Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan.
Kokoro Research Center, Kyoto University, Kyoto City, Kyoto, Japan.
PLoS One. 2022 Aug 17;17(8):e0271914. doi: 10.1371/journal.pone.0271914. eCollection 2022.
Cardiovascular disease is a leading cause of death in the Kingdom of Bhutan, and early detection of hypertension is critical for preventing cardiovascular disease. However, health-seeking behavior, including blood pressure measurement, is infrequently investigated in Bhutan. Therefore, this study investigated factors related to blood pressure measurement in Bhutan. We performed a secondary data analysis of a target population of 1,962 individuals using data from the "2014 Bhutan STEPS survey data"as a cross-sectional study. Approximately 26% of those with hypertension who were detected during the STEPS survey had never had their blood pressure measured. Previous blood pressure measurement was significantly associated with age and working status in men (self-employed [odds ratio (OR): 0.219, 95% CI: 0.133-0.361], non-working [OR: 0.114, 95% CI: 0.050-0.263], employee [OR: 1.000]). Previous blood pressure measurement was significantly associated with higher income in women (Quartile-2 [OR: 1.984, 95% CI: 1.209-3.255], Quartile-1 [OR: 2.161, 95% CI: 1.415-3.299], Quartile-4 [OR: 1.000]). A family history of hypertension (OR: 2.019, 95% CI: 1.549-2.243) increased the likelihood of having experienced a blood pressure measurement in both men and women. Multivariate logistic regression showed that people with unhealthy lifestyles (high salt intake [adjusted odds ratio (AOR): 0.247, 95% confidence interval (CI): 0.068-0.893], tobacco use [AOR: 0.538, 95% CI: 0.380-0.761]) had a decreased likelihood of previous blood pressure measurement. To promote the early detection of hypertension in Bhutan, we suggest that more attention be paid to low-income women, non-working, self-employed, and low-income men, and a reduction of barriers to blood pressure measurement. Before the STEPS survey, a substantial number of hypertensive people had never had their blood pressure measured or were unconcerned about their health. As a result, we propose that early blood pressure monitoring and treatment for people with hypertension or at higher risk of hypertension be given increased emphasis.
心血管疾病是不丹王国的主要死亡原因，早期发现高血压对于预防心血管疾病至关重要。然而，在不丹，人们的健康寻求行为，包括血压测量，并不常见。因此，本研究调查了与不丹血压测量相关的因素。我们对“2014 年不丹 STEPS 调查数据”中的目标人群 1962 人进行了二次数据分析，采用横断面研究。在 STEPS 调查中发现的高血压患者中，约有 26%从未测量过血压。男性中，之前测量过血压与年龄和工作状态显著相关（个体经营者[比值比（OR）：0.219，95%置信区间（CI）：0.133-0.361]，非工作者[OR：0.114，95% CI：0.050-0.263]，雇员[OR：1.000]）。女性中，之前测量过血压与更高的收入显著相关（四分位 2[OR：1.984，95% CI：1.209-3.255]，四分位 1[OR：2.161，95% CI：1.415-3.299]，四分位 4[OR：1.000]）。高血压家族史（男性 OR：2.019，95% CI：1.549-2.243；女性 OR：2.019，95% CI：1.549-2.243）增加了男女经历血压测量的可能性。多变量逻辑回归显示，生活方式不健康的人（高盐摄入[调整后的比值比（AOR）：0.247，95%置信区间（CI）：0.068-0.893]，吸烟[AOR：0.538，95% CI：0.380-0.761]）以前测量血压的可能性降低。为了促进不丹高血压的早期发现，我们建议更多关注低收入女性、非工作者、个体经营者和低收入男性，并减少血压测量的障碍。在 STEPS 调查之前，大量高血压患者从未测量过血压或对自己的健康状况漠不关心。因此，我们建议更加重视高血压或高血压风险较高人群的早期血压监测和治疗。
