Factors Associated with Uncontrolled Hypertension among Adults  Aged 35 Years and Older in Narathiwat Province

Areefan  Mahmud; Rhysa McNeil; Kriangsak  Damchoom

doi:10.69650/ahstr.2025.4084

Authors

Areefan Mahmud Faculty of Science and Technology, Prince of Songkla University, Pattani Campus, Pattani, 94000, Thailand
Rhysa McNeil Faculty of Science and Technology, Prince of Songkla University, Pattani Campus, Pattani, 94000, Thailand; Centre of Excellence in Mathematics, Commission on Higher Education (CHE), Ministry of Education, Ratchathewi, Bangkok, 10400, Thailand
Kriangsak Damchoom Centre of Excellence in Mathematics, Commission on Higher Education (CHE), Ministry of Education, Ratchathewi, Bangkok, 10400, Thailand https://orcid.org/0009-0007-8094-8553

DOI:

https://doi.org/10.69650/ahstr.2025.4084

Keywords:

Uncontrolled hypertension, Blood pressure, Associated factors, Southern Thailand

Abstract

Uncontrolled hypertension is an important public health issue and one of the leading contributor to global disease and mortality. The objective of this study was to determine the factors associated with uncontrolled hypertension among adults aged 35 years or older in Narathiwat province who had undergone hypertension screening for at least one year. Data were obtained from the Health Data Center of the national health database system from October 2012 to September 2022. A total of 43,015 adults were diagnosed with hypertension. Among them, 14,696 adults had uncontrolled hypertension, while 28,319 had achieved controlled blood pressure. Descriptive statistics and multiple logistic regression were employed to analyze the data. The overall prevalence of uncontrolled hypertension was 65.84%. The results showed that an uncontrolled hypertension was prevalent among older adults with aged more than 55 years, those who were single, those with no formal education, the unemployed, smokers, underweight adults, those who had been under care for a longer period, and those who had complications of diabetes mellitus. Therefore, this is suggested to raise awareness and encourage a healthy lifestyle to prevent or control hypertension.

References

Aberhe, W., Mariye, T., Bahrey, D., Zereabruk, K., Hailay, A., Mebrahtom, G., Gemechu, K., & Medhin, B. (2020). Prevalence and factors associated with uncontrolled hypertension among adult hypertensive patients on follow-up at Northern Ethiopia, 2019: cross-sectional study. Pan African Medical Journal, 15(36), 187. https://doi.org/10.11604/pamj.2020.36.187.23312

Aekplakorn, W., Chariyalertsak, S., Kessomboon, P., Sangthong, R., Inthawong, R., Putwatana, P., & Taneepanichskul, S. (2011). Prevalence and management of diabetes and metabolic risk factors in Thai adults: the Thai National Health Examination Survey IV, 2009. Diabetes care, 34(9), 1980-1985. https://doi.org/10.2337/dc11-0099

Aekplakorn, W., Chariyalertsak, S., Kessomboon, P., Assanangkornchai, S., Taneepanichskul, S., Goldstein, A., Cazabon, D., Neelapaichit, N., & Aimiosior, O. (2024). Trends in hypertension prevalence, awareness, treatment, and control in the Thai population, 2004 to 2020. BMC Public Health, 24(1), 3149. https://doi.org/10.1186/s12889-024-20643-1

Böhm, M., Mahfoud, F., Ukena, C., Hoppe, U. C., Narkiewicz, K., Negoita, M., Ruilope, L., Schlaich, M. P., Schmieder, R.E., & Whitbourn, R. (2015). First report of the Global SYMPLICITY Registry on the effect of renal artery denervation in patients with uncontrolled hypertension. Hypertension, 65(4), 766-774. https://doi.org/10.1161/HYPERTENSIONAHA.114.05010

Cherfane, M,, Vallee, A., Kab, S., Salameh, P., Goldberg, M., Zins, M., & Blacher, J. (2024). Risk factors for uncontrolled blood pressure among individuals with hypertension on treatment: the CONSTANCES population-based study. International Journal of Epidemiology, 53(2), dyae027. https://doi.org/10.1093/ije/dyae027

Dzudie, A., Kengne, A.P., Muna, W.F., Ba, H., Menanga, A., Kouam, C.K., Abah, J., Monkam, Y., Biholong, C., & Mintom, P. (2012). Prevalence, awareness, treatment and control of hypertension in a self-selected sub-Saharan African urban population: a cross-sectional study. BMJ open, 2(4), e001217. https://doi.org/10.1136/bmjopen-2012-001217

Farhadi, F., Aliyari, R., Ebrahimi, H., Hashemi, H., Emamian, M.H., & Fotouhi, A. (2023). Prevalence of uncontrolled hypertension and its associated factors in 50–74 years old Iranian adults: a population-based study. BMC Cardiovasc Discord, 23(318), 37355590. https://doi.org/10.1186/s12872-023-03357-x

Fryar, C. D., Kit, B., Carroll, M. D., & Afful, J. (2024). Hypertension prevalence, awareness, treatment, and control among adults age 18 and older: United States, August 2021-August 2023. NCHS Data Brief. https://www.cdc.gov/nchs/data/databriefs/db511.pdf

Gansevoort, R.T., Correa-Rotter, R., Hemmelgarn, B.R., Jafar, T.H., Heerspink, H.J.L., Mann, J.F., Matsushita, K., & Wen, C.P. (2013). Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention. The Lancet, 382(9889), 339-352. https://doi.org/10.1016/S0140-6736(13)60595-4

Ghazali, R., Lukmana, K. A., Naing, D. K. S., Kadir, F., Jeffree, M. S., Robinson, F., Giloi, N., Ibrahim, M. Y., D'Souza, U. J. A., & Mathew, G. G. (2020). Factors associated with uncontrolled hypertension among hypertensive patients reported from different primary health clinics in Tuaran, Sabah, Malaysia: a cross-sectional study. Türkiye Klinikleri. Tip Bilimleri Dergisi, 40(1), 52-58. https://doi.org/10.5336/medsci.2019-66559

Gobezie, M. Y., Hassen, M., Tesfaye, N. A., Solomon, T., Demessie, M. B., Wendie, T. F., Tadesse, G., Kassa, T. D., & Berhe, F. T. (2024). Prevalence of uncontrolled hypertension and contributing factors in Ethiopia: a systematic review and meta-analysis. Frontiers in Cardiovascular Medicine, 11, 1335823. https://doi.org/10.3389/fcvm.2024.1335823

Iyer, A. S., Ahmed, M. I., Filippatos, G. S., Ekundayo, O. J., Aban, I. B., Love, T. E., Nanda, C. N., Bakris, G. L., Fonarow, G. C., Aronow, W. S., & Ahmed, A. (2010). Uncontrolled hypertension and increased risk for incident heart failure in older adults with hypertension: findings from a propensity-matched prospective population study. Journal of the American Society of Hypertension, 4(1), 22-31. https://doi.org/10.1016/j.jash.2010.02.002

Kaplan, R. C., Baldoni, P. L., Strizich, G. M., Pérez-Stable, E. J., Saccone, N. L., Peralta, C. A., Perreira, K. M., Gellman, M. D., Williams-Nguyen, J. S., Rodriguez, C. J., Lee, D. J., Daviglus, M., Talavera, G. A., Lash, J. P., Cai, J., & Franceschini, N. (2020). Current Smoking Raises Risk of Incident Hypertension: Hispanic Community Health Study–Study of Latinos Free. American Journal of Hypertension, 34(2), 190–197. https://doi.org/10.1093/ajh/hpaa152

Kapoor, M., Dhar, M., Mirza, A., Saxena, V., & Pathania, M. (2021). Factors responsible for uncontrolled hypertension in adults over 50 years of age: A pilot study from Northern India. Indian Heart Journal., 73(5), 644–646. https://doi.org/10.1016/j.ihj.2021.07.003

Katatwire, D., & Meremo, A. (2023). Prevalence of and factors associated with uncontrolled hypertension among patients with early chronic kidney disease attending tertiary hospitals in Dodoma, Tanzania: a cross sectional study. BMJ Open, 13, e074441. https://doi.org/10.1136/bmjopen-2023-074441

Liew, S. J., Lee, J. T., Tan, C. S., Koh, G. H. K., Dam, R. V., & Riemenschneider, F. M. (2019). Sociodemographic factors in relation to hypertension prevalence, awareness, treatment and control in a multi-ethnic Asian population: a crosssectional study. BMJ Open, 9, e025869. https://doi.org/10.1136/bmjopen-2018-025869

McNagny, S. E., Ahluwalia, J. S., Clark, W. S., & Resnicow, K. A. (1997). Cigarette smoking and severe uncontrolled hypertension in inner-city African Americans. American Journal of Medicine, 103(2), 121-127.https://doi.org/10.1016/S0002-9343(97)00131-9

McNaughton, D. C., Jacobson, T. A., & Kripalani, S. (2015). Low Literacy is associated with Uncontrolled blood pressure in primary care patients with hypertension and heart disease. Patient Education and Counseling, 96(2), 165–170. https://doi.org/10.1016/j.pec.2014.05.007

Meelab, S., Bunupuradah, I., Suttiruang, J., Sakulrojanawong, S., Thongkua, N., Chantawiboonchai, C., Chirabandhu, P., Lertthanaporn, S., Suwanthip, K., & Songsaengthum, C. (2019). Prevalence and associated factors of uncontrolled blood pressure among hypertensive patients in the rural communities in the central areas in Thailand: A cross-sectional study. PloS one, 14(2), e0212572.

Meher, M., Pradhan, S., & Pradhan, S. R. (2023). Risk Factors Associated with Hypertension in Young Adults: A Systematic Review. Cureus, 15(4), e37467, https://doi.org/10.7759/cureus.37467

Meyer, S. R., Harpe, R. L., Vollenweider, P., Marques-Vidal, P., & Vauher, J. (2025). Factor associated with and risk of cardiovascular disease in people with uncontrolled hypertension. Scientific Reports, 15(375). https://doi.org/10.1038/s41598-024-84824-z

Mills, K. T., Stefanescu, A., & He, J. (2020). The global epidemiology of hypertension. Nature Reviews Nephrology, 16(4), 223-237. https://doi.org/10.1038/s41581-019-0244-2

Mitra, M., & Wulandari, W. (2019). Factors Affecting Uncontrolled Blood Pressure among Elderly Hypertensive Patients in Pekanbaru City, Indonesia, Open Access Macedonian Journal of Medical Sciences, 7(7), 1209-1213. https://doi.org/10.3889/oamjms.2019.255

Panpakdee, O., Hanucharurnkul, S., Sritanyarat, W., Kompayak, J., & Tanomsup, S. (2003). Self-care process in Thai people with hypertension: An emerging model. Thai Journal of Nursing, 7(2), 121-136.

Porapakkham, Y., Pattaraarchachai, J., & Aekplakorn, W. (2008). Prevalence, awareness, treatment and control of hypertension and diabetes mellitus among the elderly: the 2004 National Health Examination Survey III, Thailand. Singapore medical journal, 49(11), 868.

R Core Team. (2020). R: A language and environment for statistical computing. https://www.R-project.org/

Rabizadeh, S., Gholami, G., Kani, S. M., Rajab, A., Farrokhpour, H., Esteghamati, A., & Nakhjavani, M. (2021). Uncontrolled hypertension in patients with type 2 diabetes: What are the correlates? Journal of Clinical Hypertension, 23(9), 1776–1785. https://doi.org/10.1111/jch.14352

Ramezankhani, A, Azizi, F., & Hadaegh, F. (2019). Associations of marital status with diabetes, hypertension, cardiovascular disease and all-cause mortality: A long-term follow-up study. Plos One, 14(4), e0215593. https://doi.org/10.1371/journal.pone.0215593

Shobron, S., Hidayat, S., & Hasan, M. A. K. (2020). Political strategy of muslim minorities in South Thailand. International Journal of Advanced Science and Technology, 29 (6), 3899-3913.

WHO. (2022). World Health Organization (WHO). key facts.

WHO. (2023). Global report on hypertension: the race against a silent killer. World Health Organization.

Zacher, M. (2023). Educational disparities in hypertension prevalence and blood pressure percentiles in the health and retirement study. Journal of Gerontology Series B: Psychological Sciences and Social Sciences, 778(9),1535–1544. https://doi.org/10.1093/geronb/gbad084