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Journal Article Epublish

PubMed: 40721995 DOI: 10.1186/s12872-025-05025-8

The relationship between hypertension, anemia, and BMI in women of reproductive age: evidence from a nationwide health study.

BMC Cardiovasc Disord 25(1):553

Authors: Shiva Raj Acharya, Diwash Timilsina, Sandip Pahari, Sabitri Acharya, Navin Ray

Affiliations

  • National Clinical Research Center for Collaborative Medicine, Research Institute for Korean Medicine, Pusan National University, 20, Geumo-ro Mulgeum-eup, Yangsan, 50612, Republic of Korea. Yonsei University College of Medicine, Wonju, Republic of Korea.
  • Department of Health Informatics, Swansea University, Sketty, Swansea, UK.
  • School of Health and Allied Sciences, Pokhara University, Kaski, Nepal.
  • Sharda School of Nursing Science and Research, Sharda University, Greater Noida, India.
  • Department of Integrative Biomedical Sciences, Pusan National University, Yangsan, Korea.

Abstract

BACKGROUND

Hypertension, anemia, and malnutrition are significant global health challenges. While prior studies have primarily focused on the prevalence of these conditions in Nepal, no research has investigated the interrelationship among them. Therefore, this study aimed to investigate the association of hypertension with anemia, blood hemoglobin levels, and body mass index (BMI) among women of reproductive age.

METHODS

Using multilevel logistic regression models, we analyzed nationally representative data from the 2022 Nepal Demographic and Health Survey (NDHS). A total of 4,133 eligible women aged 15-49 were included in this study. Hypertension (systolic pressure ≥ 140 mmHg or diastolic pressure ≥ 90 mmHg), anemia (blood hemoglobin < 12 g/dl), and BMI categories were defined according to the World Health Organization (WHO) guideline. Student's t-test, Pearson's Chi-square, and linear regression analysis were performed in the analysis.

RESULTS

The mean age of the participants was 29.78 ± 9.61 years. The prevalence of hypertension was significantly higher in women without anemia than those with anemia (9.0% vs. 5.4%, p < 0.001). An inverse association was observed between hypertension and anemia (OR, 0.73; 95% CI: 0.55-0.96; p < 0.01). Increased hemoglobin levels (systolic: β, 1.24; 95% CI: 0.14-1.46; diastolic: β = 1.57, 95% CI: 1.38-1.71) and BMI (systolic: β = 0.89, 95% CI: 0.80-0.99; diastolic: β = 0.84, 95% CI: 0.68-0.92) were positively correlated with hypertension. Smoking, overweight, obesity, and increased mid-upper arm circumference (MUAC) were found to increase the risk of hypertension.

CONCLUSION

This study demonstrates a positive association between hypertension and BMI, while anemia was linked to a lower risk of hypertension. The findings suggest that higher hemoglobin levels may serve as an independent risk factor for hypertension. Therefore, regular screening of hemoglobin levels and BMI, along with interventions addressing dietary and lifestyle factors is recommended to mitigate the risk of hypertension.

MeSH

Hemoglobins, Hypertension, Blood, Anemia, Cardiovascular Diseases, Prevalence