Chowdhury Mohammad Ziaul Islam, Haque Md Ashiqul, Farhana Zaki, Anik Ataul Mustufa, Chowdhury Amadul Hoque, Haque Sabrina Mahfuja, Marjana Lu-Lu-Wal, Bristi Piali Dey, Al Mamun Bm Abu, Uddin Mohammad Jasim, Fatema Jain, Rahman Md Meshbahur, Akter Tanjila, Tani Tania Akhter, Turin Tanvir C
Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada,
Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh,
Vasc Health Risk Manag. 2018 Aug 21;14:165-181. doi: 10.2147/VHRM.S166111. eCollection 2018.
Cardiovascular disease (CVD) is a group of conditions affecting the functioning of the heart or blood vessels and is one of the leading causes of death globally. Like other countries, CVD prevalence is also rising among the adults in Bangladesh. Epidemiological studies have shown not only a high CVD prevalence but also a significant increase in its prevalence in Bangladesh in the last few decades. To have a better understanding of the current CVD prevalence scenario, we conducted this systematic review and meta-analysis. Our objective was to assess the prevalence of CVD among the Bangladeshi adult population using evidence from the published scientific literature.
Electronic databases such as MEDLINE, Embase and PubMed were searched. We also manually checked the references of all relevant publications that describe the prevalence of CVD in Bangladeshi adults. To pool the CVD prevalence, we used random-effects meta-analysis. We assessed heterogeneity using both the formal tests and the subgroup analyses. We also assessed study quality and examined publication bias.
We retrieved 755 potentially relevant papers through searches of electronic and gray literature, of which only 13 met inclusion criteria after the screening and were included in this review. Of the studies that met inclusion criteria, three were carried out in rural populations, five in both urban and rural populations and two in strictly urban populations. Male and female participation in the studies was almost equal. The weighted pooled prevalence of CVD was 5.0%, regardless of the types of CVD, gender and geographical location of the study participants. There was also a high heterogeneity in the observed CVD prevalence. Weighted pooled prevalence of overall CVD in the Bangladeshi population was higher in urban areas (8%) compared to rural areas (2%). However, no such difference was observed in terms of gender (3% for both males and females). The highest reported prevalence (21%) was for heart disease, while the lowest reported prevalence (1%) was for stroke. Sources of heterogeneity were often unexplained. The criteria used to assess study quality were fulfilled by only a few studies, and adequate sample size criteria was missed by almost all of them. In addition, there was evidence of small-study effects.
A high CVD prevalence along with an upward trend was observed in Bangladeshi adults. Proper strategies are required for primary prevention of CVD so that a further increase can be alleviated and the morbidity and mortality associated with it can be reduced.
心血管疾病（CVD）是一组影响心脏或血管功能的病症，是全球主要死因之一。与其他国家一样，孟加拉国成年人中的心血管疾病患病率也在上升。流行病学研究表明，在过去几十年中，孟加拉国不仅心血管疾病患病率很高，而且其患病率还显著增加。为了更好地了解当前心血管疾病患病率情况，我们进行了这项系统评价和荟萃分析。我们的目的是利用已发表的科学文献中的证据评估孟加拉国成年人群中心血管疾病的患病率。
检索了MEDLINE、Embase和PubMed等电子数据库。我们还手动检查了所有描述孟加拉国成年人心血管疾病患病率的相关出版物的参考文献。为了汇总心血管疾病患病率，我们使用随机效应荟萃分析。我们使用正式检验和亚组分析评估异质性。我们还评估了研究质量并检查了发表偏倚。
通过检索电子文献和灰色文献，我们检索到755篇潜在相关论文，其中只有13篇在筛选后符合纳入标准并被纳入本综述。在符合纳入标准的研究中，三项在农村人群中进行，五项在城乡人群中进行，两项在严格意义上的城市人群中进行。参与研究的男性和女性几乎相等。无论心血管疾病的类型、研究参与者的性别和地理位置如何，心血管疾病的加权合并患病率为5.0%。观察到的心血管疾病患病率也存在高度异质性。孟加拉国人群中总体心血管疾病的加权合并患病率在城市地区（8%）高于农村地区（2%）。然而，在性别方面未观察到此类差异（男性和女性均为3%）。报告的最高患病率（21%）是心脏病，而报告的最低患病率（1%）是中风。异质性来源往往无法解释。只有少数研究满足用于评估研究质量的标准，几乎所有研究都未达到足够的样本量标准。此外，有证据表明存在小研究效应。
在孟加拉国成年人中观察到心血管疾病患病率很高且呈上升趋势。需要采取适当的策略进行心血管疾病的一级预防，以便缓解患病率的进一步上升并降低与之相关的发病率和死亡率。
