Hypertension Prevalence, Awareness and its Association with Sleep Quality and Stress among Adults in Semi-Urban District of Nepal

Abstract

Background: Hypertension is a major public health challenge globally, contributing to cardiovascular morbidity and mortality. Despite its rising prevalence, awareness, treatment, and control remain inadequate. Sleep quality and psychological stress are increasingly recognized as important correlates, yet evidence from Nepal is limited.

Methods: A community-based cross-sectional study was conducted among 300 adults in Ramgram Municipality, Nawalparasi District. Participants were selected using cluster sampling. Data were collected through face-to-face interview using the World Health Organization STEPS questionnaire, the Perceived Stress Scale, and the Pittsburgh Sleep Quality Index, along with anthropometric measurements. Associations between hypertension and socio-demographic, behavioral, and psychosocial factors were examined using chi-square test and logistic regression.

Results: The prevalence of hypertension was 36%, with awareness at 24% and 34.25% newly identified cases. Among hypertensive individuals, 59% were on treatment and 46% had controlled blood pressure. Age was the strongest predictor, with participants aged 61 years and above showing markedly higher odds (Adjusted Odds Ratio = 26.809, p < 0.001). Obesity was also strongly associated (AOR = 7.661, p = 0.001). Moderate salt intake (5–9 g/day) had protective (AOR = 0.168, p = 0.020) effect of hypertension. Poor sleep quality (AOR = 3.406, p < 0.001) and very poor sleep quality (AOR = 3.199, p = 0.044) significantly increased hypertension risk, while perceived stress showed a non-significant trend (AOR = 1.54, p = 0.172).

Conclusion: Hypertension is highly prevalent in semi-urban Nepali population, with low awareness and substantial hidden cases. Age, obesity, salt intake, and poor sleep quality were key determinants. Public health interventions focusing on lifestyle modification, awareness, and early detection are urgently needed to reduce the burden of hypertension in Nepal.