Abstract
Cardiovascular disease is the leading cause of death in the Kingdom of Bhutan. Thus, the early detection and prevention of hypertension is critical for reducing cardiovascular disease. However, the influence of sociocultural factors on vulnerability to hypertension needs further investigation. This study performed secondary data analysis on 1,909 individuals in a cross-sectional study (the National survey for noncommunicable disease risk factors and mental health using World Health Organization (WHO) STEPS approach in Bhutan- 2014). Multivariate logistic regression demonstrated a significant association between gender with marital status and hypertension. Women had a higher odds ratio than men (Ref) when married (AOR: 1.27, 95% confidence intervals (CI): 1.23-1.31), and when separated, divorced, or widowed (AOR: 1.18, 95% CI: 1.12-1.26). People who speak the Tshanglakha language scored the highest odds (AOR: 1.24, 95% CI: 1.20-1.27), followed by Lhotshamkha (AOR: 1.09, 95% CI: 1.06-1.12) and Dzongkha (Ref) after adjusting for various social and biomedical factors. Additionally, tobacco use displayed decreased odds for hypertension. To promote the early detection and prevention of hypertension, these cultural factors should be considered even within small geographic areas, such as Bhutan. It is necessary to strengthen hypertension preventive strategies for people who speak Tshanglakha and Lhotshamkha. Furthermore, careful consideration should be given to preventing hypertension among adults aged 40 years or more, women who are married, separated, divorced, or widowed, and men who never married in Bhutan.
Highlights
According to the World Health Organization (WHO), 38 million people die from noncommunicable diseases (NCDs) annually
Regarding gender with marital status, never-married men (AOR: 2.22; 95% confidence intervals (CI): 1.23–4.01) displayed increased odds of acquiring hypertension compared to married or cohabitant men [Reference: AOR:1]
In contrast to the whole sample, multivariable analysis of the weighted data from adults aged 40 years or more (Table 4) revealed five servings of fruit and vegetables or less per day (AOR: 1.21; 95% CI: 1.16–1.27) increased the odds of having hypertension
Summary
According to the World Health Organization (WHO), 38 million people die from noncommunicable diseases (NCDs) annually. The increase in NCDs has led to an economic burden on individuals, families, society, and the global community [2]. Hypertension is the most critical global risk factor for morbidity and mortality, being one of the strongest risk factors for most forms of cardiovascular disease acquired during one’s lifetime. Asymptomatic changes in several organs associated with hypertension are a vital indicator of the continued progression of cardiovascular disease [3]. Strategies such as screening, early detection, counseling, and continued follow-up of people with hypertension are required to prevent cardiovascular-related diseases [4]. Several studies have reported that hypertension is significantly related to chronic stress, race, place of residence, and social factors [4,5,6,7,8,9]
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