Hypertension and its determinants among adults in high mountain villages of the Northern Areas of Pakistan

We studied the prevalence and determinants of hypertension among adults in mountainous rural villages in the Ghizar district Northern Areas of Pakista n, an area that recently has undergone substantial economic development. We selected a stratified random sample of 4203 adults (age >18 years) from 16 villages in Punial Valley of Ghizar district where the number of study sub jects from each village was proportionate to the sire of the village. We ob tained blood pressure (BP) records by taking the mean of the second and thi rd BP measurement, using a standard mercury sphygmomanometer, and assessed risk factors for hypertension in the study subjects. The mean +/- s.d. bloo d pressures (mm Hg) were 125 +/- 19 systolic and 80 +/- 12 diastolic in men and 125 +/- 22 systolic and 78 +/- 14 diastolic in women, The 125 +/- 22 s ystolic and 78 rt 14 diastolic in women. The mm Hg, or systolic BP greater than or equal to 140 mm Hg or currently taking antihypertensive medication) was 15%, increasing from 4% in the 18-29 year age group to 36% among perso ns 60 years of age or older. The age-standardised prevalence of hypertensio n was 14% (12.5% among men and 14% among women). There was no significant d ifference in prevalence of hypertension in males, and in females. Multivari ate analysis revealed that age, and higher body mass index (overweight and obesity) were independently associated with higher prevalence of hypertensi on. People with hypertension were more likely to have a first-degree relati ve with physician-diagnosed hypertension (OR = 1.90, 95% CI 1.49, 2), Hyper tension is a significant health problem in rural northern Pakistan, The pri mary health care programme in the Northern Areas of Pakistan needs to addre ss this problem, especially identifying people at risk.