Prevalence and factors associated with elevated blood pressure among age 15 above in federally administered tribal areas of Pakistan

Date of Award


Document Type


Degree Name

Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)


Community Health Sciences


Hypertension is the commonest cardiovascular disorder, which is globally the leading contributor to the burden of disease. It has emerged as major public health problem in developing countries including Pakistan. Proportional mortality of cardiovascular diseases in Pakistan is 12%. National health Survey of Pakistan estimates the prevalence of elevated blood pressure to be 17.9% in age 15 and above in all the four provinces, but has not included The Federally Administered Tribal Areas of Pakistan in the survey because of inaccessibility and limited resources. Moreover, no study on elevated blood pressure on FATA was available, so there was need to assess the prevalence and associated factors in this distinct area having population of 3.1 million. A cross sectional study was conducted during July-September 1999, among 729 individuals of age 15 and above in The Federally Administered Tribal Areas of Pakistan and only pregnant women were excluded from the study. A pre-tested questionnaire in local language (Pushtho) with informed consent was administered with the help of trained interviewers to assess the prevalence and factors associated with the elevated blood pressure. The principal investigator took the measurements of blood pressure, height and weight of the males and trained female health personnel took the measurements of females per tradition of the area. The fasting blood glucose, cholesterol, high density lipoprotein and low density lipoprotein tests were done in the laboratory of the Khyber Medical College, Peshawar. The prevalence of elevated BP i.e. ≥ 140/90 mm Hg among all respondents was 4.91%, while the prevalence of fasting cholesterol ≥ 200 mg/dl and fasting blood glucose ≥ 126 mg/dl was 215% and 4.7% respectively. According to AKU anxiety and depression scale with the cutoff rate of ≥ 19 score, the prevalence of anxiety and depression was 50.3 % among total respondents. In multivariate analysis gender, age, BMI and family history of hypertension in first degree relatives were important variables and additive interaction between age and sex was noted during analysis. The high prevalence of elevated blood pressure in the present study indicates that immediate steps should be taken to confirm the clinical status of FATA population. Preventive efforts should be focused on the control of obesity status of FATA residents and should be health educated about the harmful effects of traditional dietary habits and sedentary lifestyles. Primary level intervention and monitoring of high-risk group people like having positive family history of elevated blood pressure should be done. More prevalence studies and future research is recommended to identify the socio-culturally-appropriate interventions to change their unhealthy lifestyle.

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