Implications of the dissemination of healthy lifestyle advice for Afghan adults without histories of hypertension diagnosis or treatment

Halimzai, Iftikhar and Nakamura, Keiko and Seino, Kaoruko and Miyashita, Ayano and Hemat, Shafiqullah and Alemi, Sharifullah and Saeedzai, Sayed Ataullah (2025) Implications of the dissemination of healthy lifestyle advice for Afghan adults without histories of hypertension diagnosis or treatment. Journal of Rural Medicine, 20 (2). pp. 102-111. ISSN 1880-487X (In Press)

Abstract

Objectives: This study explored the relationship between receiving healthy lifestyle advice from healthcare providers and hypertension among undiagnosed individuals in Afghanistan, defined as adults with no previous hypertension diagnosis or treatment history. Materials and Methods: Data were extracted from the 2018–19 Afghanistan National Non-Communicable Diseases Risk Factors Survey, comprising 2,838 participants. Outcomes included hypertension (systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg) and elevated blood pressure (systolic blood pressure 120–129 mmHg and diastolic blood pressure <80 mmHg). Bivariate and multivariable multinomial logistic regression analyses were conducted to assess associated factors. Results: Among the 2,838 participants, 1,344 (47.4%) had hypertension and 344 (12.1%) had elevated blood pressure. Most participants were aged <40 years (63.8%), male (55.8%), and ever-married (80.2%). Multivariable analysis revealed that not receiving healthy lifestyle advice was significantly associated with hypertension (adjusted relative risk ratio [aRRR]=1.24; 95% confidence interval [CI]: 1.04–1.47) and elevated blood pressure (aRRR=1.40; 95% CI: 1.08–1.81). Sociodemographic and behavioral factors such as age, sex, marital status, education, occupation, fruit consumption, physical activity, and excess weight were significantly associated with hypertension, whereas only sex and excess weight were significantly associated with elevated blood pressure. Conclusion: Our findings underscore the association between receiving healthy lifestyle advice from healthcare providers and a lower prevalence of hypertension among undiagnosed Afghan adults. Accordingly, healthcare providers should recommend lifestyle changes to help manage hypertension among adults.