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Sex differences in prevalence and determinants of hypertension among adults: a cross-sectional survey of one rural village in Bangladesh.

ABSTRACT: OBJECTIVE:Prevention of mortality due to cardiovascular disease (CVD) through control of hypertension is a public health priority in Bangladesh. Our objective was to assess sex differences in prevalence and determinants of hypertension among adults in one rural area of Bangladesh. STUDY DESIGN:Cross-sectional. SETTING AND PARTICIPANTS:From January 2014 to December 2015, we conducted a cross-sectional study of 2600 men and women aged ?18 years located in one rural district of Bangladesh. We collected data on demographics, behavioural factors, physical measurements and health history. PRIMARY OUTCOME MEASURES:Our primary outcome was hypertension (systolic blood pressure ?140?or diastolic blood pressure ?90?mm Hg). RESULTS:The average age of participants was 41.6 years and 53.7% were women. Hypertension prevalence was 6.9% (95% CI 5.9 to 7.9), and was significantly higher among women (8.9%) than men (4.5%). The highest prevalence of hypertension was observed among women aged ?60 years at 21.3% (95% CI 16.6 to 26.7). A higher proportion of men with hypertension were aware of their condition (72.2%) compared with women (52.4%). Determinants of hypertension included older age, higher education, current tobacco use, increasing body mass index, and hyperglycaemia. CONCLUSION:Our research suggests that hypertension prevalence is higher among women than men in rural Bangladesh. Sex-specific interventions should be developed to inform adults of the necessary lifestyle changes that may reduce the risk of hypertension and subsequent CVDs.

SUBMITTER: Islam JY

PROVIDER: S-EPMC7467534 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Sex differences in prevalence and determinants of hypertension among adults: a cross-sectional survey of one rural village in Bangladesh.

Islam Jessica Yasmine JY Zaman M Mostafa MM Ahmed Jasim Uddin JU Choudhury Sohel Reza SR Khan Hasanuzzaman H Zissan Tashfin T

BMJ open 20200901 9

<h4>Objective</h4>Prevention of mortality due to cardiovascular disease (CVD) through control of hypertension is a public health priority in Bangladesh. Our objective was to assess sex differences in prevalence and determinants of hypertension among adults in one rural area of Bangladesh.<h4>Study design</h4>Cross-sectional.<h4>Setting and participants</h4>From January 2014 to December 2015, we conducted a cross-sectional study of 2600 men and women aged ≥18 years located in one rural district o ...[more]

PMID: 32873676

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Project description:ObjectiveWe implemented this study to report the prevalence and associated risk factors of hypertension among adult men and women aged >30 years residing in selected urban and rural areas of Dhaka division, Bangladesh.DesignCross-sectional study.SettingTwo urban (Dhaka city north and Dhaka city south) and two rural (Narsinghdi and Gazipur district) areas of the Dhaka division.ParticipantsA total of 4856 male and female participants were included in the final analysis, of whom 2340 (48.2%) were from urban and 2516 (51.8%) were from rural areas.Primary outcomeHypertension was the dependent variable for this study and was operationally defined as systolic blood pressure >140?mm of Hg and/or diastolic blood pressure >90?mm of Hg, and/or persons with already diagnosed hypertension.ResultsThe overall prevalence of hypertension was 31.0%, and the prevalence was higher among urban participants (urban: 36.9%, rural: 30.6%). Age (across all categories), female (urban-adjusted OR (AOR): 1.3, 95%?CI: 1.0 to 1.5 and rural-AOR: 1.7, 95%?CI: 1.4 to 2.1)), higher educational status (urban-AOR: 1.7, 95%?CI: 1.3 to 2.2 and rural-AOR: 2.1, 95%?CI: 1.5 to 3.1), inadequate physical activity (urban-AOR: 1.3, 95%?CI: 1.0 to 1.7 and rural-AOR: 1.5, 95%?CI: 1.2 to 1.9) and overweight/obesity (urban-AOR: 2.7, 95%?CI: 2.1 to 3.3 and rural-AOR: 2.1, 95%?CI: 1.7 to 2.5) were associated with hypertension in both urban and rural areas. Women who were not currently married during the survey had higher odds of hypertension only in the rural areas (rural-AOR: 1.8, 95%?CI: 1.3 to 2.4), and respondents who were not working during the survey had higher odds of hypertension only in the urban areas (AOR: 1.7, 95%?CI: 1.0 to 2.6).ConclusionSince the prevalence of hypertension was high in urban and rural areas, the government of Bangladesh should consider implementing hypertension prevention programmes focusing young population of Dhaka division. In addition, early screening programmes and management of hypertension need to be strengthened for people with hypertension in both the areas.

Project description:ObjectivesWith the increasing burden of non-communicable diseases in low-income and middle-income countries, biological risk factors, such as hyperglycaemia, are a major public health concern in Bangladesh. Hyperglycaemia is an excess of glucose in the bloodstream and is often associated with type 2 diabetes mellitus. Nationally representative data of hyperglycaemia prevalence starting from age ≥18 years are currently unavailable for Bangladeshi adults. The objective of this study was to assess the prevalence and determinants of hyperglycaemia among adults in Bangladesh aged ≥18 years.Study designCross-sectional, population-based study.Setting and participantsData for this analysis were collected in November to December 2015, from a population-based nationally representative sample of 1843 adults, aged ≥18 years, from both urban and rural areas of Bangladesh. Demographic information, capillary blood glucose, blood pressure, height, weight, waist circumference and treatment history were recorded.Primary outcome measuresHyperglycaemia was defined as a random capillary blood glucose level of ≥11.1 mmol/L (ie, in the diabetic range) or currently taking medication to control type 2 diabetes, based on self-report.ResultsOverall, the prevalence of hyperglycaemia was 5.5% (95% CI 4.5% to 6.6%) and was significantly higher among urban (9.8%, 95% CI 7.7% to 12.2%) than rural residents (2.8%, 95% CI 1.9% to 3.9%). The age-standardised prevalence of hyperglycaemia was 5.6% (95% CI 4.6% to 6.8%). Among both urban and rural residents, the associated determinants of hyperglycaemia included hypertension and abdominal obesity. About 5% of the total population self-reported have been previously diagnosed with type 2 diabetes; among these adults, over 25% were not taking medications to control their diabetes.ConclusionsOur study found that about 1 in 20 Bangladeshi adults aged ≥18 years have hyperglycaemia. To control and prevent the development of type 2 diabetes, data from this study can be used to inform public health programming and provide descriptive information on surveillance of progress towards controlling diabetes in Bangladesh.

Project description:ObjectivesLow-income and middle-income countries are undergoing epidemiological transition, however, progression is varied. Bangladesh is simultaneously experiencing continuing burden of communicable diseases and emerging burden of non-communicable diseases (NCDs). For effective use of limited resources, an increased understanding of the shifting burden and better characterisation of risk factors of NCDs, including hypertension is needed. This study provides data on prevalence and factors associated with hypertension among males and females 35 years and older in rural Bangladesh.MethodsThis is a population-based cross-sectional study conducted in Zakiganj and Kanaighat subdistricts of Sylhet district of Bangladesh. Blood pressure was measured and data on risk factors were collected using STEPS instrument from 864 males and 946 females aged 35 years and older between August 2017 and January 2018. Individuals with systolic blood pressure of ?140?mm Hg or diastolic blood pressure of ?90?mm Hg or taking antihypertensive drugs were considered hypertensive. Bivariate and multivariate analyses were performed to identify factors associated with hypertension.ResultsThe prevalence of hypertension was 18.8% (95% CI 16.3 to 21.5) and 18.7% (95% CI 16.3 to 21.3) in adult males and females, respectively. Among those who were hypertensive, the prevalence of controlled, uncontrolled and unaware/newly identified hypertension was 23.5%, 25.9% and 50.6%, respectively among males and 38.4%, 22.6% and 39.0%, respectively among females. Another 22.7% males and 17.8% females had prehypertension. Increasing age and higher waist circumference (?90?cm for males and ?80?cm for females) were positively associated with hypertension both in males (OR 4.0, 95%?CI 2.5 to 6.4) and females (OR 2.8, 95%?CI 2.0 to 4.1).ConclusionsIn view of the high burden of hypertension and prehypertension, a context-specific scalable public health programme including behaviour change communications, particularly to increase physical activity and consumption of healthy diet, as well as identification and management of hypertension needs to be developed and implemented.

Project description:BackgroundPortopulmonary hypertension (POPH), pulmonary arterial hypertension that develops in the setting of portal hypertension, can lead to right-sided heart failure and death. Being female is a known risk factor for POPH, but little is known about the effect of sex on clinical manifestations, hemodynamics, treatment response, and survival.Research questionWe sought to characterize sex differences in clinical characteristics, pulmonary hemodynamics, treatment response, and survival in patients with POPH.Study design and methodsWe performed a retrospective cohort study of adult candidates for liver transplant (LT) who had POPH within the Organ Procurement and Transplantation Network database. Females and males were compared. Multivariate regression was performed to assess the association between sex and pulmonary vascular resistance (PVR) and survival. Patients were also stratified by age (50 years) to determine how age modifies the relationship between sex and hemodynamics and survival.ResultsWe included 190 adults (103 male, 87 female). Compared with men, women had a lower model for end-stage liver disease (MELD) score (12.1± 4.2 vs 13.8 ± 4.9; P = .01) and were more likely to have autoimmune liver disease. Women had a higher baseline PVR (610.6 ± 366.6 vs 461.0 ± 185.3 dynes-s-cm-5; P < .001) and posttreatment PVR (244.6 ± 119.5 vs 202.0 ± 87.7 dynes-s-cm-5; P = .008) and a greater treatment response (ΔPVR) (-359.3 ± 381.9 vs -260.2 ± 177.3 dynes-s-cm-5; P = .03). In multivariate analysis, female sex (or gender) remained associated with a higher baseline PVR (P = .008). Women and men had overall similar survival (P > .05). When patients were stratified by age, being female was independently associated with worse waiting list survival after adjusting for MELD and PVR in younger patients (HR, 6.61; 95% CI, 1.25-35.08; P = .03) but not in older patients.InterpretationCompared with male candidates, female candidates for LT who had POPH had a higher PVR and lower MELD score and were more likely to have autoimmune liver disease. Women and men had similar overall survival, but female sex (or gender) was associated with worse survival in younger patients.

Project description:The objective of this study was to estimate the magnitude and determinants of inadequate weight gain in the third-trimester among rural women in Matlab, Bangladesh.The study analyzed data on weight gain in the third trimester in 1,883 pregnant women in Matlab, Bangladesh. All these women were admitted to Matlab hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) for childbirth during 2012-2014, and they had singleton live births at term. Data were retrieved from the electronic databases of Matlab Health and Demographic Surveillance System and Matlab hospital. A multivariable logistic regression for inadequate weight gain in the third trimester (?4 kg) was built with sociodemographic, environmental and maternal factors as predictors.One thousand and twenty-six (54%) pregnant women had inadequate weight gain in the third trimester. In the multivariable model, short stature turned out to be the most robust risk factor for inadequate weight gain in the third trimester (OR = 2.5; 95% CI 1.8, 3.5 for short compared to tall women). Pre-third-trimester BMI was inversely associated with insufficient weight gain (OR = 0.96; 95% CI 0.93, 0.99 for 1 unit increase in BMI). Other risk factors for inadequate weight gain in the third trimester were advanced age (OR = 1.9; 95% CI 1.2, 3.1 for ?35 years compared to ?19 years), parity (OR = 1.5; 95% CI 1.2, 1.9 for multipara compared to nulliparous women), low socioeconomic status (OR = 1.7; 95% CI 1.2, 2.3 for women in the lowest compared to women in the highest wealth quintile), low level of education (OR = 1.6; 95% CI 1.2, 2.1 for ?5 years compared to ?10 years of education), belonging to the Hindu religious community (OR = 1.8; 95% CI 1.3, 2.5), consuming arsenic-contaminated water (OR = 1.4; 95% CI 1.1, 1.9), and conceiving during monsoon or dry season compared to summer (OR = 1.4; 95% CI 1.1, 1.8).Among rural Bangladeshi women in Matlab, third-trimester weight gain was in general poor. Maternal characteristics such as short stature, low BMI, advanced age, parity, low level of education and socioeconomic status, being Hindu, intake of arsenic contaminated water, and conceiving during monsoon or dry season were the risk factors for inadequate weight gain in the third trimester. Special attention should be given during prenatal care to women with the risk factors identified in this study.

Dataset Information

Sex differences in prevalence and determinants of hypertension among adults: a cross-sectional survey of one rural village in Bangladesh.

Publications

Sex differences in prevalence and determinants of hypertension among adults: a cross-sectional survey of one rural village in Bangladesh.

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