Health-Risk Transition and 8-Year Hypertension Incidence in a Nationwide Thai Cohort Study

Abstract

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.

Body Mass Index and Risk of Hypertension: 8-Year Prospective Findings From a Nationwide Thai Cohort Study

“…The study analysed 40 548 participants who were STOU students living in all regions of Thailand, representing Thai people well socio-demographically (Seubsman, Yiengprugsawan, & Sleigh, 2012). A previous 4 and 8 years follow up study in 2009 and 2013 demonstrated all risk factors for hypertension in Thai people but this study focused on association of body mass index and risk of incident hypertension (Thawornchaisit et al, 2013c(Thawornchaisit et al, , 2018. Worldwide there are many studies reporting body mass index and risk of hypertension.…”

“…During this time Thailand transformed from a low-to a middle-income country. In 2005, the TCS data revealed the baseline prevalence of hypertension was 4.6% and follow-up at 4 and 8 years showed the cumulative incidence of hypertension over those periods was 3.5% and 5.1%, respectively (Thawornchaisit et al, 2013a;Thawornchaisit et al, 2013cThawornchaisit et al, , 2018. We noted in our previous TCS reports that aging, obesity, physical inactivity, and several underlying conditions including diabetes mellitus, high blood lipids and kidney disease are major risk factors of hypertension in Thai people.…”

“…During this period the average BMI in Thai people continuously increased from 22.8 kg/m 2 in women and 21.6 kg/m 2 in men in 2009 to 24.6 kg/m 2 and 23.6 kg/m 2 in 2014 respectively (Aekplakorn, 2016;Aekplakorn et al, 2014). Increased prevalence of hypertension is likely associated with an increased prevalence of obesity and this connection needs more detailed assessment across Thailand and elsewhere (Shihab et al, 2012;Thawornchaisit et al, 2013cThawornchaisit et al, , 2018.…”

“…In Thailand few studies investigated the association of obesity and hypertension (Thawornchaisit et al, 2013a;Thawornchaisit et al, 2013cThawornchaisit et al, , 2018. To fill this gap in our knowledge regarding the overall health risk transition in Thailand we began in 2005 a nationwide Thai Cohort Study (TCS) and followed up every 4 years until 2013.…”