Objective: Rapid economic growth is transforming Thailand into a middle-income country. Also emerging are chronic diseases particularly hypertension, diabetes mellitus and kidney disease. There are few studies of the incidence of hypertension. We analyse the effect on 8-year incidence of hypertension of transitional health-risk factors including demography, socioeconomic status (SES), body mass index (BMI), sedentariness, physical activity, underlying diseases, personal behaviours, food, fruit and vegetable consumption. Design and Methods:Health-risk factors and their effects on the incidence of hypertension were evaluated prospectively in the national Thai Cohort Study from 2005 to 2013. All data were derived from 40,548 Sukhothai Thammathirat Open University students returning mail-based questionnaire surveys in both 2005 and 2013. Adjusted relative risks of association between each risk factor and incidence of hypertension were calculated after controlling for confounding factors. Results:In Thailand, the 8-year incidence of hypertension was 5.1% (men 7.1%, women 3.6%). Hypertension was associated with ageing, higher BMI, diabetes mellitus, chronic kidney disease, high lipids, SES, lower education level, lower household asset, physical inactivity, smoking, instant food intake and soft drink. Sex, having a partner, urbanization and sedentary habits had no influence on hypertension. Conclusion:In Thailand, hypertension is becoming a serious risk factor for chronic disease with a wide array of associations with modern life. As Thailand's socio-economy develops the health-risk transition will further impact on population health. Thais should be encouraged by government policy to consume less instant food, maintain normal BMI, increased physical activity, stop smoking and consume less soft drink.
Objective: Kidney disease (KD) is increasing its burden in Thailand but prospective observational KD studies are few. So we analysed 8-year nationwide Thai Cohort Study (TCS) data on KD incidence, distribution and risk association among Thais. Design and Method:TCS is a longitudinal study of the Thai health-risk transition among Open University student residing nationwide. At baseline (2005) the cohort members analysed here were aged 15-88 years and did not have KD. At the follow up in 2013 (n=41638) incident KD was reported based on doctor diagnosis. We analysed the 8-year cumulative incidence of KD and its association with risk factors by using multivariable logistic regression. Results:The incidence of KD (2005 to 2013) was 4.0%; the rate in men (5.9) was significantly higher than in women (2.5). KD increased significantly for both increasing age and body mass index (BMI) (p trend <0.001 for both). Its incidence was strongly associated with concurrent diseases including hypertension, diabetes and high blood lipids and moderately associated with increased frequency of cigarette smoking, instant food, roast or smoked food and soft drink consumption. KD decreased with increases in personal income, household assets, walking and physical activity. Conclusion:Physical activity, high income and household assets prevented KD. Lifestyle changes such as smoking and high consumption of instant, roast or smoked food and soft drink increased risk of KD. Government should encourage more physical activity and less smoking, salt and sugar.
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