38.5 % of respondents were classified as hypertensive and 42.5 % as overweight.

Urban residents had a higher probability of being obese and having hypertension.

High obesity and hypertension rates were clustered in central and eastern Nepal.

Low obesity and hypertension rates were found in western Nepal.

Sociodemographic and geographic factors, obesity, and hypertension interact.

Overweight/obesity and hypertension pose significant global health challenges. This study examines the spatial distribution, sociodemographic determinants, and clustering patterns of these conditions in Nepal.

We conducted a comprehensive spatial-epidemiological analysis of 136,235 participants from the 2022 Nepal Demographic and Health Survey. Outcome variables in this study were overweight/obesity (present/absent) and hypertension (present/absent). A weighted descriptive and inferential analysis addressed the complex survey design and non-response rate. We used spatial scan statistics to identify areas with higher or lower-than-expected cases, and geospatial mapping to illustrate the distribution of cases and the significant spatial clusters. Multivariable logistic regression models determine the association between the outcome variables and respondents’ age, gender, marital status, education level, and wealth.

Overall, 42.5 % of respondents were obese, and 38.5 % had hypertension. Respondents who were women, middle-aged, married, educated, wealthy, and living in cities had higher odds of being overweight. Similarly, respondents who were male, older, single, poor, uneducated, and lived in cities had higher odds of having hypertension. A spatial scan statistic using the Bernoulli model identified twelve (seven low and five high rate) significant clusters for obesity and eleven (five low and six high rate) for hypertension.

This study showed the utility of health risk mapping across Nepal, emphasizing the complex interaction between sociodemographic and geographic factors impacting the prevalence of obesity and hypertension. The findings highlighted the need for targeted interventions in the high-risk regions of Nepal based on the identified risk factors to mitigate the impact.

Obesity

Hypertension

Spatial analysis

Clustering

Sociodemographic factors

© 2025 The Author(s). Published by Elsevier Ltd.