{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T07:10:25Z","timestamp":1769238625248,"version":"3.49.0"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2022,2,18]],"date-time":"2022-02-18T00:00:00Z","timestamp":1645142400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011099","name":"Center for Computational, Evolutionary and Human Genomics, Stanford University","doi-asserted-by":"publisher","award":["Seed Grant"],"award-info":[{"award-number":["Seed Grant"]}],"id":[{"id":"10.13039\/100011099","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012025","name":"New York University Abu Dhabi","doi-asserted-by":"crossref","award":["Faculty Research Fund"],"award-info":[{"award-number":["Faculty Research Fund"]}],"id":[{"id":"10.13039\/100012025","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Indigenous populations residing in low- and middle-income countries (LMICs) are highly underrepresented in medicine and public health research. Specifically, data on non-communicable diseases (NCDs) from indigenous populations remains scarce. Despite the increasing burden of NCDs in the Himalayan region, their prevalence in many indigenous populations remains understudied. The nationally representative public health surveys often do not include the indigenous communities, especially those that reside in rural areas or exist in small numbers. This observational cross-sectional survey study aimed to assess the prevalence of three NCD risk factors namely obesity, hypertension, and tachycardia and identify dietary and lifestyle variables associated with them across underrepresented indigenous populations of Nepal. A total of 311 individuals (53.3% women, 46.7% men) with mean age 43\u00b115 years from 12 indigenous Nepali communities residing in rural (47.9%) or semi-urban (52.1%) areas volunteered to participate in this study. Univariate tests and multivariable logistic regressions were used to analyze the survey data. The mean systolic and diastolic blood pressures were 121.3\u00b119.5 mmHg and 81.3\u00b111.8 mmHg respectively. Overall, the prevalence of obesity and tachycardia was low (0.64% and 3.22%, respectively) but hypertension was prevalent at 23.8%. Hypertension was not significantly different across populations, but it was associated with age, BMI, and tobacco use, and collectively, these variables explained 13.9% variation in hypertension prevalence. Although we were unable to detect direct associations between individual determinants of hypertension identified in non-indigenous Nepalis, such as education levels, alcohol consumption, and smoking in this study, having one or more determinants increased the odds of hypertension in the indigenous participants. Furthermore, ~14% of the hypertensive individuals had none of the universally identified hypertension risk factors. The lack of association between previously identified risk factors for hypertension in these individuals indicates that the additional determinants of hypertension remain to be identified in indigenous Nepali populations.<\/jats:p>","DOI":"10.1371\/journal.pgph.0000133","type":"journal-article","created":{"date-parts":[[2022,2,18]],"date-time":"2022-02-18T18:25:00Z","timestamp":1645208700000},"page":"e0000133","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Prevalence and determinants of hypertension in underrepresented indigenous populations of Nepal"],"prefix":"10.1371","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6312-2019","authenticated-orcid":true,"given":"Tsedenia Workneh","family":"Denekew","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9109-5732","authenticated-orcid":true,"given":"Yoshina","family":"Gautam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0979-1406","authenticated-orcid":true,"given":"Dinesh","family":"Bhandari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guru Prasad","family":"Gautam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeevan Bahadur","family":"Sherchand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6478-7442","authenticated-orcid":true,"given":"Amod K.","family":"Pokhrel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3227-1086","authenticated-orcid":true,"given":"Aashish R.","family":"Jha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,2,18]]},"reference":[{"issue":"5","key":"pgph.0000133.ref001","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1093\/heapol\/czz043","article-title":"The process of prioritization of non-communicable diseases in the global health policy arena","volume":"34","author":"O Heller","year":"2019","journal-title":"Health policy and planning"},{"issue":"10","key":"pgph.0000133.ref002","doi-asserted-by":"crossref","first-page":"e1295","DOI":"10.1016\/S2214-109X(19)30370-5","article-title":"The rising burden of non-communicable diseases in sub-Saharan Africa","volume":"7","author":"JJ Bigna","year":"2019","journal-title":"The Lancet Global Health"},{"issue":"1","key":"pgph.0000133.ref003","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2017-000535","article-title":"Evaluation of research on interventions aligned to WHO \u2018Best Buys\u2019 for NCDs in low-income and lower-middle-income countries: a systematic review from 1990 to 2015","volume":"3","author":"LN Allen","year":"2018","journal-title":"BMJ global health"},{"issue":"2","key":"pgph.0000133.ref004","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2458-14-S2-S1","article-title":"NCDs in low and middle-income countries-assessing the capacity of health systems to respond to population needs","volume":"14","author":"P Allotey","year":"2014","journal-title":"BMC public health"},{"issue":"1","key":"pgph.0000133.ref005","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1478-4505-11-31","article-title":"The financial burden from non-communicable diseases in low-and middle-income countries: a literature review","volume":"11","author":"HT Kankeu","year":"2013","journal-title":"Health Research Policy and Systems"},{"issue":"2","key":"pgph.0000133.ref006","doi-asserted-by":"crossref","first-page":"e134","DOI":"10.1016\/S2214-109X(17)30493-X","article-title":"Indigenous languages and global health","volume":"6","author":"D Flood","year":"2018","journal-title":"The Lancet Global Health"},{"issue":"1","key":"pgph.0000133.ref007","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12939-017-0521-2","article-title":"Engaging with complexity to improve the health of indigenous people: a call for the use of systems thinking to tackle health inequity","volume":"16","author":"A Hern\u00e1ndez","year":"2017","journal-title":"International Journal for Equity in Health"},{"issue":"120","key":"pgph.0000133.ref008","doi-asserted-by":"crossref","first-page":"n120","DOI":"10.14507\/epaa.v23.2052","article-title":"The World Indigenous Research Alliance (WIRA): Mediating and Mobilizing Indigenous Peoples\u2019 Educational Knowledge and Aspirations","volume":"23","author":"P Whitinui","year":"2015","journal-title":"education policy analysis archives"},{"key":"pgph.0000133.ref009","unstructured":"National Foundation for Development of Indigenous Nationalities (NFDIN): an introduction. 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