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July 18, 2016BMC Public Health61 citationsOpen Access

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

MBMarius B BjertnessUniversity of OsloAHAung Soe HtetUniversity of OsloHMHelmut E. MeyerUniversity College Dublin

Key Result

The prevalence of hypertension in Myanmar was 30.1% in males and 29.8% in females, with high BMI significantly increasing the odds of hypertension (males OR 2.6; females OR 2.3).

Study Design

Type

Cross-Sectional (n=7,429)

Multicenter

Yes

Structured PICO

P
Population
7,319 citizens of Myanmar aged 15-64 years, mean age 40.4, 39.1% male (n=2,862). Exclusions: pregnant women, mentally and physically too ill subjects, temporary residents (<6 months), armed forces personnel, prisoners, hospitalized patients, monks, and nuns.
O
Outcome
Prevalence of hypertension (defined as systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg, or currently taking antihypertensive medications)

Hypertension is highly prevalent (approximately 30%) among adults in Myanmar and is strongly associated with modifiable metabolic and behavioral risk factors such as high BMI, increased waist circumference, and physical inactivity.

Main Result

Effect estimate: OR 2.6 (males), OR 2.3 (females) for high BMI (95% CI 2.1-3.3 (males), 2.0-2.7 (females))

Limitations

  • Recall bias from self-reported lifestyle factors
  • Unknown extent of non-response bias
  • Selection bias due to selecting only household members at home during the visit
  • Exclusion of monks, nuns, and armed forces personnel
  • Missing information about salt intake (e.g., ngapi) and blood lipids

Abstract

BACKGROUND: 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. METHODS: 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). RESULTS: 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. CONCLUSIONS: 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.

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Cite This Study

Bjertness et al. (2016) conducted a cross-sectional in Hypertension (n=7,429). Risk factors (high BMI, high waist circumference) was evaluated on Prevalence and determinants of hypertension (OR 2.6 (males), OR 2.3 (females) for high BMI, 95% CI 2.1-3.3 (males), 2.0-2.7 (females)). The prevalence of hypertension in Myanmar was 30.1% in males and 29.8% in females, with high BMI significantly increasing the odds of hypertension (males OR 2.6; females OR 2.3).

synapsesocial.com/papers/6a09de70b0d552aa8b45ecc9https://doi.org/10.1186/s12889-016-3275-7
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