Abstract: FR-PO557

Characterizing the Burden of Hypertension in High Alpine Himalayan Villages of Nepal

Session Information

Category: Hypertension

  • 1104 Hypertension: Clinical and Translational - Salt and Hypertension

Authors

  • Garlo, Katherine, Brigham and Women's Hospital , Boston, Massachusetts, United States
  • Charytan, David M., Brigham and Women's Hospital , Boston, Massachusetts, United States
Background

Villages in the Ganesh Himal mountains are located in a remote high altitude regions of the Himalayans where there is limited access to basic resources and medical care. The burden of hypertension (HTN) has never been assessed in these communities. The primary objectives of this evaluation were to determine the prevalence of HTN while providing clinical care at medical camps with Himalayan Healthcare (HHC).

Methods

We conducted a retrospective observational evaluation of adults ≥18 years living in Himalayan villages at ≥15,000 feet elevation who attended HHC clinics during the spring medical trek of 2017. HTN was defined as systolic (SBP) and diastolic blood pressure (DBP) ≥150/80 mmHg on two measurements by manual cuff. This cut off was selected given the limited medical resources available for treatment. Urine samples were sought for albumin and glucose in individuals with HTN.

Results

A total of 650 individuals (mean 50±19.9 years, 75%F) received care at the medical camps. BP was ≥150/80 mmHg in 43 patients (6.6%, mean age 65±13.8 years, 60%F) mean SBP among hypertensive patients was 172±18.3 mm Hg, and mean DBP was 96 ±11.6 mm Hg. There were 607 individuals (93.4%) without HTN (mean age 49 yrs ±19.8, 76%F, Table 1). Urine analysis was available in 48.8% of the HTN group of which 23.8% had trace albumin and 0.0% had glucosuria.

Conclusion

In high elevation Himalayan villages of Nepal the prevalence of HTN with BP ≥150/80mmHg was low but the severity of hypertension was high. Nearly one quarter of hypertensive individuals had albuminuria suggesting that end organ damage to the kidney is common. Our findings may under estimate the true prevalence of HTN given the predominance of females in the sample population and the high BP cut off. These results support a need for targeted interventions to diagnosis and manage HTN in high-altitude communities. They also have implications for public health policy in developing countries with limited resources.

Table 1: Blood Pressure in Ganesh Himal Villages of the Himalayan Mountains
 OverallSertung VillageLapa Village
All Individuals, N
Age years, (mean ±SD)
Sex, Female N (%)
650
50 ±19.9
488 (75.0)
346
51 ±20.2
249 (72.0)
304
48 ±19.4
238 (78.3)
BP ≥150/80, N (%)
Age years, (mean ±SD)
Sex, Female N (%)
43 (6.6)
64.8 ±13.8
26 (60)
19 (5.5)
62.6 ±19.1
12 (63.2)
24 (7.9)
66.5 ±13.4
14 (58.3)
BP <150/80, N (%)
Age years, (mean ±SD)
Sex, Female N (%)
607 (93.4)
49 ±19.8
461 (76.0)
327 (94.5)
50.8 ±20.3
237 (72.5)
280 (92.1)
46.9 ±14.3
224 (80.0)