence of hypertension is high in Nepal, whereas its awareness, treatment and control rates are low at entire population level.

doi: 10.1097/HJH.0000000000001745

Effectiveness of interventions for reducing non-occupational sedentary behaviour in adults and older adults: a systematic review and meta-analysis

Abstract

Background
No systematic reviews of the effectiveness of interventions for reducing non-occupational sedentary behaviour are available. Therefore, the aim of this systematic review was to assess the effectiveness of interventions for reducing non-occupational sedentary behaviour in adults and older adults.

Methods
An electronic search of nine databases was performed. Randomised controlled trials (RCT) and cluster RCTs among adults testing the effectiveness of interventions aimed to reduce non-occupational sedentary behaviour were considered for inclusion. Two review authors independently screened studies for eligibility, completed data extraction and assessed the risk of bias.

Results
Nineteen studies that evaluated multicomponent lifestyle interventions, counselling or education, television (TV) control devices and workplace interventions were included. Evidence from the meta-analyses suggested that interventions can reduce leisure sitting time in adults in the medium term (−30 min/day; 95% CI −58 to –2), and TV viewing in the short term (−61 min/day; 95% CI −79 to –43) and medium term (−11 min/day; 95% CI −20 to –2). No significant pooled effects were found for transport sitting time, leisure-time computer use and longer term outcomes. No evidence was available on the effectiveness of interventions for reducing non-occupational sedentary time in older adults.

Conclusions
The findings of this systematic review suggest the interventions may be effective in reducing non-occupational sedentary behaviour in the short to medium term in adults. However, no significant effect was found on longer term outcomes. The quality of evidence was, however, low to very low. No evidence was available on the effectiveness of non-occupational interventions on reducing sedentary time in older adults. Further high-quality research with larger samples is warranted

Cite this article as: Shrestha N, Grgic J, Wiesner G, et al Effectiveness of interventions for reducing non-occupational sedentary behaviour in adults and older adults: a systematic review and meta-analysis Br J Sports Med Published Online First: 13 January 2018. doi: 10.1136/bjsports-2017-098270

The Impact of Obesity in the Workplace: a Review of Contributing Factors, Consequences and Potential Solutions

This narrative review summarized findings from previous reviews and the most recently published studies, regarding the following: (1) the association between two occupational risk factors—shift work and sedentary work—and obesity, (2) the effects of obesity on workplace productivity and (3) the effectiveness of workplace interventions aimed at preventing or reducing obesity. Despite some inconsistencies in findings, there is convincing evidence that shift work increases the risk of obesity, while most studies did not show a significant association between sedentary work and obesity. Overweight and obesity were found to be associated with absenteeism, disability pension and overall work impairment, whilst evidence of their relationship with presenteeism, unemployment and early retirement was not consistent. Due to the vast heterogeneity in the types of workplace-based interventions to prevent or treat obesity, no sound conclusions can as yet be drawn about their overall effectiveness and best practice recommendations for their implementation.

Full text can be found at: http://link.springer.com/article/10.1007/s13679-016-0227-6

Podcast

Most people would probably benefit from increasing the amount of physical activity that they do and one way to achieve this might be reducing the amount of time we spend sitting down at work. A new Cochrane Review from January 2015 looks at interventions that might help with this. Hear more about it from me at.. http://www.cochrane.org/podcasts/10.1002/14651858.CD010912.pub2

workplace sitting video

Workplace interventions for reducing sitting at work

Most jobs today are sedentary, requiring people to sit for long periods of time, even though there is growing interest in being more active. This is getting worse as advances in technology and increased peer pressure mean that many people do not leave their desk, even for communicating with their colleagues. Although doing the recommended levels of physical activity of 150 minutes of moderate-intensity aerobic exercise each week and resistance exercises twice a week outside of work can help, this is not enough. There is still an increased risk of premature mortality, cardiovascular disease, obesity and diabetes if one sits for prolonged periods. A Cochrane review titled “workplace interventions to reduce sitting at work” looked at ways to make it easier for people to sit less at work but, when we think of an average office, we can see how reducing sitting is a huge challenge. It might need changes to the architecture, new furniture, or changes in the office routine, which can be expensive and disruptive. This makes it even more important to find out that whether interventions that aim to reduce sitting, such as desks at which you can work while standing, actually do reduce sitting. The authors found some evidence that it might be possible to make a difference.

Full text can be found at:

http://onlinelibrary.wiley.com/doi/10.1002/14651858.C
D010912.pub2/abstract