**1. Introduction**

Non-communicable diseases (NCDs) are an increasing trend globally, and according to the World Health Organization (WHO), NCDs kill over 41 million people each year, equivalent to 71% of all the deaths worldwide. NCDs are chronic diseases that could affect the long and multifactorial origins of genetic, physiological, environmental, and behavioral factors. The WHO aims to reduce premature mortality from NCDs by one-third by 2030 [1]. The mortality from NCDs also ranks first in Thailand, and the mortality for all ages caused by prevalent NCDs is as follows: diabetes (4%), chronic pulmonary diseases (9%), cancer (17%), and cardiovascular diseases (CVDs) (29%), respectively—according to the WHO country profile for Thailand 2018 [1]. The highest proportion of mortality contributed by CVDs included stroke and ischemic heart diseases (IHDs), accounting for a quarter of all CVD deaths. The mortality from stroke has doubled, and that of IHD has increased by 50%

**Citation:** Aung, T.N.N.; Shirayama, Y.; Moolphate, S.; Lorga, T.; Jamnongprasatporn, W.; Yuasa, M.; Aung, M.N. Prevalence and Risk Factors for Hypertension among Myanmar Migrant Workers in Thailand. *Int. J. Environ. Res. Public Health* **2022**, *19*, 3511. https:// doi.org/10.3390/ijerph19063511

Academic Editors: Gabriele Grunig, Laura L. Hayman and Kevin Pottie

Received: 30 December 2021 Accepted: 14 March 2022 Published: 16 March 2022

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in the past decade. Hypertension was attributed to two-thirds of stroke cases and half of IHDs in Thailand in 2017 [2]. Hypertension is a serious medical condition that significantly increases the risks of heart, brain, kidney, and other diseases. It is defined as systolic BP (SBP) ≥ 140 mmHg and/or diastolic BP (DBP) ≥ 90 mmHg, or reported treatment for hypertension [3]. The prevalence of hypertension is rising globally, and it is predicted to increase to 29.2% by 2025 [4]. Hypertension is one of the established modifiable risk factors for CVDs, and its prevalence is also increased in Thailand. According to the Thailand national health survey in 2014, one out of four Thai adults has hypertension, a disease named as a silent killer [5].

Thailand is currently hosting 2–3 million migrant workers from its neighboring countries such as Myanmar, Cambodia, and Laos [6]. Amongst them, Myanmar migrant workers comprised 80% of the total migrant population in Thailand. Moving to a country richer than their native country, they may adopt unhealthy lifestyle behaviors, which could affect exposures and vulnerability to NCD risk factors throughout their migration process, as highlighted by the International Organization for Migration [7]. Furthermore, upon return, some migrants arrive home less healthy than when they left, and the health care facilities there are limited. The burden of NCDs by migration is variable, and it depends on the migration status, country of settlement, and type of NCD [8]. In fact, modifiable behavioral risk factors for NCDs have been established, and much literature on preventing NCDs through lifestyle modifications, health education, and health-promoting activities may be limited in its accessibility for migrant workers. According to the Thailand Migration Report 2019, migrant workers are only screened for infectious diseases upon registration, and little is known about NCDs [9]. Even though NCDs are the number one cause of mortality in Thailand, screening for NCDs and long-term follow-up for chronic health conditions are still lacking among the migrant population. The affected individuals may be relatively young, and CVDs may not be a current problem. However, they may become a problem soon. The transition of epidemiological risk factors, limited accessibility to health-promoting activities due to the language barrier, and poor health education may impact their risks for NCDs. Moreover, their mobile nature and variable immigration status may determine the daily self-management of their diseases, continuing medical treatment, and follow-up visits to nearby health care facilities, subsequently affecting the complications of NCDs among this vulnerable population. The potentially higher burden of NCDs, by not being prevented or effectively controlled, could impact healthcare costs and the labor productivity of the host country. Therefore, it is important to determine migrant workers' risky health behaviors to prevent prevalent NCDs such as hypertension. Our study aimed to determine the prevalence and associated risk factors for hypertension among migrant workers from Myanmar legally working in Thailand, since migration itself is a specific health challenge, and research focusing on the health and social security threats of migrant populations is consistently necessary to ensure a healthy global workforce.

#### **2. Materials and Methods**
