BRAC James P Grant School of Public Health, BRAC University, 28, 6th Floor, Medona Tower, Bir Uttam AK Khandakar Rd, Dhaka, 1213, Bangladesh.
Centre for Primary Health Care and Equity, University of New South Wales, Kensington, NSW, 2052, Australia.
BMC Public Health. 2022 Nov 11;22(1):2063. doi: 10.1186/s12889-022-14456-3.
In low- and middle- income countries such as Bangladesh, urban slum dwellers are particualry vulnerable to hypertension due to inadequate facilities for screening and management, as well as inadequate health literacy among them. However, there is scarcity of evidence on hypertension among the urban slum dwellers in Bangladesh. The present study aimed to determine the prevalence and factors associated with hypertension among urban slum dwellers in Bangladesh.
Data were collected as part of a large-scale cross-sectional survey conducted by Building Resources Across Communities (BRAC) between October 2015 and January 2016. The present analysis was performed among 1155 urban slum dwellers aged 35 years or above. A structured questionnaire was adminstered to collect data electronically and blood pressure measurements were taken using standardised procedures. Binary logistic regression with generalized estimating equation modelling was performed to estimate the factors associated with hypertension.
The prevalence of hypertension was 28.3% among urban slum dwellers aged 35 years and above. In adjusted analysis, urban slum dwellers aged 45-54 years (AOR: 1.64, 95% CI: 1.17-2.28), 55-64 years (AOR: 2.47, 95% CI: 1.73-3.53) and ≥ 65 years (AOR: 2.34, 95% CI: 1.47-3.72), from wealthier households (AOR: 1.94, 95% CI: 1.18-3.20), sleeping < 7 h per day (AOR: 1.87, 95% CI: 1.39-2.51), who were overweight (AOR: 1.53, 95% CI: 1.09-2.14) or obese (AOR: 2.34, 95% CI: 1.71-3.20), and having self-reported diabetes (AOR: 3.08, 95% CI: 1.88-5.04) had an increased risk of hypertension. Moreover, 51.0% of the participants were taking anti-hypertensive medications and 26.4% of them had their hypertension in control.
The findings highlight a high burden of hypertension and poor management of it among the slum dwellers in Bangladesh requiring a novel approach to improve care. It is integral to effectively implement the available national non-communicable disease (NCD) control guidelines and redesign the current urban primary health care system to have better coordination.
在孟加拉国等中低收入国家，由于缺乏筛查和管理设施以及居民健康素养不足，城市贫民窟居民尤其容易患高血压。然而，有关孟加拉国城市贫民窟居民高血压的证据稀缺。本研究旨在确定孟加拉国城市贫民窟居民高血压的患病率和相关因素。
数据是作为 Building Resources Across Communities (BRAC) 于 2015 年 10 月至 2016 年 1 月之间进行的一项大规模横断面调查的一部分收集的。本分析在年龄在 35 岁及以上的 1155 名城市贫民窟居民中进行。使用结构化问卷通过电子方式收集数据，并使用标准程序测量血压。使用广义估计方程模型进行二元逻辑回归分析，以评估与高血压相关的因素。
年龄在 35 岁及以上的城市贫民窟居民中，高血压的患病率为 28.3%。在调整分析中，年龄在 45-54 岁（OR：1.64，95%CI：1.17-2.28），55-64 岁（OR：2.47，95%CI：1.73-3.53）和≥65 岁（OR：2.34，95%CI：1.47-3.72），来自富裕家庭（OR：1.94，95%CI：1.18-3.20），每天睡眠<7 小时（OR：1.87，95%CI：1.39-2.51），超重（OR：1.53，95%CI：1.09-2.14）或肥胖（OR：2.34，95%CI：1.71-3.20）以及有自我报告的糖尿病（OR：3.08，95%CI：1.88-5.04）的居民，患高血压的风险增加。此外，51.0%的参与者正在服用抗高血压药物，其中 26.4%的患者高血压得到了控制。
研究结果表明，孟加拉国贫民窟居民高血压负担沉重，且管理不善，需要采取新的方法来改善护理。有效实施现有的国家非传染性疾病（NCD）控制指南并重新设计当前的城市初级卫生保健系统以实现更好的协调是至关重要的。
