Health-Risk Transition and 8-Year Hypertension Incidence in a Nationwide Thai Cohort Study

OBJECTIVE: Rapid economic growth is transforming Thailand into a middle-income country. Also emerging are chronic diseases particularly hypertension, diabetes mellitus and kidney disease. There are few studies of the incidence of hypertension. We analyse the effect on 8-year incidence of hypertension of transitional health-risk factors including demography, socioeconomic status (SES), body mass index (BMI), sedentariness, physical activity, underlying diseases, personal behaviours, food, fruit and vegetable consumption.

DESIGN & METHODS: Health-risk factors and their effects on the incidence of hypertension were evaluated prospectively in the national Thai Cohort Study from 2005 to 2013. All data were derived from 40,548 Sukhothai Thammathirat Open University students returning mail-based questionnaire surveys in both 2005 and 2013. Adjusted relative risks of association between each risk factor and incidence of hypertension were calculated after controlling for confounding factors.

RESULTS: In Thailand, the 8-year incidence of hypertension was 5.1% (men 7.1%, women 3.6%). Hypertension was associated with ageing, higher BMI, diabetes mellitus, chronic kidney disease, high lipids, SES, lower education level, lower household asset, physical inactivity, smoking, instant food intake and soft drink. Sex, having a partner, urbanization and sedentary habits had no influence on hypertension.

CONCLUSION: In Thailand, hypertension is becoming a serious risk factor for chronic disease with a wide array of associations with modern life. As Thailand’s socio-economy develops the health-risk transition will further impact on population health. Thais should be encouraged by government policy to consume less instant food, maintain normal BMI, increased physical activity, stop smoking and consume less soft drink.