Chowdhury Muhammad Abdul Baker, Uddin Md Jamal, Haque Md Rabiul, Ibrahimou Boubakari
Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA.
Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh.
BMC Cardiovasc Disord. 2016 Jan 25;16:22. doi: 10.1186/s12872-016-0197-3.
Hypertension is an increasing problem in Southeast Asia, particularly in Bangladesh. Although some epidemiological studies on hypertension have been conducted in Bangladesh, the factors associated with hypertension in this nation remain unclear. We aimed to determine the factors associated with hypertension among the adults in Bangladesh.
We conducted a cross-sectional study using data from the nationally representative 2011 Bangladesh Demographic and Health Survey (BDHS). A total of 7,839 (3,964 women and 3,875 men) adults aged 35 years and older who participated in the survey was included. Hypertension was defined by a systolic blood pressure ≥ 140 mmHg and/or, diastolic blood pressure ≥ 90 mmHg and/or, receipt of an anti-hypertensive medication at time of the survey. The degree of association between the risk factors and the outcome was assessed by the odd ratio (OR) obtained from the bivariate and multivariable logistic regression models.
The overall prevalence of hypertension was 26.4 %, and the prevalence was higher in women (32.4%) than men (20.3%). Study participants with the age group of 60-69 years had higher odds of having hypertension (AOR: 3.77, 95% CI: 3.01-4.72) than the age group 35-39 years. Moreover, individuals who had higher educational attainment (AOR: 1.63, 95% C.I: 1.25-2.14) and higher wealth status (AOR = 1.91, 95% CI: 1.54-2.38) had higher odds of having hypertension than the individuals with no education and lower social status, respectively. The analysis also showed that high BMI (AOR: 2.19, 95% C.I: 1.87-2.57) and having diabetes (AOR: 1.54, 95% C.I: 1.31-1.83) were associated with the increasing risk of hypertension.
Our study shows that the risk of hypertension was significantly associated with older age, sex, education, place of residence, working status, wealth index, BMI, and diabetes. Moreover, hypertension is largely untreated, especially in rural settings. The health system needs to develop appropriate strategies including early diagnosis, awareness via mass media, and health education programs for changing lifestyles should be initiated for older age, wealthy, and/or higher educated individuals in Bangladesh. Moreover, area-specific longitudinal research is necessary to find out the underlying causes of regional variations.
高血压在东南亚地区,尤其是在孟加拉国,正成为一个日益严重的问题。尽管孟加拉国已经开展了一些关于高血压的流行病学研究,但该国与高血压相关的因素仍不明确。我们旨在确定孟加拉国成年人中与高血压相关的因素。
我们利用具有全国代表性的2011年孟加拉国人口与健康调查(BDHS)的数据进行了一项横断面研究。共有7839名(3964名女性和3875名男性)年龄在35岁及以上且参与了该调查的成年人被纳入研究。高血压的定义为收缩压≥140 mmHg和/或舒张压≥90 mmHg和/或在调查时正在接受抗高血压药物治疗。通过二元和多变量逻辑回归模型获得的比值比(OR)来评估风险因素与结果之间的关联程度。
高血压的总体患病率为26.4%,女性患病率(32.4%)高于男性(20.3%)。60 - 69岁年龄组的研究参与者患高血压的几率(调整后比值比:3.77,95%置信区间:3.01 - 4.72)高于35 - 39岁年龄组。此外,受教育程度较高的个体(调整后比值比:1.63,95%置信区间:1.25 - 2.14)和财富状况较高的个体(调整后比值比 = 1.91,95%置信区间:1.54 - 2.38)患高血压的几率分别高于未受过教育和社会地位较低的个体。分析还表明,高体重指数(调整后比值比:2.19,95%置信区间:1.87 - 2.57)和患有糖尿病(调整后比值比:1.54,95%置信区间:1.31 - 1.83)与高血压风险增加相关。
我们的研究表明,高血压风险与年龄、性别、教育程度、居住地点、工作状态、财富指数、体重指数和糖尿病显著相关。此外,高血压在很大程度上未得到治疗,尤其是在农村地区。卫生系统需要制定适当的策略,包括早期诊断、通过大众媒体提高认识,并应为孟加拉国年龄较大、富裕和/或受教育程度较高的个体启动改变生活方式的健康教育项目。此外,有必要开展特定地区的纵向研究以找出区域差异的潜在原因。