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Inequalities in the prevalence of undiagnosed hypertension among Bangladeshi adults: evidence from a nationwide survey.

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Ahmed, Sayem ORCID: https://orcid.org/0000-0001-9499-1500, Tariqujjaman, Md., Rahman, Md. Arafat, Hasan, Md. Zahid and Hasan, Md. Mehedi (2019) 'Inequalities in the prevalence of undiagnosed hypertension among Bangladeshi adults: evidence from a nationwide survey.'. International Journal for Equity in Health, Vol 18, Issue 1, e33.

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Abstract

BACKGROUND In recent years, developing countries like Bangladesh are facing a higher burden of non-communicable diseases such as hypertension as a result of demographic transition. Prevalence of hypertension is often studied in this setting. However, evidence on undiagnosed hypertension is not widely available in the existing literature. Therefore, the current study focuses on inequalities in the prevalence of undiagnosed hypertension in Bangladesh. METHODS A total of 8835 participants aged 35+ years were included in this study using nationally representative Bangladesh Demographic and Health Survey 2011 (BDHS). In the survey, systolic blood pressure (SBP) and diastolic blood pressure (DBP) of these participants were measured three times with approximately 10 minutes of an interval between each measurement. Any respondent with either SBP ≥ 140 mmHg or DBP ≥ 90 mmHg was considered as patient with hypertension as per the guidelines from American Heart Association. Among the participants, undiagnosed hypertension was defined as having SBP > =140 mmHg or DBP > =90 mmHg and never taking prescribed medicine or being told by health professionals to lower/control blood pressure. Multiple logistic regression analysis was applied for identifying factors associated with undiagnosed hypertension. Further, socioeconomic inequalities in the prevalence of undiagnosed hypertension were estimated using Concentration Index (C). RESULTS We found 978 (59.9% of the total) were undiagnosed among 1685 hypertensive patients studied. Regression analysis showed individuals with being underweight, having poor socioeconomic conditions, and lower educational qualifications were more likely to have undiagnosed hypertension. A similar association between undiagnosed hypertension and socioeconomic quintiles was observed using concentration index (C = - 0.07). On the other hand, individuals from higher age group (50-64 or above), female sex, and Sylhet region were at lower risk of undiagnosed hypertension. CONCLUSIONS This study showed that a large proportion of the cases with hypertension are remained undiagnosed in Bangladesh, especially among the poor and low educated population. Screening and awareness building initiatives on hypertension should be taken for this group of population to reduce the burden of undiagnosed hypertension.

Item Type: Article
Subjects: WA Public Health > WA 105 Epidemiology
WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WG Cardiovascular System > WG 20 Research (General)
Faculty: Department: Biological Sciences > Department of Tropical Disease Biology
Digital Object Identifer (DOI): https://doi.org/10.1186/s12939-019-0930-5
Depositing User: Stacy Murtagh
Date Deposited: 06 Mar 2019 16:11
Last Modified: 08 Mar 2019 14:54
URI: https://archive.lstmed.ac.uk/id/eprint/10314

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