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

• DOI: 10.1371/journal.pone.0271914
• Publication Date: 2022-08-17T17:38:10Z
• Authors: Hiromi Kohori Segawa; Hironori Uematsu; Nidup Dorji; Ugyen Wangdi; Chencho Dorjee; Pemba Yangchen; Susumu Kunisawa; Ryota Sakamoto; Yuichi Imanaka
• Keywords: Male; Quartile; Science; Health, Toxicology and Mutagenesis; Population; Logistic regression; Blood Pressure; Nursing; FOS: Health sciences; Effects of Dietary Sodium on Health; 03 medical and health sciences; 0302 clinical medicine; Sociology; 5. Gender equality; Risk Factors; Health Sciences; Pathology; Humans; Bhutan; Internal medicine; Cross-sectional study; Demography; Nutrition and Dietetics; Q; Confidence interval; R; 1. No poverty; Management of Hypertension and Cardiovascular Risk Factors; Impact of Climate Change on Human Health; Odds ratio; FOS: Sociology; 3. Good health; Cross-Sectional Studies; Environmental health; Cardiovascular Diseases; Environmental Science; Physical Sciences; Hypertension; Blood pressure; Medicine; Female; Cardiology and Cardiovascular Medicine; Gerontology; Research Article

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.