Prevalence and determinants of hypertension in Myanmar - a nationwide cross-sectional study

• Published in: BMC public health Vol. 16; no. 1; p. 590
• Main Authors: Bjertness, Marius B, Htet, Aung Soe, Meyer, Haakon E, Htike, Maung Maung Than, Zaw, Ko Ko, Oo, Win Myint, Latt, Tint Swe, Sherpa, Lhamo Y, Bjertness, Espen
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 18.07.2016; BioMed Central; BMC
• Subjects: Adolescent; Adult; Alcohol; Alcohol Drinking - adverse effects; Alcohol Drinking - epidemiology; Blood pressure; Body Mass Index; Body size; Cardiovascular diseases; Cerebrovascular diseases; Confidence intervals; Cooking; Coronary artery disease; Cross-Sectional Studies; Demographics; Disease; Distribution; Economic development; Economic growth; Economics; Female; Females; GDP; Gender; Graph theory; Gross Domestic Product; Heart diseases; Heart rate; Households; Humans; Hypertension; Hypertension - epidemiology; Hypertension - etiology; Ischemia; Life expectancy; Malaria; Male; Males; Methods; Middle Aged; Minority & ethnic groups; Myanmar - epidemiology; NCD risk factors; Obesity - complications; Oils & fats; Physical activity; Population; Prevalence; Prevalence studies (Epidemiology); Public health; Questionnaires; Regression analysis; Risk analysis; Risk Factors; Risk taking; Rural areas; Sesame oil; Smoking; Smoking - adverse effects; Smoking - epidemiology; Statistical analysis; Tobacco; Tuberculosis; Underweight; Urban areas; Urbanization; Vector-borne diseases; Waist Circumference; Womens health; Young Adult; Myanmar; Myanmar (Burma); Hypertension; Myanmar; Waist circumference; Body-mass index; Alcohol; NCD risk factors; Nationwide; Smoking
• DOI: 10.1186/s12889-016-3275-7
• ISSN: 1471-2458

Non-communicable diseases (NCDs), malaria and tuberculosis dominate the disease pattern in Myanmar. Due to urbanization, westernized lifestyle and economic development, it is likely that NCDs such as cerebrovascular disease and ischemic heart disease are on a rise. The leading behavioral- and metabolic NCDs risk factors are tobacco smoke, dietary risks and alcohol use, and high blood pressure and body mass index, respectively. The study aimed at estimating the prevalence and determinants of hypertension, including metabolic-, behavioral- and socio-demographic risk factors. A nationwide, cross-sectional study of 7429 citizens of Myanmar aged 15-64 years were examined in 2009, using the WHO STEPS methodology. In separate analyses by gender, odds radios (ORs) and 95 % confidence intervals (CIs) for determinants of hypertension were estimated using logistic regression analyses. Confounders included in analyses were chosen based on Directed acyclic graphs (DAGs). The prevalence of hypertension was 30.1 % (95 % CI: 28.4-31.8) in males and 29.8 % (28.5-31.1) in females. The mean BMI was 21.7 (SD 4.3) kg/m(2) for males and 23.0 (5.1) kg/m(2) for females. In fully adjusted analyses, we found in both genders increased OR for hypertension if the participants had high BMI (males: OR = 2.6; 95 % CI 2.1-3.3, females: OR = 2.3; 2.0-2.7) and high waist circumference (males: OR = 3.4; 1.8-6.8, females: OR = 2.7; 2.2-3.3). In both sexes, associations were also found between hypertension and low physical activity at work, or living in urban areas or the delta region. Being underweight and use of sesame oil in cooking was associated with lower odds for hypertension. The prevalence of hypertension was high and associated with metabolic-, behavioral- and socio-demographic factors. Due to expected rapid economic growth in Myanmar we recommend similar studies in the future to follow up and describe trends in the risk factors, especially modifiable factors, which will most likely be on rise. Studies on effectiveness on interventions are needed, and policies to reduce the burden of NCD risk factors should be implemented if proven effective in similar settings.