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Prevalence and risk factors of hypertension in rural Bangladesh: A population-based cross-sectional study
Sobiya Aziz Badat1, C Emdad Haque1, Shakhawat Hossain2
1Natural Resources Institute, University of Manitoba, Winnipeg, Manitoba, Canada.
Insights
Hypertension affects one-third of adults in rural Bangladesh. Key risk factors include age and obesity, with significant gender and socioeconomic disparities. Policy must consider these factors for effective intervention.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Non-communicable diseases (NCDs), including hypertension, pose significant mortality risks in low- and middle-income countries (LMICs).
- Rural Bangladesh faces a data gap regarding hypertension prevalence and associated risk factors.
- Understanding these factors is crucial for developing targeted public health strategies.
Purpose of the Study:
- To determine the prevalence and distribution of hypertension in rural Bangladesh.
- To identify demographic, socioeconomic, lifestyle, and behavioral risk factors associated with hypertension.
- To inform evidence-based policy interventions for hypertension control.
Main Methods:
- A cross-sectional survey was conducted in 2017, encompassing 7384 households across 149 villages in rural Bangladesh.
- Data collected included blood pressure, anthropometric measurements, socioeconomic status, lifestyle, and behavioral factors from adults aged 18 years and above.
- Multivariate logistic regression analyses were employed to identify predictors of hypertension.
Main Results:
- Elevated blood pressure (prehypertension or hypertension) was observed in 33.7% of men and 28.6% of women.
- Age and overweight/obesity were the strongest hypertension risk factors for both genders.
- Significant associations were found between hypertension, age, gender, socioeconomic status, tobacco consumption (women), and physical activity levels (gender-specific).
Conclusions:
- Hypertension is highly prevalent in rural Bangladesh, with significant variations based on gender and socioeconomic status.
- Age and overweight/obesity are critical risk factors, necessitating focused interventions.
- Policy interventions must address gender-specific risks, rural-urban disparities, and socioeconomic contexts for effective hypertension management.
Abstract:
Non-communicable diseases (NCDs), such as hypertension, are amongst the most fatal conditions afflicting people living in low- and middle-income countries (LMIC), including Bangladesh. This study addresses the lack of population-based studies in rural Bangladesh by examining the prevalence and distribution of hypertension and its associated risk factors. To this end, we surveyed adults aged ≥18 years (i.e., household heads and their spouses) from 7384 households across 149 villages in rural Bangladesh in 2017 using a semi-structured questionnaire to collect data on blood pressure, anthropometric, socioeconomic, lifestyle, and behavioral risk factors. Multivariate logistic regression analyses identified age, gender, and socioeconomic status as potential predictors of hypertension. The findings also showed that men and women from higher socioeconomic status (SES) groups had higher rates of overweight and obesity, risk factors for the development of hypertension (4.29% and 1.4% in adult men; 5.8% and 2.29% in adult women), as well as higher rates of fruit and vegetable consumption (10.29% and 7.25% in adult men; 9.95% and 6.84% in adult women). A significant association between tobacco consumption and age was observed for women (p=<0.0001), while higher levels of physical activity were found among men aged 45-54 years [OR:1.9, CI 95% (1.1-3.1)]. Furthermore, women in the highest SES brackets were 1.3 times as likely to engage in "moderate" physical activity as those in the lowest brackets. Age and overweight/obesity were found to be the strongest risk factors for hypertension in both genders, while education was not found to be significantly associated with hypertension in women. Notably, the findings revealed that 33.7% of men and 28.6% of women had elevated blood pressure, qualifying them as either prehypertensive or hypertensive. As such, we recommend that policy interventions aimed at stemming the growth of hypertension among Bangladesh's rural populations should take gender-specific risk factors, rural-urban disparities, and socioeconomic context into serious policy consideration.
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