Hypertension In Thailand Research Articles

The Association between Moderate Physical Activity and Stress in Thai Older Adults with Hypertension

Background: Hypertension is a serious health concern for Thailand’s aging population. Although moderate physical activity is beneficial to physical and mental health, there are limited studies to specifically examine the relationship between physical activity and stress among older adults with hypertension in Thailand. Methods: This cross-sectional study was conducted from December 2022 to June 2023 through face-to-face interviews by questionnaires. Multiple logistic regression was employed to investigate the associations between moderate physical activity and stress. Results: The study included203 older adults with hypertension. The majority of the participants were female (78.82%) and aged over 69 years (69.46%). Moderate physical activity was reported by 36.45%, while 10.34% experienced stress. Older adults with hypertension who engaged in moderate physical activity were 93% less likely to experience stress compared to those who did not (AOR=0.07, 95% CI: 0.01 - 0.98, p=0.048). Additionally, those who graduated higher education levelwere less likely to experience stress. Conclusion: Moderate physical activity and a higher education level were associated with a lower experience of stress among older adults with hypertension. Healthcare professionals should incorporate physical activity and stress management strategies into their care plans for older adults with hypertension.Encouraging and promoting physical activity and educational opportunities are important to reduce stress levels in seniors with hypertension.

May Measurement Month 2021: an analysis of blood pressure screening results from Thailand.

Blood pressure (BP) measurement is the mainstay for diagnosing and treating hypertension. Blood pressure screening in the May Measurement Month (MMM) project is helpful for the early detection of hypertension, which is usually asymptomatic. This study aimed to investigate the epidemiology of hypertension from data in the MMM21 project in Thailand. A cross-sectional study was conducted according to the MMM clinical study protocol for MMM21 in all regions of Thailand from August to November 2021. We included adults aged ≥18 years. Baseline characteristics, history of hypertension diagnosis, and treatment were collected through the questionnaires followed by three standardized BP measurements, 1 min apart. We included 10 940 participants with a mean age of 41.3 (SD ± 13.5) years. Only 6% never had their BP measured before. Of all participants, 30.2% had hypertension, and among this hypertensive population, 50.3% were aware, and 46.2% were taking antihypertensive medications. Of participants with hypertension, 31.6% had controlled BP (<140/90 mmHg), and BP control was 68.5% among those taking antihypertensive medication. The proportion of participants who had diabetes, were on aspirin, and were on statin were 6, 7.2, and 11.4%, respectively. Almost all participants (93.7%) had received at least one COVID-19 vaccination, and 8.0% reported a previous COVID-19 positive test. Most of the participants (97.4%) received hypertension care at no cost. Hypertension awareness and overall BP control rate were relatively low, while most subjects had previously had their BP checked. The widespread use of BP measurement may improve the diagnosis and treatment of hypertension to improve the care of those with hypertension in Thailand.

Effects of participatory action-oriented training (PAOT) intervention for hypertension management among intercity van drivers.

This study aims to evaluated the effectiveness of participatory action-oriented training (PAOT) intervention for hypertension management among intercity van drivers. This quasi-experimental study applied concept and process of participatory actionoriented training and self-management to guide the development of the intervention addressing improvement in hypertension management behaviors. A total of 104 intercity van drivers with uncontrolled hypertension in Thailand were recruited to participate in this program. The intervention group (N = 52) received PAOT program, while the control group (N = 52) received conventional program. Data on hypertension management behaviors, and blood pressure were measured at baseline, 1 month and 3 months after intervention. At 3 months after intervention, hypertension management behavior, and systolic blood pressure were significantly different between 2 groups (p < 0.05). This PAOT was found to be feasible and could potentially improve hypertension management, and blood pressure level of intercity van drivers. The program should be applied in further studies with other workplaces in both formal and informal sectors with different characteristics and other health issues. Int J Occup Med Environ Health. 2024;37(2):194-204.

Factors associated with electrocardiographic left ventricular hypertrophy among patients with hypertension in Thailand

BackgroundLeft ventricular hypertrophy (LVH) strongly predicts cardiovascular diseases (CVD) and death. One-fourth of Thai adults suffer from hypertension. Nevertheless, the information on LVH among Thai patients with hypertension is not well characterized. We aimed to identify the prevalence and factors associated with electrocardiographic LVH (ECG-LVH) among patients with hypertension in Thailand.MethodsThe present study obtained the dataset from the Thailand Diabetes Mellitus/Hypertension study, which included hypertension patients aged 20 years and older receiving continuous care at outpatient clinics in hospitals nationwide in 2011–2015 and 2018. Meanwhile, those without a record of 12-lead electrocardiography (ECG) were excluded from the analysis. ECG-LVH was defined as the LVH noted regarding ECG interpretation in the medical records. Multivariable logistic regression analysis was utilized for determining factors associated with ECG-LVH and presented as the adjusted odds ratio (AOR) and 95% confidence interval (CI).ResultsFrom 226,420 hypertensive patients in the Thailand Diabetes Mellitus/Hypertension study, 38,807 individuals (17.1%) with ECG data recorded were included in the analysis. The mean age was 64.8 ± 11.5 years, and 62.2% were women. Overall, 1,557 study participants had ECG-LVH, with an estimated prevalence of 4.0% (95% CI, 3.8–4.2%). Age-adjusted ECG-LVH prevalence among women and men was 3.4 and 5.1%, respectively (P < 0.001). Multivariable analysis determined factors associated with ECG-LVH, including being men (AOR, 1.49; 95% CI, 1.31–1.69), individuals aged 70 to 79 years (AOR, 1.56; 95% CI, 1.20–2.02) and ≥ 80 years (AOR, 2.10; 95% CI, 1.58–2.78) compared to individuals aged less than 50 years, current smokers (AOR, 1.26; 95% CI, 1.09–1.46) compared to those who never smoked, systolic blood pressure ≥ 140 mmHg and diastolic blood pressure ≥ 90 mmHg (AOR, 1.58; 95% CI, 1.30–1.92) compared to systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg.ConclusionsThe current study illustrated the prevalence of ECG-LVH among Thai patients with hypertension who had ECG recorded and identified high-risk groups who tended to have ECG-LVH. The findings underscore the need for targeted interventions, particularly among high-risk groups such as older individuals, men, and current smokers, to address modifiable factors associated with ECG-LVH.

Association between obesity and new-onset heart failure among patients with hypertension in Thailand

BackgroundIn Thailand, the epidemiological data on the relationship between obesity and heart failure (HF) among high-risk populations was limited. We assessed the association between body mass index (BMI) and the new-onset HF among people with hypertension (HTN), and also assessed the effect modifier of uncontrolled HTN on this association.MethodsWe analyzed the data obtained from the 2018 Thailand DM/HT study database. Thai people with HTN aged 20 years and older receiving continuous care at outpatient clinics in hospitals nationwide were included. The new-onset HF was defined regarding the ICD-10 as I50 in the medical records within 12 months. Obesity was defined as BMI ≥\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\ge$$\\end{document} 25 kg/m2. Multivariable log-binomial regression analysis was used to determine the association between BMI and new-onset HF and presented as the adjusted risk ratio (aRR) and 95% confidence interval (CI).ResultsA total of 35,756 participants were included in the analysis. In all, 50.0% of the participants had BP control for the last two consecutive visits. The mean BMI was 25.1 ±\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pm$$\\end{document} 4.7 kg/m2. New-onset HF occurred in 75 participants (0.21%; 95% CI 0.17–0.26). After adjusting for potential confounders, an elevated BMI was associated with new-onset HF (p value for quadratic trend < 0.001). In comparison with participants with normal BMI (18.5–22.9 kg/m2), the aRR for new-onset HF was 1.57 (95% CI 0.80–3.07) and 3.97 (95% CI 1.95–8.10) in those with BMI 25.0–29.9, and ≥ 30.0 kg/m2. For participants with obesity, aRR for new-onset HF was 2.05 (95% CI 1.24–3.39) compared to non-obese participants. The study found that among patients with control BP, obesity was associated with a higher risk of new-onset HF with an adjusted RR of 2.33 (95% CI 1.12–4.83). For those with uncontrolled BP, the adjusted RR was 1.83 (95% CI 0.93–3.58), but there was no heterogeneity with p value = 0.642.ConclusionAn increased BMI had a higher risk for new-onset HF among Thai people with HTN. Obesity was independently associated with new-onset HF among people with HTN, regardless of uncontrolled HTN. Our findings highlight that weight reduction is crucial for mitigating the risk of HF development in HTN patients, regardless of their BP control status.

Stakeholder-Informed Solutions To Address Barriers for Alcohol Screening and Brief Intervention in Thai Hypertension Care.

Premature deaths from NCDs disproportionately affect people in low- and middle-income countries. Since alcohol use is one of the most common causes of reversible hypertension, interventions targeting alcohol use may be a feasible and effective low-cost approach to synergistically reduce the prevalence of harmful drinking and high blood pressure. This study sought to identify key factors in successfully implementing alcohol use screening and brief intervention in hypertension care in Thailand. For this purpose, we surveyed participants (NRound 1 = 91, NRound 2 = 27) from three different groups of Thai stakeholders (policy- and decisionmakers, primary healthcare practitioners, and patients diagnosed with hypertension) in a two-round stakeholder elicitation. In round 1, we identified limited resources, lack of clear guidelines for lifestyle intervention, stigmatization, and inconsistent monitoring of patients' alcohol use as important barriers. In round 2, we sought to elicit solutions for the barriers identified in round 1. While stakeholders emphasized the need for adaptability to existing realities in Thai primary healthcare such as a high workload and limited digitization, they favorably evaluated a digital alcohol assessment tool with integrated, tailored advice for brief intervention as a potential scalable solution. Findings suggest that as one possible route to reduce the NCD burden caused by hypertension in Thailand, primary healthcare services may be enhanced by digital tools that support resource-effective, intuitive, and seamless delivery of alcohol screening and brief intervention.

Perceptions on quality of life among older adults with hypertension in Thailand: a qualitative study

PurposeThis study aims to explore the perceptions of quality of life among older Thai adults with hypertension.Design/methodology/approachA descriptive qualitative design was used. Semistructured interviews were conducted with 40 older adults. Thematic analysis was used to analyze the data.FindingsThe analyses were divided into six major themes: happiness in life; health and functionality; activity in social relationships; religion anchor; autonomy to manage their own life; and security in finances and environment.Practical implicationsThe findings can guide health care professionals and policymakers when planning and implementing interventions and policies for improving the quality of life of older adults, particularly that of rural older adults with low incomes.Originality/valueThe findings showed minor differences between urban and rural older adults in financial security, where the rural participants expressed greater financial insecurity than the urban counterparts. However, no other major differences emerged.

Sex differences in the risk factors of disability among community-dwelling older adults with hypertension: Longitudinal results from the Health, Aging, and Retirement in Thailand study (HART).

Hypertension poses a serious health problem among Thai older adults which could subsequently lead to disability. However, little to no research has been conducted to understand modifiable risk factors of disability among community-dwelling older adults with hypertension in Thailand. In addition, sex is an important social determinant of health, but its role in disability among older adults with hypertension is less clear. This study focused on community-dwelling older adults with hypertension in Thailand and investigated predictors of disability and examined sex differences in the risk factors that were associated with disability in this population. Longitudinal data were from the Health, Aging, and Retirement in Thailand (HART) survey (2015-2017; N = 916). The outcome variable was difficulty with the activity of daily living at follow-up. Potential risk factors included sociodemographic information, health behaviors/health status, and disability at baseline. Descriptive analysis and logistic regression analysis were employed to analyze the data. Most of the participants were female and between aged 60 and 69 years old. Being in an older age group (OR = 1.78, 95% CI: 1.07-2.97, p < 0.05), having more chronic conditions (OR = 1.38, 95% CI: 1.10-1.73, p < 0.01), experiencing obesity (OR = 2.02, 95% CI: 1.11-3.69, p < 0.05), and having disability at baseline (OR = 2.42, 95% CI: 1.09-5.37, p < 0.05) significantly predicted disability at 2 year follow-up among community-dwelling Thai older adults with hypertension. The effects of these risk factors on disability at follow-up did not differ by sex. However, different risk factors of disability were observed across sexes. The situations of disability among older adults with hypertension in Thailand are likely to aggravate due to the rapid aging of the population. Our analysis provided useful information regarding significant predictors of disability and sex-specific risk factors of disability. Tailored promotion and prevention programs should be readily available to prevent disability among community-dwelling older adults with hypertension in Thailand.

Factors Associated with CKD among Middle Age and Elderly Populations with T2DM and Hypertension in Thailand

This study analyzed the risk factors of chronic kidney disease (CKD) among middle-age and elderly populations with Type 2 Diabetes Mellitus (T2DM) and hypertension and its associated factors in Thailand. The cross-sectional study used the data from the records of 43 standard healthcare folders of the Heath Data Center (HDC) of the Ministry of Public Health (MoPH) with population of 19,342,297. The inclusion criteria included people aged &gt; 45 with complete comorbidity data. 3,957,040 respondents passed the requirements and had processed for analysis. The multivariable analysis was used to analyze the factors associated with CKD when controlling for the effect of other covariates. The prevalence of CKD among middle-age and elderly populations with comorbidities was 4.97%. The multivariable analysis in the adjusted model indicated that factors that were associated with CKD included age ≥80 years (ORadj: 9.40, 95% CI: 8.51–10.38), being female (1.03, 1.01–1.07), and being comorbidity (6.69, 6.47–6.92). There is an urgent need for screening attempts to avoid early detection and improved practice for managing T2DM, hypertension, and CKD in the T2DM population in Thailand. Keywords: chronic kidney disease, type 2 diabetes mellitus, hypertension. https://doi.org/10.55463/issn.1674-2974.50.3.21

RISK FACTORS OF DISABILITY AMONG COMMUNITY-DWELLING OLDER ADULTS WITH HYPERTENSION IN THAILAND: THE HART STUDY

Abstract About 60% of the older adults in Thailand experience hypertension, a condition that increases the risks of disability. However, little to no study has investigated modifiable risk factors to prevent disability in this segment of population in Thailand. Therefore, this study aims to investigate factors associated with disability among community-dwelling older adults aged 60 years or above with hypertension in Thailand. Longitudinal data (wave-1 [2015] and wave-2 [2017]) were from the Health, Aging, and Retirement in Thailand (HART) survey. Descriptive analysis and logistic regression analysis were employed to analyze the data. Outcome variables were difficulty with activity of daily living, hearing-related disability, vision-related disability, and pain-related disability in wave-2. Sociodemographic information, health behaviors/health status, mental illness, chronic diseases, and disability at baseline were independent variables. The results showed that older age significantly predicted difficulty with activity of daily living and hearing-related disability among community-dwelling older adults with hypertension in Thailand. Drinking alcohol significantly predicted vision-related disability. No factors were found to be a significant factor for pain-related disability. Our analysis provided useful information for the prevention of disability among older adults with hypertension in Thailand.

Effective coverage of diabetes and hypertension: an analysis of Thailand’s national insurance database 2016–2019

ObjectivesThis study assesses effective coverage of diabetes and hypertension in Thailand during 2016–2019.DesignMixed method, analysis of National health insurance database 2016–2019 and in-depth interviews.SettingBeneficiaries of Universal Coverage Scheme residing outside...

The Prevent-U Application: Developing Mobile Phone Application for Elderly with Risk of Hypertension in Thailand (Study Protocol)

Currently, hypertension is one of five major non-communicable diseases (NCDs) in Thailand that places a large burden on the public health system and in terms of health care costs. Hypertension affects a patient’s essential bodily functions, can damage and deteriorate arteries, and may lead to serious health problems. While much previous research has focused on hypertension patients, there is a lack of studies about the prevention of hypertension among elderly people at risk for developing hypertension. So, we conducted an action research study to develop a mobile phone application, called Prevent-U, for the elderly at risk of developing hypertension. Lasting a total of 9 months, this study consisted of 4 phases (PDCA). After participants completed the application, we evaluated the user satisfaction with the application among 45 participants. Data were analyzed by descriptive statistics. Factors related to high blood pressure were lack of physical activity, poor food consumption behavior, having a moderate level of stress, and not consistently measuring their blood pressure. We integrated these factors into creating application. The Prevent-U application consisted of 5 systems: personal mode, data mode, collecting mode, report mode and consult mode. Based on the data from 45 participants, the mean score of overall user satisfaction was 2.53. A mobile phone application for preventing hypertension is an intervention that may capture the interest of patient and lead to positive outcomes. We selected this format to encourage participants to take care of their blood pressure and ultimately to change poor behavior that can lead to developing hypertension. Our preliminary results show that our application may help engage patients in managing and controlling their blood pressure. However, we are still waiting for the results of a study on the process of implementation of this application.

Thai Physicians’ Opinions about the Use of Home Blood Pressure Monitoring

Hypertension is a powerful modifiable risk factor for cardiovascular disease. The prevalence of hypertension in Thailand is increasing progressively. Patients with hypertension are usually asymptomatic, and thus proper blood pressure measurement is required to diagnose and assess the blood pressure control. Home blood pressure monitoring (HBPM) is recognized as a useful tool in hypertension management and is recommended by many organizations, including the Thai Hypertension Society. The proven benefits of HBPM beyond the usual clinic measurement is that it allowed detection of white-coat hypertension and masked hypertension, better prediction of cardiovascular events, better assessment of the status of blood pressure control, and improved treatment compliance. Despite these benefits, the use of HBPM has remained low in many countries. The Asia HBPM Survey is a collaborative study of participants from 11 countries in Asia. The present study aimed to investigate physicians’ rationale, challenge, and attitudes toward the use of HBPM for hypertensive patients. Herein, the authors report Thai physicians’ responses in the Asia HBPM Survey.

Internet Use, Electronic Health Literacy, and Hypertension Control among the Elderly at an Urban Primary Care Center in Thailand: A Cross-Sectional Study

This study aimed to explore the internet usage and electronic health literacy (eHL) among adults aged 60 and older with hypertension and to explore the associations between eHL and blood pressure control. A cross-sectional survey was conducted at an out-patient primacy care clinic in the urban city center of Chiang Mai, Thailand. eHL was measured using the eHealth Literacy Scale (eHEALS). Logistic regression was used to identify the association between eHL and blood pressure, adjusting for age and sex as a priori confounders and key sociodemographic factors previously identified in univariable analysis. A total of 110 older adult patients with a history of diagnosed hypertension agreed to participate. The mean age of the participants was 67 years old. Fifty-six participants (50.9%) had used the internet in their lifetime. Among internet users, 37 out of 56 participants (66%) could be classified as having high eHL. However, there was insufficient evidence for associations among internet use, eHL and hypertension control. This result potentially creates new opportunities for eHealth education and interventions. Efforts to produce centralized clear, reliable health information targeting this demographic would be worthwhile to help manage chronic diseases such as hypertension in Thailand in the future.

Prevalence of and factors associated with stroke in hypertensive patients in Thailand from 2014 to 2018: A nationwide cross-sectional study

Stroke is a significant cause of death and disability. In Thailand, it imposes a major health burden, and the prevalence of stroke is increasing, particularly in patients with hypertension (HT), diabetes mellitus (DM), and dyslipidemia (DLP). We aimed to determine the trends in the prevalence of stroke and the associated factors among Thai patients with HT. Nationwide cross-sectional studies were conducted annually in 2014, 2015 and 2018 based on data obtained from the Thailand DM/HT study. Nationally, representative patients with HT in Thailand were sampled with stratified one-stage cluster sampling. A total of 104,028 participants were included in this study. The prevalence of stroke remained constant, with prevalence rates of 4.0%, 3.8%, and 3.9% in 2014, 2015 and 2018, respectively (p for trend = 0.221). Our findings suggested that the management of stroke patients who are covered by the universal coverage scheme should be evaluated. Effective interventions, including promoting smoking cessation, attenuating cholesterol levels, and controlling blood pressure should be provided to hypertensive patients to prevent ischemic stroke. Young adults with HT should be more concerned about the possibility of stroke. The use of prophylactic low-dose aspirin should be carefully monitored to prevent hemorrhagic stroke.

Asian management of hypertension: Current status, home blood pressure, and specific concerns in Thailand.

The prevalence of hypertension is increasing, but rates of awareness, treatment, and blood pressure (BP) control are also increasing. In terms of cardiovascular disease, the prevalence of coronary artery disease (CAD) and stroke is similar, but stroke mortality is higher than that from CAD. Home BP monitoring (HBPM) is an important tool for determining the presence of white-coat or masked hypertension, facilitating drug cost savings or effective cardiovascular risk management strategies, respectively. However, there are a number of barriers to use of HBPM in Thailand. These include lack of availability (particularly in lower socioeconomic groups), lack of awareness of the importance of white-coat and masked hypertension, and concerns about device reliability. The latest Thai Hypertension Society guidelines recommend that physicians and nurses encourage their patients to use their HBPM devices, and these are increasingly being utilized in clinical practice for both diagnostic purposes and therapeutic monitoring. Calcium channel blockers are the most commonly used antihypertensive agents in Thailand, followed by angiotensin receptor blockers, ß-blockers, and diuretics. Angiotensin-converting enzyme inhibitors are used less often due to drug-related cough, and the use of fixed drug combinations is low because of their high cost and more complex reimbursement process. Ongoing work is needed to improve the primary prevention and effective treatment of hypertension in Thailand.

Improved adherence in older patients with hypertension: An observational study of a community-based intervention.

This study sought to assess the effect of a community-based intervention influencing adherence status at baseline, 1, 3 and 6months, and to evaluate the impact that a community-based intervention and socio-economic factors have on adherence. Although high-quality treatment and modern hypertension clinical practice guidelines have been developed worldwide, the outcomes of patients with hypertension in Thailand are not optimal. Implementing a person-centred and integrated health services model to improve hypertension management, such as a community-based intervention, is challenging for healthcare providers in Thailand. An observational study of a community-based intervention. The study comprised residents in 17 villages in one province of Thailand. A sample of 156 participants was allocated into the intervention and the control groups. Inclusion criteria were people aged 60years or older diagnosed with hypertension. Exclusion criteria included the latest record of extreme hypertension and having a documented history of cognitive impairment. The intervention group received the 4-week community-based intervention programme. Multiple linear regression was applied to predict the adherence status at each phase. Multiple logistic regression was then implemented to predict influencing factors between the groups. Patients who received the intervention had significantly lower adherence scores (reflecting a higher level of adherence) at 3 and 6months after intervention by 1.66 and 1.45 times, respectively, when adjusting for other variables. After 6months, the intervention was associated with a significant improvement in adherence when adjusting for other variables. This study provides evidence to support the use of community-based interventions as an effective adjunct to hospital-based care of hypertension patients in Thailand. Understanding factors between health outcomes and social determinants of health is crucial for informing the development of culturally appropriate interventions.

Prevalence and associated factors of uncontrolled hypertension among Thai patients with hypertension: A nationwide cross-sectional survey

Background Hypertension is the most common causes of cardiovascular diseases. The information on the prevalence of uncontrolled hypertension in Thailand is lacking. The objectives of this study were to determine prevalence of uncontrolled hypertension among Thai patients with hypertension and to determine factors associated with uncontrolled hypertension in a nationwide survey. Methods A cross-sectional study to assess national outcomes among patients with hypertension who visited 831 public hospitals in Thailand was conducted in 2015 to evaluate status of care among patients with hypertension aged at least 18 years who received medical treatment in the target hospital for the last 12 months. Results A total of 32,440 patients with hypertension were included in this study. Uncontrolled hypertension was detected among 8312 patients (25.6%). Multivariate analysis was conducted to determine which factors were most associated with uncontrolled hypertension, and the results showed age AORs 0.97 (95% CI: 0.96–0.98), diabetes comorbidity AORs 1.35 (95% CI: 1.13–1.60), waist circumferences ≥ 90 cm. AORs 1.18 (95% CI: 1.04–1.34), body mass index (BMI) ≥ 30 kg/m2 AORs 1.37 (95% CI: 1.15–1.62) and uric acid level ≥ 7 mg/dL AORs1.15 (95% CI: 1.01–1.30) were the highest associated factors for uncontrolled hypertension in this population. Conclusion Our data emphasized that uncontrolled hypertension was a problem among patients with hypertension. The results of this study could be used to recommend health information be provided to patients with hypertensions having comorbidity or any risk factors to be aware of uncontrolled hypertension and its complication.

Prevalence of hypertension in Thailand: Hotspot clustering detected by spatial analysis.

Spatial pattern detection can be a useful tool for understanding the geographical distribution of hypertension (HT). The aim of this study was to apply the technique of local indicators of spatial association statistics to examine the spatial patterns of HT in the 76 provinces of Thailand. Previous studies have demonstrated that socioeconomic status (SES), economic growth, population density and urbanization have effects on the occurrence of disease. Research has suggested that night-time light (NTL) can be used as a proxy for a number of variables, including urbanization, density, economic growth and SES. To date, there has not been any study on spatial patterns of HT and there is no information on how NTL might correlate with HT. Therefore, this study has investigated NTL as a parameter for detection of hotspots of HT in Thailand. It was found that HT clusters occurred in Bangkok and in metropolitan areas. In addition, significantly low-rate clusters were seen in some provinces in the Northeast and also in southern provinces. These findings should facilitate control and prevention of HT and, therefore, serve as support for researchers, decision-makers, academics and public health officials to propose more sound and effective strategies for the control of HT in Thailand and elsewhere.

Socioeconomic disparities in income, education and geographic location for hypertension among Thai adults: Results from the National Socioeconomic Survey

Background: Hypertension (HT) has been one of the leading global risk factors for health and the leading cause of death in Thailand for decades. The influence of socioeconomic factors on HT has been varied and inconclusive. The aim of this study was to determine the association between socioeconomic determinants and HT in Thailand. Methods: This study used data from the National Socioeconomic Survey, a cross-sectional study that was conducted by the National Statistical Office of Thailand in the years 2005, 2006 and 2007. In our analysis, data were collected on gender, age, marital status, smoking status, education, status of work, occupation, current liability (short-term debt), household monthly income, residential area, region and previously diagnosed HT by a physician. Results: The odds of having HT were significantly higher among those who had household monthly income, education, residential area and region. The participants who had monthly income of <10001 baht (2005: AOR = 3.19, 95%CI:1.47 - 6.92; 2006: AOR 2.53, 95%CI:1.37 - 4.69; 2007: AOR = 3.35, 95%CI: 1.97 - 7.00), were living in Bangkok compared with the Northeast region (2005: AOR = 1.72, 95%CI:1.37 - 2.17; 2006: AOR = 2.44, 95%CI: 1.89 - 3.13; 2007: AOR = 2.63, 95%CI 2.08 - 3.45), lived as an urban resident (2005: AOR= 1.32, 95%CI: 1.12 - 1.56; 2006: AOR= 1.21, 95%CI: 1.02 - 1.43; 2007: AOR= 1.47, 95%CI: 1.18 - 1.62), and finished primary education (2005: AOR =1.21, 95%CI: 1.03 - 1.43; 2006: AOR= 1.23, 95%CI: 1.04 - 1.46; 2007: AOR= 1.18, 95%CI: 1.01 - 1.38) when controlling for other covariates. Conclusion: This study indicated that socioeconomic disparity has an influence on HT. Those with low educational attainment, low income, lived in urban regions, and were metropolitan residents (Bangkok) were vulnerable to HT.