Identification of Predictive Factors of BMI and High Risk Hypertension in Rural Nicaraguan Community

Abstract

Background: Cardiovascular disease is an increasing concern in Nicaragua and a growing number of organizations are working to confront it. Health needs assessments focusing on cardiovascular disease are a recommended first step in community-level work. In 2012, two non-governmental organizations, Salud Juntos and AMOS Health, collaborated to undertake a health needs assessment in a rural northern Nicaraguan community. Methods: Collaborators used adapted WHO STEPS and CDC BRFSS questions to create a survey tool to help identify health behaviors which may contribute to overweight/obesity or high risk hypertension in the community. Local community health workers conducted the survey in the small community and attempted universal sample of the adult population, ultimately reaching 91/114 adults. Anthropometric and blood pressure measures were included. Descriptive statistics and regression modeling were used to analyze the data. Results: Descriptive data revealed a community with low smoking and drinking, lack of screening for diabetes, and notable consumption of fried processed foods and sugary drinks. Males were also found to be, on average, more physically active than women. Women were found to have a three-fold higher prevalence of overweight and obesity than men. 20% of interviewees were found to be hypertensive, the majority of whom were untreated and previously undiagnosed. Our regression based analysis did enable us to identify any health behaviors as associated with the outcomes of BMI or high risk hypertension. Conclusion: We felt that the characterization chronic disease burden in the community through our survey methods and analysis yielded a useful starting point for intervention planning and implementation - likely focusing on hypertension treatment, and physical activity in women.