Lifestyle practices and associated factors among adults with hypertension: Conquering Hypertension in Vietnam-solutions at the grassroots level study

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Abstract

Background

Vietnam is experiencing an increasing prevalence of hypertension in its adult population. In addition to medical therapy, modifying adverse lifestyle practices is important for effective blood pressure control. There are limited data on unhealthy lifestyle practices in patients with chronic diseases, however, particularly among hypertensive patients living in rural Vietnam. Our study objectives were to examine the prevalence of unhealthy lifestyle practices and associated factors among rural Vietnamese adults with uncontrolled hypertension.

Methods

Data from the baseline survey of a cluster randomized trial among hypertensive Vietnamese adults (2017–2022) were utilized. Information on unhealthy lifestyle practices including smoking, excessive alcohol consumption, physical inactivity, and inadequate fruit and vegetable intake was collected from study participants. The primary study outcome was having ≥2 unhealthy lifestyle practices. A multivariable logistic regression model was used to examine factors associated with the primary study outcome.

Results

The mean age of the 671 patients was 67 years and 45.0% were men. Nearly three out of every four participants had one or fewer unhealthy practices, 24.0% had two, and 3.3% had three or all four unhealthy lifestyle practices. Men, individuals who did unpaid work or were unemployed, and individuals with hypertension level III were more likely to have ≥2 unhealthy lifestyle practices, whereas individuals with higher education were less likely to have ≥2 unhealthy lifestyle practices compared with respective comparison groups.

Conclusions

We observed a high prevalence of unhealthy lifestyle practices among rural Vietnamese patients with uncontrolled hypertension. Several demographic factors were associated with a greater number of unhealthy lifestyle practices. Newer interventions and educational programs encouraging lifestyle modification practices are needed to control hypertension among adults living in rural settings of Vietnam.

Related collections

Most cited references 22

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Paul A James, Suzanne Oparil, Barry L Carter … (2014)

Hypertension is the most common condition seen in primary care and leads to myocardial infarction, stroke, renal failure, and death if not detected early and treated appropriately. Patients want to be assured that blood pressure (BP) treatment will reduce their disease burden, while clinicians want guidance on hypertension management using the best scientific evidence. This report takes a rigorous, evidence-based approach to recommend treatment thresholds, goals, and medications in the management of hypertension in adults. Evidence was drawn from randomized controlled trials, which represent the gold standard for determining efficacy and effectiveness. Evidence quality and recommendations were graded based on their effect on important outcomes. There is strong evidence to support treating hypertensive persons aged 60 years or older to a BP goal of less than 150/90 mm Hg and hypertensive persons 30 through 59 years of age to a diastolic goal of less than 90 mm Hg; however, there is insufficient evidence in hypertensive persons younger than 60 years for a systolic goal, or in those younger than 30 years for a diastolic goal, so the panel recommends a BP of less than 140/90 mm Hg for those groups based on expert opinion. The same thresholds and goals are recommended for hypertensive adults with diabetes or nondiabetic chronic kidney disease (CKD) as for the general hypertensive population younger than 60 years. There is moderate evidence to support initiating drug treatment with an angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, calcium channel blocker, or thiazide-type diuretic in the nonblack hypertensive population, including those with diabetes. In the black hypertensive population, including those with diabetes, a calcium channel blocker or thiazide-type diuretic is recommended as initial therapy. There is moderate evidence to support initial or add-on antihypertensive therapy with an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in persons with CKD to improve kidney outcomes. Although this guideline provides evidence-based recommendations for the management of high BP and should meet the clinical needs of most patients, these recommendations are not a substitute for clinical judgment, and decisions about care must carefully consider and incorporate the clinical characteristics and circumstances of each individual patient.

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The objective of this study was to estimate mean blood pressure (BP), prevalence of hypertension (defined as BP ≥140/90 mm Hg) and its awareness, treatment and control in the Vietnamese adult population. This cross-sectional survey took place in eight Vietnamese provinces and cities. Multi-stage stratified sampling was used to select 9832 participants from the general population aged 25 years and over. Trained observers obtained two or three BP measurements from each person, using an automatic sphygmomanometer. Information on socio-geographical factors and anti-hypertensive medications was obtained using a standard questionnaire. The overall prevalence of hypertension was 25.1%, 28.3% in men and 23.1% in women. Among hypertensives, 48.4% were aware of their elevated BP, 29.6% had treatment and 10.7% achieved targeted BP control (<140/90 mm Hg). Among hypertensive aware, 61.1% had treatment, and among hypertensive treated, 36.3% had well control. Hypertension increased with age in both men and women. The hypertension was significantly higher in urban than in rural areas (32.7 vs 17.3%, P<0.001). Hypertension is a major and increasing public health problem in Vietnam. Prevalence among adults is high, whereas the proportions of hypertensives aware, treated and controlled were unacceptably low. These results imply an urgent need to develop national strategies to improve prevention and control of hypertension in Vietnam.

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Is Open Access

Does better education mitigate risky health behavior? A mendelian randomization study

Jutta Viinikainen, Alex Bryson, Petri Böckerman … (2022)

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Author and article information

Contributors

Phuong H. Nguyen:

ORCID: https://orcid.org/0009-0004-1609-8257

Role: ConceptualizationRole: Formal analysisRole: MethodologyRole: VisualizationRole: Writing – original draft

Robert J. Goldberg: Role: SupervisionRole: Writing – review & editing

Jeroan J. Allison: Role: Funding acquisitionRole: Supervision

Diep B. Nguyen: Role: Supervision

Ha T. Tran: Role: Supervision

Oanh M. Tran: Role: Funding acquisitionRole: Supervision

Duc A. Ha: Role: Funding acquisitionRole: Supervision

Hieu L. Nguyen: Role: Supervision

Brittany A. Tran: Role: Supervision

Bo Wang: Role: Methodology

Hoa L. Nguyen: Role: SupervisionRole: Writing – review & editing

Christophe Leroyer: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS One

Journal ID (publisher-id): plos

Title: PLOS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 6 June 2024

Publication date Collection: 2024

Volume: 19

Issue: 6

Electronic Location Identifier: e0303354

Affiliations

[1 ] Department of Sociology of Health, Faculty of Public Health, Thai Binh University of Medical and Pharmacy, Thai Binh, Vietnam

[2 ] Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, United States of America

[3 ] Department of Epidemiology, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam

[4 ] Center for Training and Research on Substance Abuse-HIV, Hanoi Medical University, Hanoi, Vietnam

[5 ] Health Strategy and Policy Institute, Hanoi, Vietnam

[6 ] Hanoi Medical University Hospital, Hanoi, Vietnam

[7 ] Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, United States of America

Universite de Bretagne Occidentale, FRANCE

Author notes

Competing Interests: NO authors have competing interests

* E-mail: hphuong.950522@ 123456gmail.com

Author information

Phuong H. Nguyen https://orcid.org/0009-0004-1609-8257

Article

Publisher ID: PONE-D-23-35910

DOI: 10.1371/journal.pone.0303354

PMC ID: 11156363

PubMed ID: 38843274

SO-VID: d483a38c-bddb-410f-93cb-f64153c5105e

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 23 November 2023

Date accepted : 24 April 2024

Page count

Figures: 0, Tables: 3, Pages: 10

Funding

Funded by: National Institute of Health

Award ID: 1U01HL138631-01

Funded by: funder-id http://dx.doi.org/10.13039/100000061, Fogarty International Center;

Award ID: D43TW011394-01

The authors who were funded included Dr. Jeroan J. Allison, Dr. Duc A. Ha, and Dr. Oanh M. Tran. The present study was supported by the “Training Program for Strengthening Capacity in Non-communicable Diseases- D43TW011394-01” which was funded by the National Institutes of Health/ Fogarty International Center. The authors who were funded included Dr. Jeroan J. Allison and Dr. Hoa L. Nguyen. The funders had no role in our study design, data collection and analysis activities, decision to publish, or preparation of the manuscript.

Custom metadata

Data Availability The authors confirm that, for approved reasons, some access restrictions apply to the data underlying the findings. The data underlying the study are human subject clinical data. Data are available from the Vietnam Health Strategy and Policy Institute (HSPI) Institutional Data Access/Ethics Committee for researchers who meet the criteria for access to confidential data. Requests may be made to Giang Nguyen, Email: nguyengiang@ 123456hspi.org.vn .

ScienceOpen disciplines: Uncategorized

Data availability: