Table 1
Characteristics of study participants.
| CHARACTERISTICS | MEN | WOMEN | TOTAL |
|---|---|---|---|
| n = 317 | n = 683 | 1000 | |
| n (%) | n (%) | n (%) | |
| Sex distribution, % | 31.7 | 68.3 | |
| Age, years | |||
| 20–29 | 2 (0.6) | 1 (0.2) | 3 (0.3) |
| 30–39 | 7 (2.2) | 15 (2.2) | 22 (2.2) |
| 40–49 | 20 (6.3) | 51 (7.5) | 71 (7.1) |
| 50–59 | 65 (20.5) | 158 (23.1) | 223 (22.3) |
| 60–69 | 115 (36.3) | 236 (34.6) | 351 (35.1) |
| 70–79 | 87 (27.4) | 164 (24.0) | 251 (25.1) |
| ≥80 | 21 (6.6) | 58 (8.5) | 79 (7.9) |
| mean (SD) | 64.3 (11.0) | 64.1 (11.2) | 64.2 (11.2) |
| median (Q1–Q3) | 65.0 (58.0–72.0) | 65.0 (57.0–72.0) | 65.0 (57.0–72.0) |
| Geographical region | |||
| Central | 78 (24.6) | 176 (25.8) | 254 (25.4) |
| Northeast | 79 (24.9) | 167 (24.5) | 246 (24.6) |
| North | 87 (27.4) | 165 (24.2) | 252 (25.2) |
| South | 73 (23.0) | 175 (25.6) | 248 (24.8) |
| Health insurance scheme | |||
| Universal health coverage | 278 (87.7) | 613 (89.8) | 891 (89.1) |
| Civil servant medical benefits | 24 (7.6) | 53 (7.8) | 77 (7.7) |
| Social security | 9 (2.8) | 10 (1.5) | 19 (1.9) |
| Others | 6 (1.9) | 7 (1.0) | 13 (1.3) |
| Religion | |||
| Buddhism | 292 (92.1) | 636 (93.1) | 928 (92.8) |
| Christian | 19 (6.0) | 35 (5.1) | 54 (5.4) |
| Islam | 6 (1.9) | 11 (1.6) | 17 (1.7) |
| Others | 0 (0.0) | 1 (0.2) | 1 (0.1) |
| Marital status | |||
| Married | 249 (78.6) | 425 (62.2) | 674 (67.4) |
| Widowed | 33 (10.4) | 192 (28.1) | 225 (22.5) |
| Divorced/separated | 15 (4.7) | 36 (5.3) | 51 (5.1) |
| Never married | 20 (6.3) | 30 (4.4) | 50 (5.0) |
| Educational attainment | |||
| Never attend | 29 (9.2) | 87 (12.7) | 116 (11.6) |
| Nonformal | 2 (0.6) | 2 (0.3) | 4 (0.4) |
| Grade 1–6 | 213 (67.2) | 512 (75.0) | 725 (72.5) |
| Grade 7–9 | 25 (7.9) | 35 (5.1) | 60 (6.0) |
| Grade 10–12 | 26 (8.2) | 32 (4.7) | 58 (5.8) |
| Vocational | 13 (4.1) | 6 (0.9) | 19 (1.9) |
| Bachelor’s degree or higher | 9 (2.8) | 9 (1.3) | 18 (1.8) |
| Occupation | |||
| No occupation/retired | 113 (35.7) | 349 (51.1) | 462 (46.2) |
| Agricultural workers | 143 (45.1) | 208 (30.5) | 351 (35.1) |
| Seller | 22 (6.9) | 72 (10.5) | 94 (9.4) |
| Homemaker | 2 (0.6) | 28 (4.1) | 30 (3.0) |
| Service | 7 (2.2) | 8 (1.2) | 15 (1.5) |
| Government officer | 5 (1.6) | 5 (0.7) | 10 (1.0) |
| Mechanic | 8 (2.5) | 0 (0.0) | 8 (0.8) |
| Professional | 3 (1.0) | 2 (0.3) | 5 (0.5) |
| Priest | 4 (1.3) | 0 (0.0) | 4 (0.4) |
| Others | 10 (3.2) | 11 (1.6) | 21 (2.1) |
| Household income, per year | |||
| Under 50,000 Thai Baht | 142 (44.8) | 377 (55.2) | 519 (51.9) |
| 50,000–99,999 Baht | 78 (24.6) | 143 (20.9) | 221 (22.1) |
| 100,000–149,999 Baht | 41 (12.9) | 70 (10.3) | 111 (11.1) |
| 150,000–199,999 Baht | 13 (4.1) | 21 (3.1) | 34 (3.4) |
| 200,000–249,999 Baht | 13 (4.1) | 27 (4.0) | 40 (4.0) |
| 250,000–299,999 Baht | 3 (1.0) | 3 (0.4) | 6 (0.6) |
| 300,000 Baht and over | 14 (4.4) | 30 (4.4) | 44 (4.4) |
| No intention to respond | 13 (4.1) | 12 (1.8) | 25 (2.5) |
| Duration of hypertension treatment, years | |||
| 1–3 | 72 (22.7) | 130 (19.0) | 202 (20.2) |
| 4–6 | 62 (19.6) | 122 (17.9) | 184 (18.4) |
| 7–9 | 86 (27.1) | 172 (25.2) | 258 (25.8) |
| ≥10 | 97 (30.6) | 259 (37.9) | 356 (35.6) |
| mean (SD) | 8.0 (5.7) | 8.5 (5.1) | 8.3 (5.3) |
| median (Q1–Q3) | 8.0 (4.0–11.0) | 8.0 (4.0–12.0) | 8.0 (4.0–11.0) |
| Systolic blood pressure, mmHg | |||
| Mean (SD) | 134.5 (16.8) | 135.0 (17.0) | 134.8 (16.9) |
| Median (Q1–Q3) | 132.3 (124.7–143.7) | 133.3 (123.3–144.3) | 133.0 (123.7–144.4) |
| Diastolic blood pressure, mmHg | |||
| Mean (SD) | 77.2 (10.3) | 78.4 (10.5) | 77.6 (10.4) |
| Median (Q1–Q3) | 76.3 (69.7–84.0) | 78.0 (71.0–84.7) | 76.7 (70.2–84.3) |
| Body mass index, kg/m2 | |||
| Mean (SD) | 24.2 (4.7) | 25.8 (5.1) | 25.3 (5.1) |
| Median (Q1–Q3) | 23.7 (21.1–26.6) | 25.5 (22.3–28.5) | 24.8 (21.7–28.0) |
[i] SD: standard deviation, Q1–Q3: interquartile range.
Figure 1
Prevalence of hypertension control among people with hypertension in rural Thailand in 2024, stratified by sex (A), age (B), and geographical region (C).
Table 2
Multivariable analysis for factors associated with hypertension control among people with hypertension in rural Thailand.
| FACTORS | HTN CONTROL (<140/90) | HTN CONTROL (OPTIMAL TARGET)* | ||
|---|---|---|---|---|
| ADJUSTED PR (95% CI) | p-VALUE | ADJUSTED PR (95% CI) | p-VALUE | |
| Sex | ||||
| Women | Ref. | Ref. | ||
| Men | 1.05 (0.83–1.27) | 0.663 | 1.00 (0.75–1.24) | 0.970 |
| Age, years | ||||
| 20–44 | 0.64 (0.29–0.99) | 0.046 | 0.27 (0.01–0.53) | <0.001 |
| 45–65 | 1.01 (0.77–1.26) | 0.906 | 0.64 (0.57–0.71) | <0.001 |
| ≥65 | Ref. | Ref. | ||
| Geographical region | ||||
| North | Ref. | Ref. | ||
| Central | 0.87 (0.73–1.01) | 0.067 | 0.84 (0.62–1.05) | 0.143 |
| Northeast | 0.86 (0.72–0.99) | 0.034 | 0.99 (0.82–1.17) | 0.928 |
| South | 0.78 (0.66–0.91) | 0.001 | 0.65 (0.57–0.74) | <0.001 |
| Health insurance scheme | ||||
| Universal health coverage | Ref. | Ref. | ||
| Civil servant medical benefits | 0.92 (0.64–1.2) | 0.555 | 0.78 (0.39–1.16) | 0.256 |
| Social security | 1.28 (1.05–1.50) | 0.016 | 1.41 (0.99–1.83) | 0.058 |
| Others | 1.15 (0.79–1.50) | 0.411 | 0.88 (0.49–1.27) | 0.553 |
| Marital status | ||||
| Married | Ref. | Ref. | ||
| Widowed/divorced | 0.94 (0.83–1.04) | 0.253 | 0.78 (0.61–0.95) | 0.010 |
| Never married | 0.61 (0.23–0.99) | 0.049 | 0.86 (0.59–1.13) | 0.302 |
| Educational attainment | ||||
| Ever education attainment | Ref. | Ref. | ||
| Never attend | 0.84 (0.73–0.95) | 0.004 | 1.01 (0.85–1.16) | 0.928 |
| Occupation | ||||
| No occupation/retired | Ref. | Ref. | ||
| Farming/agriculture | 1.08 (0.93–1.24) | 0.302 | 1.01 (0.85–1.17) | 0.897 |
| Others | 0.88 (0.75–1.01) | 0.068 | 0.89 (0.71–1.07) | 0.250 |
| Household income per year, Thai Baht | ||||
| Under 50,000 | Ref. | Ref. | ||
| 50,000–99,999 | 0.77 (0.61–0.93) | 0.005 | 0.80 (0.61–0.99) | 0.036 |
| 100,000–149,999 | 0.85 (0.66–1.05) | 0.141 | 0.75 (0.56–0.94) | 0.008 |
| 150,000 and over | 0.78 (0.60–0.97) | 0.026 | 0.93 (0.66–1.19) | 0.576 |
| No intention to respond | 1.12 (0.80–1.44) | 0.477 | 1.53 (1.01–2.04) | 0.044 |
| Duration of hypertension treatment, years | ||||
| 1–3 | Ref. | Ref. | ||
| 4–6 | 1.10 (0.95–1.25) | 0.210 | 1.12 (0.76–1.48) | 0.519 |
| 7–9 | 1.09 (0.96–1.22) | 0.158 | 1.36 (0.96–1.75) | 0.078 |
| ≥10 | 0.92 (0.83–1.00) | 0.063 | 1.01 (0.71–1.31) | 0.953 |
| Add extra salt or salty sauce | ||||
| 1 time per week and lower | Ref. | Ref. | ||
| 2–4 times per week and higher | 0.62 (0.37–0.87) | 0.003 | 0.47 (0.18–0.76) | <0.001 |
| Physical activity level | ||||
| High | Ref. | Ref. | ||
| Moderate | 0.98 (0.87–1.09) | 0.753 | 0.88 (0.73–1.03) | 0.127 |
| Low | 0.29 (0.01–0.75) | 0.002 | 0.29 (0.01–0.68) | <0.001 |
| Sleep duration, hours | ||||
| <8 | Ref. | Ref. | ||
| ≥8 | 1.08 (0.85–1.30) | 0.512 | 1.12 (0.75–1.49) | 0.524 |
| Smoking status | ||||
| Never smoker | Ref. | Ref. | ||
| Former smoker | 1.08 (0.90–1.26) | 0.407 | 1.14 (0.90–1.39) | 0.253 |
| Current smoker | 1.03 (0.72–1.35) | 0.839 | 1.00 (0.66–1.35) | 0.984 |
| Alcohol use | ||||
| Lifetime abstainer | Ref. | Ref. | ||
| Former drinker | 0.93 (0.73–1.12) | 0.461 | 0.90 (0.72–1.08) | 0.257 |
| Current drinker | 0.93 (0.76–1.11) | 0.459 | 0.78 (0.50–1.05) | 0.106 |
| Antihypertensive medication use | ||||
| No medication use | 0.76 (0.45–1.07) | 0.239 | 0.76 (0.41–1.12) | 0.191 |
| Single therapy | Ref. | Ref. | ||
| Dual therapy | 1.13 (0.99–1.26) | 0.083 | 1.39 (1.12–1.66) | 0.004 |
| Poly therapy | 1.20 (1.01–1.39) | 0.037 | 1.43 (1.16–1.70) | 0.002 |
| Type 2 diabetes | ||||
| No | Ref. | Ref. | ||
| Yes | 0.92 (0.75–1.08) | 0.321 | 0.85 (0.61–1.08) | 0.202 |
| Hyperlipidemia | ||||
| No | Ref. | Ref. | ||
| Yes | 0.89 (0.54–1.24) | 0.533 | 1.30 (0.52–2.08) | 0.451 |
| Chronic kidney disease | ||||
| No | Ref. | Ref. | ||
| Yes | 0.92 (0.70–1.14) | 0.467 | 0.86 (0.58–1.14) | 0.323 |
| Body mass index, kg/m2 | ||||
| <23.0 | Ref. | Ref. | ||
| 23.0–<25.0 | 0.93 (0.77–1.08) | 0.338 | 0.88 (0.71–1.05) | 0.170 |
| ≥25 | 0.86 (0.74–0.99) | 0.028 | 0.85 (0.70–0.99) | 0.035 |
| Psychological stress | ||||
| Low | Ref. | Ref. | ||
| Moderate | 1.02 (0.92–1.11) | 0.722 | 0.92 (0.77–1.07) | 0.260 |
| High | 0.93 (0.17–2.03) | 0.896 | 0.97 (0.01–2.30) | 0.966 |
| Depression | ||||
| Non-minimal | Ref. | Ref. | ||
| Mild to moderately severe | 1.19 (0.98–1.39) | 0.079 | 1.39 (0.96–1.82) | 0.074 |
| Moderate to severe | 0.99 (0.39–1.58) | 0.965 | 1.32 (0.67–1.98) | 0.335 |
| General anxiety | ||||
| Minimal | Ref. | Ref. | ||
| Mild to severe | 1.36 (1.05–1.66) | 0.023 | 1.10 (0.84–1.37) | 0.449 |
[i] *Systolic blood pressure<130 mmHg and diastolic blood pressure <80 mmHg for those aged 20–64 years, systolic blood pressure <140 mmHg and diastolic blood pressure <80 mmHg for those aged 65 years and older.
HTN: hypertension, PR: prevalence ratio, CI: confidence interval.
Table 3
Prevalence of cardiovascular risk factors among people with hypertension in rural Thailand in 2024, stratified by sex, age, and geographical region.
| CARDIOVASCULAR RISK FACTORS | AGE-ADJUSTED SEX-SPECIFIC WEIGHTED % | SEX-ADJUSTED AGE-SPECIFIC WEIGHTED % | AGE- AND SEX-ADJUSTED GEOGRAPHICAL REGION-SPECIFIC WEIGHTED % | TOTAL | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| MEN | WOMEN | 20–44 | 45–64 | ≥65 | CENTRAL | NORTHEAST | NORTH | SOUTH | ||
| Metabolic risk factors | ||||||||||
| Dyslipidemia§ | 92.5 | 98.7† | 100 | 95.6 | 97.4 | 97.1 | 98.0 | 94.8 | 95.1 | 96.5 |
| High waist to hip ratio (≥0.90 in men and ≥0.85 in women) | 56.0 | 77.0‡ | 90.2 | 73.3 | 65.9 | 82.9 | 65.9 | 71.7 | 73.3 | 69.7 |
| Low HDL cholesterol (<40 mg/dL in men, < 50 mg/dL in women) | 69.7 | 58.2 | 67.2 | 64.5 | 59.0*c | 55.9‡f | 54.3†g, †h | 67.1 | 79.9 | 62.4 |
| Abdominal obesity (≥90 cm in men, ≥80 cm in women) | 35.7 | 72.5† | 85.2 | 71.4 | 49.3‡c | 75.1‡e | 56.1 | 53.0†i | 68.1 | 59.7 |
| High LDL cholesterol (≥100 mg/dL) | 56.2 | 59.9 | 66.0 | 69.4 | 48.7†c | 56.4 | 65.0*g, †h | 52.4 | 50.9 | 58.7 |
| Obesity (BMI ≥25 kg/m2) | 41.7 | 56.1* | 89.0*a | 62.2†b | 38.7 | 59.6‡e | 52.5*g | 35.5‡i | 54.0 | 51.5 |
| High triglyceride (≥150 mg/dL) | 40.0 | 37.8 | 36.0 | 32.8 | 43.7 | 44.0*f | 36.3 | 52.4†i | 28.7 | 38.6 |
| Uncontrolled hypertension (>140/90 mmHg) | 32.9 | 37.0 | 79.2†a | 34.1†b | 32.9 | 40.9†e | 35.3*g | 22.5‡i | 42.5 | 36.1 |
| Diabetes|| | 24.6 | 37.7* | 54.1 | 35.8 | 29.6 | 47.1†e, ‡f | 40.5 | 18.7 | 19.4 | 33.2 |
| High total cholesterol (≥200 mg/dL) | 25.7 | 26.3 | 55.6 | 20.9 | 27.8 | 24.9 | 26.5 | 25.5 | 24.6 | 26.4 |
| Hyperglycemia (hemoglobin A1c ≥6.5%) | 16.3 | 21.8 | 52.8 | 19.0‡b | 17.8 | 30.5*e, ‡f | 23.8 | 13.1 | 9.0 | 20.2 |
| Hyperglycemia (fasting plasma glucose ≥126 mg/dL) | 12.8 | 16.7 | 50.5*a | 15.5*b | 12.1 | 27.3†e, ‡f | 15.7 | 10.0 | 10.5 | 15.7 |
| Chronic kidney disease# | 4.7 | 19.1* | 1.2 | 4.9*b | 24.2‡c | 9.6*d,*f | 22.6†g, ‡h | 8.8 | 5.4 | 13.6 |
| Lifestyle risk factors | ||||||||||
| Regular salt intake (at least 5–6 times per week) | 96.5 | 96.8 | 97.7 | 97 | 96.3 | 94.3†e, †f | 95.1†g, †h | 99.8 | 99.8 | 96.7 |
| Abnormal sleep duration (<6 hours or ≥10 hours) | 11.4 | 19.9* | 7.4 | 15.7 | 19.5 | 14.8*f | 17.3 | 8.9‡i | 25.2 | 16.7 |
| Current smoker | 32.1 | 1.4‡ | 7.6 | 14.5 | 8.6 | 11.0 | 11.1 | 11.4 | 9.9 | 12.5 |
| Moderate/heavier alcohol drinker (>3 drinks per week) | 16.5 | 3.5† | 6.2 | 11.2 | 4.6 | 9.9 | 7.2 | 10.2 | 7.4 | 8.2 |
| Low-level physical activity | 7.5 | 3.5* | 0‡a | 2.4‡b | 7.4*c | 3.3 | 6.3 | 1.2 | 4.2 | 4.9 |
[i] BMI: body mass index, LDL: low-density lipoprotein. HDL: high-density lipoprotein.
*p < 0.05, †p < 0.01, ‡p < 0.001, §Dyslipidemia was defined according to ICD-10 code E78 or a history of lipid-lowering medication use, high TC, high TG, high LDL cholesterol, or low HDL cholesterol, ||Diabetes was defined based on ICD-10 code E11, a history of antihyperglycemic medication use, high FPG, or high HbA1C. #Chronic kidney disease was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2 or receiving renal replacement therapy.
a20–44 vs. 45–64, b20–44 vs. 65 and older, c45–64 vs. 65 and older, dCentral vs. Northeast, eCentral vs. North, fCentral vs. South, gNortheast vs. North, hNortheast vs. South, iNorth vs. South.
Figure 2
Cardiovascular health status (Life’s Essential 8) among people with hypertension in rural Thailand in 2024, stratified by sex, age, and geographical region.
Figure 3
Prevalence of cardiovascular diseases among people with hypertension in rural Thailand in 2024, stratified by sex (A), age (B), and geographical region (C).
Figure 4
Distribution of predicted 10-year cardiovascular disease (CVD) risk using the World Health Organization laboratory-based risk chart among people with hypertension aged 40–74 without a history of CVD in rural Thailand.