Prevalence, trends and associated factors of hypertension and diabetes mellitus in Bangladesh: Evidence from BHDS 2011 and 2017–18

The evolving pandemic of non-communicable diseases like hypertension, diabetes mellitus are globally on the rise, and the trend is also escalating in Bangladesh. We aimed to assess the prevalence trend and associated factors of hypertension (HTN), diabetes mellitus (DM), and hypertension- diabetes mellitus combined (HDC) among Bangladeshi adults from 2011 to 2018. Two nationally representative cross-sectional data from Bangladesh Demographic and Health Survey (BDHS): 2011 and 2017–18 were utilized. According to baseline characteristics, the average annual rate of change (AARC) was applied to quantify the annual rate of increase/decrease in HTN, DM, and HDC from 2011 to 2018. The prevalence ratios of HTN, DM, and HDC were assessed through modified Poisson regression with robust error variance (PR, 95% Confidence Interval (CI)). The data were prepared in SPSS version 23 and exported to Stata version 13 for further analysis. Among 11,686 participants, the overall mean age of the study participants was 52.79 years, Standard Deviation (SD)±12.99, and 42.28% were female. From 2011–2018, HTN, DM, and HDC prevalence in Bangladesh has increased by 13, 3.2, and 3.1 percentage points, respectively. The average annual rate of increase was observed in the HTN and HDC prevalence by all socio-economic and demographic categories during 2011–2018. The prevalence of HDC among Chittagong residents was approximately double in 2018: 3.95% (2011) versus 6.59% (2018). Increased age, inactive workers, overweight adults, and adults in wealthy families were common risk factors associated with HTN, DM, and HDC in Bangladesh. The prevalence of developing HTN and HDC was significantly higher among adults aged ≥ 70 years (PR: 2.70, 95% CI: 2.42–3.00; PR: 2.97, 95% CI: 2.08–4.24, respectively). A comprehensive approach of different stakeholders is required to develop appropriate strategies, including appropriate weight management, adequate physical activity, and healthier food habits. Health agencies should take initiatives to spread awareness among people at an early age, but special attention is needed for older people and those at risk for NCDs.

[1]  Emon Kalyan Chowdhury,et al.  Prevalence of diabetes and prediabetes among Bangladeshi adults and associated factors: Evidence from the Demographic and Health Survey, 2017-18 , 2021, medRxiv.

[2]  Bette C Liu,et al.  Prevalence, incidence and risk factors of diabetes in Australian adults aged ≥45 years: A cohort study using linked routinely-collected data , 2020, Journal of clinical & translational endocrinology.

[3]  Md. Mujibur Rahman,et al.  Risk factors for non-communicable diseases in Bangladesh: findings of the population-based cross-sectional national survey 2018 , 2020, BMJ Open.

[4]  B. Billah,et al.  Prevalence of diabetes and pre-diabetes in Bangladesh: a systematic review and meta-analysis , 2020, BMJ Open.

[5]  T. Turin,et al.  Hypertension prevalence and its trend in Bangladesh: evidence from a systematic review and meta-analysis , 2020, Clinical Hypertension.

[6]  P. Jia,et al.  Geographic Variation and Associated Covariates of Diabetes Prevalence in India , 2020, JAMA network open.

[7]  M. Hossain,et al.  Prevalence and Risk Factors of Hypertension among Government Employees Serving in Rangpur City, Bangladesh. , 2020, Mymensingh Medical Journal.

[8]  M. Shawon,et al.  Association between body mass index (BMI) and hypertension in south Asian population: evidence from nationally-representative surveys , 2019, Clinical Hypertension.

[9]  J. Shaw,et al.  Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9th edition. , 2019, Diabetes research and clinical practice.

[10]  A. Sarker,et al.  Sex-specific prevalence, inequality and associated predictors of hypertension, diabetes, and comorbidity among Bangladeshi adults: results from a nationwide cross-sectional demographic and health survey , 2019, BMJ Open.

[11]  M. Rahman,et al.  Exploring socio-demographic-and geographical-variations in prevalence of diabetes and hypertension in Bangladesh: Bayesian spatial analysis of national health survey data. , 2019, Spatial and spatio-temporal epidemiology.

[12]  Md. Zakiul Hassan,et al.  Trends, prevalence and risk factors of overweight and obesity among women of reproductive age in Bangladesh: a pooled analysis of five national cross-sectional surveys , 2018, BMJ Open.

[13]  M. Asaduzzaman,et al.  Prevalence of Type 2 Diabetes Mellitus Among Urban Bihari Communities in Dhaka, Bangladesh: A Cross-sectional Study in a Minor Ethnic Group , 2018, Cureus.

[14]  P. Kowal,et al.  Diabetes in South African older adults: prevalence and impact on quality of life and functional disability – as assessed using SAGE Wave 1 data , 2018, Global health action.

[15]  G. Machado,et al.  Odds Ratio or Prevalence Ratio? An Overview of Reported Statistical Methods and Appropriateness of Interpretations in Cross-sectional Studies with Dichotomous Outcomes in Veterinary Medicine , 2017, Front. Vet. Sci..

[16]  Sanjay Jain,et al.  Prevalence and determinants of comorbid diabetes and hypertension: Evidence from non communicable disease risk factor STEPS survey, India. , 2017, Diabetes & metabolic syndrome.

[17]  D. Warburton,et al.  Health benefits of physical activity: a systematic review of current systematic reviews , 2017, Current opinion in cardiology.

[18]  T. Biswas,et al.  Bangladesh policy on prevention and control of non-communicable diseases: a policy analysis , 2017, BMC Public Health.

[19]  Gail M. Williams,et al.  Gender differences in hypertension awareness, antihypertensive use and blood pressure control in Bangladeshi adults: findings from a national cross-sectional survey , 2017, Journal of Health, Population and Nutrition.

[20]  M. Puhan,et al.  Physical activity and risk of comorbidities in patients with chronic obstructive pulmonary disease: a cohort study , 2017, npj Primary Care Respiratory Medicine.

[21]  C. Obermeyer,et al.  Gender disparities in midlife hypertension: a review of the evidence on the Arab region , 2017, Women's Midlife Health.

[22]  K. González,et al.  Physical Inactivity, Sedentary Behavior and Chronic Diseases , 2017, Korean journal of family medicine.

[23]  Nia Roberts,et al.  Socioeconomic status and non-communicable disease behavioural risk factors in low-income and lower-middle-income countries: a systematic review , 2017, The Lancet. Global health.

[24]  Abdullah Al Mamun,et al.  Hypertension and diabetes prevalence among adults with moderately increased BMI (23·0–24·9 kg/m2): findings from a nationwide survey in Bangladesh , 2017, Public Health Nutrition.

[25]  M. Sarker,et al.  Double Trouble: Prevalence and Factors Associated with Tuberculosis and Diabetes Comorbidity in Bangladesh , 2016, PloS one.

[26]  Saswata Ghosh,et al.  Sex differences in the risk profile of hypertension: a cross-sectional study , 2016, BMJ Open.

[27]  M. J. Uddin,et al.  Hypertension among adults in Bangladesh: evidence from a national cross-sectional survey , 2016, BMC Cardiovascular Disorders.

[28]  Jiang He,et al.  Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-Based Studies From 90 Countries. , 2015, Circulation.

[29]  Hafiz M. R. Khan,et al.  Type 2 diabetes and its correlates among adults in Bangladesh: a population based study , 2015, BMC Public Health.

[30]  T. Hasegawa,et al.  Are the Rates of Hypertension and Diabetes Higher in People from Lower Socioeconomic Status in Bangladesh? Results from a Nationally Representative Survey , 2015, PloS one.

[31]  A. Thrift,et al.  Do the socioeconomic and hypertension gradients in rural populations of low- and middle-income countries differ by geographical region? A systematic review and meta-analysis. , 2014, International journal of epidemiology.

[32]  B. Gyawali,et al.  Prevalence of Hypertension in Member Countries of South Asian Association for Regional Cooperation (SAARC): Systematic Review and Meta-Analysis , 2014, Medicine.

[33]  A. Damasceno,et al.  Hypertension in developing countries. , 2014, The Canadian journal of cardiology.

[34]  N. Saquib,et al.  High prevalence of type 2 diabetes among the urban middle class in Bangladesh , 2013, BMC Public Health.

[35]  Martin McKee,et al.  Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. , 2013, JAMA.

[36]  C. Agyemang,et al.  Prevalence, awareness, treatment and control of hypertension among slum dwellers in Nairobi, Kenya , 2013, Journal of hypertension.

[37]  A. Majumder,et al.  Hypertension in Bangladesh: a review. , 2012, Indian heart journal.

[38]  G. Chrousos,et al.  Diabetes mellitus type 2 and other chronic non-communicable diseases in the central region, Saudi Arabia (riyadh cohort 2): a decade of an epidemic , 2011, BMC medicine.

[39]  M. Yunus,et al.  Sociodemographic Differentials of Selected Noncommunicable Diseases Risk Factors Among Adults in Matlab, Bangladesh: Findings From a WHO STEPS Survey , 2011, Asia-Pacific journal of public health.

[40]  N. Alam,et al.  Epidemiological transition in rural Bangladesh, 1986–2006 , 2009, Global health action.

[41]  Chris Corcoran,et al.  Trend Tests for Binary Data , 2006 .

[42]  D. Warburton,et al.  Health benefits of physical activity: the evidence , 2006, Canadian Medical Association Journal.

[43]  Katsuhiko Kuwa,et al.  Approved IFCC recommendation on reporting results for blood glucose (abbreviated). , 2005, Clinical chemistry.

[44]  F. Hu,et al.  Coffee consumption and risk of type 2 diabetes: a systematic review. , 2005, JAMA.

[45]  K. Reynolds,et al.  Global burden of hypertension: analysis of worldwide data , 2005, The Lancet.

[46]  G. Zou,et al.  A modified poisson regression approach to prospective studies with binary data. , 2004, American journal of epidemiology.

[47]  Frank Hu,et al.  Coffee Consumption and Risk for Type 2 Diabetes Mellitus , 2004, Annals of Internal Medicine.

[48]  A. Saremi,et al.  Coffee consumption and the incidence of type 2 diabetes. , 2003, Diabetes care.

[49]  S. Tsugane,et al.  Coffee consumption and risk of type 2 diabetes mellitus , 2003, The Lancet.

[50]  A. Alwan Global status report on noncommunicable diseases 2010. , 2011 .

[51]  Physical activity/exercise and diabetes. , 2004, Diabetes care.