Objectives:
The aim of this study was to assess the status of cardiovascular health among a semi-urban population in Western Nepal and determine the factors associated with ideal cardiovascular health.

Methods:
A population-based cross-sectional study was conducted among 2,310 adults among the population aged ≥25 years in Pokhara-Lekhnath Metropolitan area in Western Nepal. The ideal, intermediate and poor cardiovascular health was defined as presence of 6–7, 4–5 and 1–3 ‘health metrics index’, respectively among a list of risk factors: current smoking, body mass index, physical activity, fruits and vegetables intake, harmful alcohol use, blood pressure, and fasting glucose levels. We used univariate and multivariable Poisson regression models adjusting for sex, age groups, ethnicity, education level and socioeconomic status and calculated the prevalence ratios with 95% Confidence Intervals (CIs).

Results:
Only 14.3% of the participants had ideal cardiovascular health, whereas 67.0% and 18.7% of the participants had intermediate and poor cardiovascular health, respectively. Age groups 45–54 years (prevalence ratio 0.88, 95% CI: 0.83 to 0.94, P < 0.001) and 55–64 years (prevalence ratio 0.84, 95% CI: 0.79 to 0.90, P < 0.001) were associated with low prevalence of ideal cardiovascular health compared to the age group 35–44 years. Moreover, being male (prevalence ratio 0.83, 95% CI: 0.77 to 0.99, P < 0.001) and Indigenous ethnicity (prevalence ratio 0.89, 95% CI: 0.85 to 0.93, P < 0.001) were associated with low prevalence of ideal cardiovascular health.

Conclusion:
A low ideal cardiovascular health and higher intermediate cardiovascular health prevalence demonstrates a slowly maturing cardiovascular disease epidemic in Nepal. Urgent efforts are needed to counter rapidly deteriorating cardiovascular health.