Changes in prevalence, awareness, treatment and control of hypertension from 2004 to 2014 among 25-74-year-old citizens in the Yangon Region, Myanmar

Abstract

BackgroundHypertension is the leading risk factor for cardiovascular diseases, and little is known about trends in prevalence, awareness, treatment and the control of hypertension in Myanmar. This study aims at evaluating changes from 2004 to 2014 in the prevalence, awareness, treatment and control of hypertension in the Yangon Region, Myanmar, and to compare associations between hypertension and selected socio-demographic, behavioural- and metabolic risk factors in 2004 and 2014.MethodsIn 2004 and 2014, household-based cross-sectional studies were conducted in urban and rural areas of Yangon Region using the WHO STEPS protocol. Through a multi-stage cluster sampling method, a total of 4448 and 1486 participated in 2004 and 2014, respectively, with the response rates above 89%.ResultsFrom 2004 to 2014, there was a significant increase in the age-standardized prevalence of hypertension from 26.7% (95% CI:24.4-29.1) – 34.6% (32.2-37.1), as well as an awareness from 19.4% (17.2-21.9) to 27.8% (24.9-31.0), while treatment and control rates did not change. The age-standardized mean systolic blood pressure increased from 122.8 (SE) ± 0.82 mmHg in 2004 to 128.1 ± 0.53 mmHg in 2014, whereas diastolic blood pressure increased from 76.2 ± 0.35 mmHg to 80.9 ± 0.53 mmHg. In multivariate analyses, hypertension was significantly associated with age, alcohol consumption, overweight and diabetes in both 2004 and 2014, and additionally associated with low physical activity and hypercholesterolemia in 2004. Combining all data, a significant association between study-year and hypertension persisted in different models with an adjustment for socio-demographic variables and behavioural variables, but not when adjusting for a combination of socio-demographic variables, the metabolic variables, BMI and hypercholesterolemia.ConclusionThe prevalence of hypertension has risen from 2004 to 2014 in both urban and rural areas of the Yangon Region, while, the awareness, treatment and control rate of hypertension remains low in urban and rural areas among both males and females. It is likely that changes in the metabolic variables, BMI and hypercholesterolemia have contributed to an increase in the prevalence of hypertension from 2004 to 2014. Factors associated with hypertension in both study years were age, alcohol consumption, overweight and diabetes. A national hypertension control programme should be implemented in order to reduce premature deaths in Myanmar.Electronic supplementary materialThe online version of this article (10.1186/s12889-017-4870-y) contains supplementary material, which is available to authorized users.

Socioeconomic Differentials in Trends in the Prevalence of Hypertension and Pre-hypertension and Hypertension Awareness, Treatment, and Control in Rural Southwestern China

“…In the study, the prevalence of pre-hypertension (50.0%) in Yunnan Province was greater than that observed in central China (27.4%) [15] or Iran (31.6%) [16]. The hypertension prevalence (39.5%) in Yunnan Province was also higher than in other parts of China (24.7%) [17] and other Asian countries, including Myanmar (34.2%) [10], Vietnam (18.4%) [18], and other low-and middle-income countries (32.3%) [19]. The prevalence of pre-hypertension and hypertension was relatively high in rural Yunnan Province across the study period.…”

“…Nevertheless, the rates in awareness, treatment and control for hypertension are remain relatively low (28.9%, 35.3%, and 3.4%, respectively) related to those described in developed countries [8,9]. Awareness and knowledge of pre-hypertension and hypertension are critical for the prevention and reduction of hypertension, particularly in rural regions where the levels of awareness and treatment are relatively lower [10].…”

Trends in Diabetes Prevalence, Awareness, Treatment and Control in Yangon Region, Myanmar, Between 2004 and 2014, Two Cross-Sectional Studies

“…It was converted from local currency (Myanmar Kyats) to United States Dollar (USD). With an exchange rate of 1 USD = 750 Kyats in 2004 [20] and 953.8 Kyats in 2014 [21]. We used the international poverty line of USD 1.9/day, defined by the World Bank for daily income subgroups [22].…”

Fatty Acid Profiles of Various Vegetable Oils and the Association between the Use of Palm Oil vs. Peanut Oil and Risk Factors for Non-Communicable Diseases in Yangon Region, Myanmar

“…The participants were sampled to reflect the general population of Yangon. In a 2014 study in Yangon, the age-standardized prevalences of hypertension and hypercholesterolemia were previously reported to be 34.6% and 46.8%, respectively, while the prevalences of diabetes were reported to be 12.1% (urban population) and 7.1% (rural population) [ 17 , 18 , 19 ]. The consumption pattern of oils in the Yangon region was comparable in both survey years.…”

“…In the Yangon region of Myanmar, the age-standardized prevalence of diabetes was 12.1% in urban areas and 7.1% in rural areas in 2014 [ 17 ]. The corresponding prevalences of hypertension were 34.5% in urban areas and 34.2% in rural areas [ 18 ], while those of hypercholesterolemia were 50.7% in urban areas and 41.6% in rural areas [ 19 ]. Vegetable oils are essential in the Myanmar diet [ 20 ] (‘Rice, oil, salt and medicine are a man’s basic needs’ is a saying in Myanmar).…”