Gender with marital status, cultural differences, and vulnerability to hypertension: Findings from the national survey for noncommunicable disease risk factors and mental health using WHO STEPS in Bhutan.

Hiromi Kohori Segawa, Hironori Uematsu, Nidup Dorji, Ugyen Wangdi, Chencho Dorjee, Pemba Yangchen, Susumu Kunisawa, Ryota Sakamoto, Yuichi Imanaka
Author Information
  1. Hiromi Kohori Segawa: Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan. ORCID
  2. Hironori Uematsu: Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan.
  3. Nidup Dorji: Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Kingdom of Bhutan. ORCID
  4. Ugyen Wangdi: Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Kingdom of Bhutan.
  5. Chencho Dorjee: Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Kingdom of Bhutan.
  6. Pemba Yangchen: Department of Non-Communicable Disease, Ministry of Health in Bhutan, Thimphu, Kingdom of Bhutan.
  7. Susumu Kunisawa: Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan.
  8. Ryota Sakamoto: Centre for Southeast Asian Studies, Kyoto University, Kyoto City, Kyoto, Japan.
  9. Yuichi Imanaka: Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan. ORCID

Abstract

Cardiovascular disease is the leading cause of death in the Kingdom of Bhutan. Thus, the early detection and prevention of hypertension is critical for reducing cardiovascular disease. However, the influence of sociocultural factors on vulnerability to hypertension needs further investigation. This study performed secondary data analysis on 1,909 individuals in a cross-sectional study (the National survey for noncommunicable disease risk factors and mental health using World Health Organization (WHO) STEPS approach in Bhutan- 2014). Multivariate logistic regression demonstrated a significant association between gender with marital status and hypertension. Women had a higher odds ratio than men (Ref) when married (AOR: 1.27, 95% confidence intervals (CI): 1.23-1.31), and when separated, divorced, or widowed (AOR: 1.18, 95% CI: 1.12-1.26). People who speak the Tshanglakha language scored the highest odds (AOR: 1.24, 95% CI: 1.20-1.27), followed by Lhotshamkha (AOR: 1.09, 95% CI: 1.06-1.12) and Dzongkha (Ref) after adjusting for various social and biomedical factors. Additionally, tobacco use displayed decreased odds for hypertension. To promote the early detection and prevention of hypertension, these cultural factors should be considered even within small geographic areas, such as Bhutan. It is necessary to strengthen hypertension preventive strategies for people who speak Tshanglakha and Lhotshamkha. Furthermore, careful consideration should be given to preventing hypertension among adults aged 40 years or more, women who are married, separated, divorced, or widowed, and men who never married in Bhutan.

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MeSH Term

Adolescent
Adult
Aged
Bhutan
Cross-Sectional Studies
Culture
Divorce
Health Surveys
Humans
Hypertension
Male
Marital Status
Middle Aged
Risk Factors
Sex Factors
Single Person
Widowhood
Young Adult

Word Cloud

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