Htet Aung Soe, Bjertness Marius B, Oo Win Myint, Kjøllesdal Marte Karoline, Sherpa Lhamo Y, Zaw Ko Ko, Ko Ko, Stigum Hein, Meyer Haakon E, Bjertness Espen
Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
International Relations Division, Ministry of Health, Nay Pyi Taw, Myanmar.
BMC Public Health. 2017 Oct 26;17(1):847. doi: 10.1186/s12889-017-4870-y.
Hypertension 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.
In 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%.
From 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.
The 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.
高血压是心血管疾病的主要危险因素，而对于缅甸高血压的患病率、知晓率、治疗率及控制率的趋势了解甚少。本研究旨在评估2004年至2014年缅甸仰光地区高血压的患病率、知晓率、治疗率及控制率的变化，并比较2004年和2014年高血压与选定的社会人口学、行为及代谢危险因素之间的关联。
2004年和2014年，在仰光地区城乡采用世界卫生组织的“STEPS”方案进行了基于家庭的横断面研究。通过多阶段整群抽样方法，2004年和2014年分别有4448人和1486人参与，应答率均高于89%。
从2004年到2014年，年龄标准化的高血压患病率从26.7%（95%可信区间：24.4 - 29.1）显著上升至34.6%（32.2 - 37.1），知晓率从19.4%（17.2 - 21.9）升至27.8%（24.9 - 31.0），而治疗率和控制率未发生变化。年龄标准化的平均收缩压从2004年的122.8（标准误）±0.82 mmHg升至2014年的128.1±0.53 mmHg，舒张压从76.2±0.35 mmHg升至80.9±0.53 mmHg。在多变量分析中，2004年和2014年高血压均与年龄、饮酒、超重和糖尿病显著相关，2004年还与低体力活动和高胆固醇血症相关。综合所有数据，在对社会人口学变量和行为变量进行调整的不同模型中，研究年份与高血压之间仍存在显著关联，但在对社会人口学变量、代谢变量、体重指数和高胆固醇血症进行综合调整时则不然。
2004年至2014年，仰光地区城乡高血压患病率均有所上升，而城乡男女的高血压知晓率、治疗率及控制率仍然较低。2004年至2014年代谢变量、体重指数和高胆固醇血症的变化可能促使了高血压患病率的上升。两个研究年份中与高血压相关的因素均为年龄、饮酒、超重和糖尿病。应实施全国性高血压控制项目以减少缅甸的过早死亡。
