Prevalence of hypertension and prehypertension in Nepal: a systematic review and meta-analysis

Abstract Background Studies regarding blood pressure of Nepal have demonstrated a contrasting prevalence. We aimed at providing a generalized estimate of the prevalence of hypertension and prehypertension in urban, suburban, and rural areas of Nepal. Methods This systematic review followed PRISMA guidelines. A thorough search of PubMed, EMBASE, and Web of Science was performed, and studies satisfying the eligibility criteria were reviewed. Pooled prevalence was calculated by random-effects model, and the sources of heterogeneity were explored with meta-regression and subgroup analysis. Results Twenty-three studies with 99,792 subjects were identified, and the estimated rate of hypertension and prehypertension were found to be 27.3% (95% CI: 23.8–30.9) and 35.4% (30.3–40.8). The prevalence of hypertension was 28.4% (22.4–34.7), 25.5% (21.4–29.8), and 24.4% (17.9–31.6) among urban, suburban, and rural populations, respectively. Moreover, rates of hypertension were found to be substantially higher in male (31.6%, 27.3–36.1) compared to female (20.0%, 14.2–26.6), and significantly higher among the middle-aged (≥40 years; 36.8%, 29.4–44.5) than among younger adults (< 40 years; 13.2%, 9.2–17.7). Further, prehypertension prevalence was found to be highest in rural areas (40.4%, 25.4–56.4) followed by urban areas (29.3%, 20.8–38.5) and lowest in suburban areas (25.5%, 18.9–32.7). Conclusions Our study identified an alarming situation of hypertension among Nepalese males and middle-aged, and a situation of concern with prehypertension in rural areas affecting almost 40 % of the population.