National Trends in the Us e of Herbal Medicines for the Treatm ent of Hypertens ion Among Adults in Mongolia from Four Cross-Sectional Surveys in 2005, 2009, 2013, and 2019

Background: The use of herbal and combined herbal and conventional treatments in people with chronic diseases, such as hypertension, is important. The aim of the present study was to assess national trends in using traditional medicines for the treatment of hypertension among adults in Mongolia from four cross-sectional surveys in 2005, 2009, 2013 and 2019. Methods: Cross-sectional data were analysed from 5,657 persons (15-64 years) of known hypertensives that participated in 2005, 2009, 2013 or 2019 Mongolia STEPS surveys. Those who knew their hypertension status were asked about the past two weeks of intake of any drug (medication) for increased blood pressure prescribed by a doctor or other health worker and the current intake of any herbal or traditional remedy for elevated blood pressure. Logistic regression was employed to assess the associations between sociodemographic and comorbid factors and herbal use and concurrent herbal and conventional treatment. Results: The prevalence of known hypertensives slightly increased from 19.0% in 2005 to 23.7% in 2019. The prevalence of current conventional treatment for hypertension among known hypertensives significantly decreased from 74.5% in 2005 to 40.1% in 2019. The proportion of current herbal treatment for hypertension among known hypertensives was overall 6.3% and decreased significantly from 11.7% in 2005 to 9.0% in 2019. The prevalence of current herbal and conventional treatment for hypertension among known hypertensives was overall 4.4% and significantly decreased from 9.9% in 2005 to 6.0% in 2019. In the 2005 survey, the prevalence of herbal use was significantly higher among those with 12 or more years of education (p<0.01) and urban residence (p<0.001), while in the study years 2009, 2013 and 2019, no significant differences were found in terms of educational level and residence status and prevalence of herbal use. In adjusted logistic regression analysis, inadequate fruit and vegetable consumption decreased the odds and older age increased the odds of herbal use and/or concurrent herbal and conventional treatment for hypertension among hypertensives. Conclusion: The prevalence of herbal and/or conventional treatment of hypertension among hypertensives has decreased among Mongolian adults over a 15-year period. Considering significant levels of herbal treatment in combination with conventional treatment for hypertension, negative drugherb effects can be expected, and appropriate actions of health systems may be needed.