Intertwined risk factors of mental health and cardiovascular diseases: A Cross-sectional survey in Godawari Municipality of Far-western Nepal
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Introduction
Cardiovascular diseases (CVDs) are the leading global cause of death, whereas mental disorders account for one-third of all global disabilities. The significant relationship between these two giant co-morbidities, and their risk factors, is intertwined, and bidirectional. However, these relational factors are less explored in the Nepalese context. Hence, we aimed to determine the prevalence of mental health status and its associated factors among people with and without cardiovascular disease risk factors.
Methods
A community-based study was carried out during Sep-Nov 2024, among 390 people aged 30-69 years with and without cardiovascular disease risk factors in Godawari Municipality, Kailali. We Data was collected with face-to-face interviews using a structured questionnaire consisting of four sections: a) socio-demographic characteristics; b) CVD risk factors; c) mental health status; and d) anthropometric measurements. Data was collected using the KoboToolbox mobile application and imported into SPSS software for statistical analysis. We present categorical variables as frequency and percentage and continuous variables as median and quartiles. We applied univariate and multivariate logistic regression to determine factors associated with depression symptoms, anxiety, and stress. The result of logistic regression was presented as crude odds ratio, adjusted odds ratio (AOR), beta coefficients (β), and their 95% confidence interval, and p-values.
Results
The prevalences of depression, anxiety and stress symptoms were found 47.2%, 62.3% and 55.1%, respectively. From multivariate logistic regression analysis, depression symptoms were positively associated with females (β = 1.002, p < .001), and presence of 1 CVDs risk factor (β = 1.082, p = .016), 2 risk factors (β = 1.362, p = .006), and ≥ 3 risk factors (β = 1.720, p = .017). Anxiety symptoms were associated with exposure to secondhand smoking (β = 0.725, p = .024), and presence of 1 risk factor (β = 1.548, p < .001), 2 risk factors (β = 1.734, p < .001), and ≥ 3 risk factors (β = 1.852, p = .022). Dalit, Janajati and Madhesi (β = 0.735, p = .026), and presence of 1 risk factor (β = 1.811, p = .001), two risk factors (β = 2.054, p = .016), and ≥ 3 risk factors (β = 2.138, p < .001) were associated with stress symptoms.
Conclusion
The study revealed that nearly fifty percent of the prevalence of each of depression, anxiety, and stress symptoms among people with and without cardiovascular disease risk factors. Mental health screening is warranted among the people with two and above CVD risk factors.
