Dataset Information

Demographic, socioeconomic, and biological correlates of hypertension in an adult population: evidence from the Bangladesh demographic and health survey 2017-18.

ABSTRACT:

Background

Bangladesh is well advanced in the epidemiologic transition from communicable to noncommunicable diseases, which now account for two out of three deaths annually. This paper examines the latest nationally representative hypertension prevalence estimates, awareness, treatment, and control-to identify their association with potential correlates.

Methods

The analyses are based on the recent Bangladesh Demographic and Health Survey 2017-18 data. Univariate analyses and bivariate analyses between the outcome variables and individual covariates were carried out. Then chi-square tests were done to see the proportional differences between them. To examine the demographic, socioeconomic and biological factors affecting hypertension, awareness, treatment and control, we used multivariate logistic regression models.

Results

We found that prevalence of hypertension for females and males together aged 35 or more has risen by half between 2011 (25.7%) to 2017 (39.4%). With the broader age range used in 2017, the prevalence is now 27.5% in the population aged 18 years or more. The factors associated with hypertension included older age, being female, urban residence, higher wealth status, minimal education, higher body mass index and high blood glucose level. Following multivariate analyses, many of these characteristics were no longer significant, leaving only age, being female, nutritional status and elevated blood glucose level as important determinants. Over half (58%) of females and males who were found to be hypertensive were not aware they had the condition. Only one in eight (13%) had the condition under control.

Conclusion

In the coming years, a rising trend in hypertension in Bangladeshi adults is expected due to demographic transition towards older age groups and increase in overweight and obesity among the population of Bangladesh. With more women being hypertensive than men, a targeted approach catering to high risk groups should be thoroughly implemented following the Multisectoral NCD Action Plan 2018-2025. Acting in close collaboration with other ministries/relevant sectors to bring an enabling environment for the citizens to adopt healthy lifestyle choices is a prerequisite for adequate prevention. While screening the adult population is essential, the public sector cannot possibly manage the ever-expanding numbers of hypertensives. The private sector and NGOs need to be drawn into the program to assist.

SUBMITTER: Iqbal A

PROVIDER: S-EPMC8235611 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BackgroundWomen's empowerment, education, and economic status are jointly introduced as women's 3E. A number of studies found the significant association of these three variables with maternal health outcomes, but no studies, to the best of knowledge, have been found to justify the joint influence of women's 3E on the birth interval. As several studies have revealed that the short birth interval increases the risk of adverse maternal, perinatal, and infant outcomes and it is also responsible for increasing the country's population size, more research is needed on the birth interval. Therefore, the present study aimed to investigate the influence of women's 3E on the short birth interval after controlling the other selected covariates.MethodsData from the Bangladesh Demographic and Health Survey (BDHS), 2017-18 have been used to serve the purpose of the study. To measure the birth interval, at least two live births for non-pregnant mothers and at least one live birth for currently pregnant mothers born in the 5 years before the survey were included in the study. The Chi-Square test was applied to know the unadjusted association of the selected covariates including women's 3E with the short birth interval. In order to find out the adjusted association of women's 3E with the short birth interval, sequential binary logistic regression models have been used.ResultsThe study found that about 23% of births in Bangladesh were born in a short birth interval. The likelihood of subsequent births of women decreases with an increase in the score of women's 3E before or after controlling the characteristics of women, child, and households. The results of the final model show that mothers with the coverage of 50% - 75%, 75% - 100%, and full coverage (100%) in 3E have a 23%, 41%, and 42% lower odds of having short birth interval compared to mothers with coverage of below 50% in 3E, respectively.Conclusion and recommendationBangladesh still lags behind in meeting the minimum requirements for inter-birth intervals set by the World Health Organization. The study has shown that the 3E in women can contribute in prolonging the duration of subsequent births in Bangladesh. Policy-making interventions are needed to raise awareness among uneducated, under-empowered and economically poor reproductive women through family planning and fertility control programs so that the country can achieve the desired fertility rate.

Project description:BackgroundCardiovascular diseases and risk factors are disproportionally concentrated among the socioeconomically disadvantaged in high-income countries; however, this relationship is not well-understood or documented in resource-limited countries.MethodsWe analysed data from the 2011 Bangladesh Demographic and Health Survey to estimate age-, sex- and location-adjusted differences in blood pressure and blood glucose outcomes by categories of a standardized wealth index and education levels. Body mass index (BMI) was examined as a secondary outcome and also assessed as a potential confounder.ResultsThere was strong evidence that the prevalence of hypertension was higher among Bangladeshi women than among men (33.6% vs 19.6%, P < 0.001), whereas the overall prevalence of hyperglycaemia was 7.1% with no evidence of sex differences. The likelihood of having hypertension was more than double for individuals in the highest vs lowest wealth quintile [odds ratio (OR) for men: 2.82, 95% confidence interval (CI): 2.32-3.44; OR for women: 2.25, 95% CI: 1.90-2.67], and for individuals with the highest level of education attained vs those with no education (OR for men: 2.55, 95% CI: 2.06-3.16; OR for women: 1.42, 95% CI: 0.99-2.03). Likewise, the likelihood of having hyperglycaemia was more than four times higher in the wealthiest compared with the poorest individuals (OR for men: 6.48, 95% CI: 5.11-8.22; OR for women: 4.77, 95% CI: 3.72-6.12), and in individuals with the highest level of education attained vs those with no education (OR for men: 4.68, 95% CI: 3.56-6.15; OR for women: 5.02, 95% CI: 3.30-7.64). There were no appreciable differences in these trends when stratified by geographical location. BMI did not attenuate these associations and exhibited similarly positive associations with education and wealth.ConclusionsIncreasing levels of wealth and educational attainment were associated with an increased likelihood of having hypertension and hyperglycaemia in Bangladesh.

Project description:BACKGROUND:Unlike developed countries, higher socioeconomic status (SES-education, and wealth) is associated with hypertension in low and middle-income countries (LMICs) with limited evidence. We examined the associations between SES and hypertension in Nepal and the extent to which these associations vary by sex and urbanity. The body mass index (BMI) was examined as a secondary outcome and assessed as a potential mediator. MATERIALS AND METHODS:We analyzed the latest Nepal Demographic and Health Survey data (N = 13,436) collected between June 2016 and January 2017, using a multistage stratified sampling technique. Participants aged 15 years or older from selected households were interviewed with an overall response rate of 97%. Primary outcomes were hypertension and normal blood pressure defined by the widely used Seventh Report of the Joint National Committee (JNC7) and the American College of Cardiology/American Heart Association (ACC/AHA) 2017. RESULTS:The prevalence of hypertension was higher in Nepalese men than women. The likelihood of being hypertensive was significantly higher in the higher education group compared with the lowest or no education group for men (OR 1.89 95% CI: 1.36, 2.61) and for women (OR 1.20 95% CI: 0.79, 1.83). People in the richest group were more likely to be hypertensive compared with people in the poorest group for men (OR 1.66 95% CI: 1.26, 2.19) and for women (OR 1.60 95% CI: 1.20, 2.12). The associations between SES (education) and hypertension were partially modified by sex and fully modified by urbanity. BMI mediated these associations. CONCLUSIONS:The higher SES was positively associated with the higher likelihood of having hypertension in Nepal according to both JNC7 and ACC/AHA 2017 guidelines. These associations were mediated by BMI, which may help to explain broader socioeconomic differentials in cardiovascular disease (CVD) and related risk factors, particularly in terms of education and wealth. Our study suggests that the mediating factor of BMI should be tackled to diminish the risk of CVD in people with higher SES in LMICs.

Project description:BackgroundPeru is a Latin American country with a significant burden of hypertension that presents worrying rates of disparities in socioeconomic determinants. However, there is a lack of studies exploring the association between those determinants, hypertension and prehypertension in Peruvian population.ObjectiveWe aimed to assess the association betwgeen socioeconomic determinants, hypertension and prehypertension using a nationally representative survey of Peruvians.MethodsWe performed a cross-sectional analysis of the Peruvian Demographic and Health Survey (2018), which is a two-staged regional-level representative survey. We used data from 33,336 people aged 15 and older. The dependent variable was blood pressure classification (normal, prehypertension and hypertension) following the Seventh Report of the Joint National Committee (JNC-7) on hypertension management. Independent variables were socioeconomic: age, sex, marital status, wealth index, health insurance, education, region and area of residence. Due to the nature of the dependent variable (more than two categories), we opted to use the multinomial regression model, adjusting the effect of the multistage sample using the svy command. We tested interactions with the adjusted Wald test.ResultsThe prevalence of prehypertension and hypertension was 33.68% and 19.77%, respectively. Awareness was higher in urban than in rural areas (9.61% vs. 8.31%, p = 0.008). Factors associated with a higher prevalence ratio of both prehypertension and hypertension were age (ratios rose with each age group), male sex (prehypertension aRPR 5.15, 95%CI 4.63-5.73; hypertension aRPR 3.85, 95% CI 3.37-4.40) and abdominal obesity (prehypertension aRPR 2.11, 95%CI 1.92-2.31; hypertension aRPR 3.04, 95% CI 2.69-3.43). Factors with a lower prevalence ratio of both diseases were secondary education (prehypertension aRPR 0.76, 95%CI 0.60-0.95; hypertension aRPR 0.75, 95% CI 0.58-0.97), higher education (prehypertension aRPR 0.78, 95%CI 0.61-0.99; hypertension aRPR 0.62, 95% CI 0.46-0.82), being married/cohabiting (prehypertension aRPR 0.87, 95%CI 0.79-0.95; hypertension aRPR 0.77, 95% CI 0.68-0.87), richest wealth index (only prehypertension aRPR 0.76, 95%CI 0.63-0.92) and living in cities different to Lima (rest of the Coastline, Highlands and Jungle). Having health insurance (only hypertension aRPR 1.26, 95%CI 1.03-1.53) and current drinking (only prehypertension aRPR 1.15, 95%CI 1.01-1.32) became significant factors in rural areas.ConclusionsWe evidenced socioeconomic disparities among people with hypertension and prehypertension. Better health policies on reducing the burden of risk factors are needed, besides, policy decision makers should focus on hypertension preventive strategies in Peru.

Project description:BackgroundInstitutional delivery rate among women in rural communities in Bangladesh remains low after several governmental interventions. A recent analysis of maternal mortality in Bangladesh revealed that women in rural communities were more likely to die from maternal complications than those in urban areas.ObjectiveThis study assessed the institutional delivery rate and associated factors among women in rural communities in Bangladesh.DesignThis was a cross-sectional study that used the 2017-2018 Bangladesh Demographic and Health Survey for analysis. To determine the factors associated with institutional delivery, multivariate logistic regression analysis was performed.Setting and participantsThe study was conducted in Bangladesh and among 3245 women who delivered live births 3 years before the survey.Main outcome measureThe outcome variable was the place of delivery which was dichotomised into institutional and home delivery/other non-professional places.ResultsThe institutional delivery rate was 44.82% (95% CI 42.02% to 47.65%). We found that women between the ages of 30 and 49 years (aOR=1.51, 95% CI 1.05 to 2.18), women whose partners attained higher education (aOR=2.02, 95% CI 1.39 to 2.94), women who had antenatal visits of 1-3 (aOR=2.54, 95% CI 1.65 to 3.90), 4-7 (aOR=4.79, 95% CI 3.04 to 7.53), and ≥8 (aOR=6.13, 95% CI 3.71 to 10.42), women who watched television (aOR=1.35, 95% CI 1.09 to 1.67) and women in the middle (aOR=1.38, 95% CI 1.05 to 1.82), rich (aOR=1.84, 95% CI 1.34 to 2.54) and richest (aOR=2.67, 95% CI 1.82 to 3.91) households were more likely to use institutional delivery. On the other hand, women who were working (aOR=0.73, 95% CI 0.60 to 0.89), women who were Muslims (aOR=0.62, 95% CI 0.44 to 0.89) and women who gave birth to two (aOR=0.61, 95% CI 0.48 to 0.77) or ≥3 children (aOR=0.46, 95% CI 0.35 to 0.60) were less likely to use institutional delivery.ConclusionThe study revealed that a low proportion of women in rural communities in Bangladesh used institutional delivery. The results of this study should be taken into account by policy-makers and governmental efforts when creating interventions or programmes aimed at increasing institutional delivery in Bangladesh.