Social and behavioral factors related to blood pressure measurement: A cross-sectional study in Bhutan

PLoS One. 2022 Aug 17;17(8):e0271914. doi: 10.1371/journal.pone.0271914. eCollection 2022.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bhutan / epidemiology
  • Blood Pressure
  • Cardiovascular Diseases*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertension* / diagnosis
  • Hypertension* / epidemiology
  • Male
  • Risk Factors

Grants and funding

This study was supported by K. Matsushita Foundation (http://matsushita-konosuke-zaidan.or.jp/en/) in the form of a grant (19-048) to HKS. This study was also supported by Kyoto University (https://ipcr.cseas.kyoto-u.ac.jp/), Program of Collaborative Research at the Centre for Southeast Asian Studies (IPCR-CSEAS) with funding (type 4) for YI and funding (type 7) for HKS. Kyoto University also supported this study with funding (Ishizue 2022) for YI. There are no grant numbers associate with the support from Kyoto University. This study was also supported by Japan Society for the Promotion of Science (JSPS Kakenhi) in the form of a grant (JP19H01075) to YI. The funders played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.