Prevalence and determinants of hypertension among urban slum dwellers in Bangladesh

Abstract

Background 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. Methods 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. Results 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. Conclusions 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.

Hypertension care cascade in an urban resettlement colony and slum in Delhi, India: a cross-sectional survey

“…However, the overall prevalence is much lower compared to the burden among older adult and elderly population estimates from nationally representative survey data from India (LASI) (36%) [ 17 ]. The burden of hypertension in the present study was also nearly similar to that observed in populated aged ≥ 35 years from urban slum areas in Bangladesh (28.3%) [ 29 ], higher compared to urban slums in Brazil (12.3%) [ 28 ] but lower than urban slums in Kolkata (42%) [ 30 ]. Our study found the prevalence of hypertension to be higher in males (32.21%) than females (26.25%).…”

“…Current tobacco users in previously diagnosed hypertension cases in this study was 113 (11.66%), a finding lower than that observed in cross-sectional studies from slums in Bangladesh (27.33%) [ 29 ], Kolkata (44.35%) [ 30 ], Kenya (32.3%) [ 47 ] and Egypt (43.65%) [ 48 ]. Among those who smoked tobacco, 41.6% women and 35.51% men were hypertensive in our study, comparatively higher than the findings from NFHS-4 (2015–2016), where 15.3% women and 22.4% men who smoked tobacco were found hypertensive [ 49 ].…”

“…In this study we observed nearly one in five previously diagnosed hypertensive cases were not initiated or not taking any anti-hypertensive medications signifying major deficiencies in the continuum of care as these patients possibly did not report back to their health system, a finding also observed in a study in slums in Bangladesh [ 29 ]. Furthermore, a majority of the patients on treatment reported medication nonadherence, a factor which was independently associated with poorly controlled blood pressure levels.…”

“…The following independent variables were considered in the analysis based on association with the study outcomes observed in previous studies [ 1 , 13 – 16 , 29 ].…”

Differential of physical activities and its association with hypertension and diabetes in Myanmar

“…The consistent findings were evident in studies conducted in Bangladesh, India, China and Peru. 21,24,[26][27][28] Our study observed that unemployed or retired persons were more likely to have diabetes than currently working individuals. Moreover, the odds of developing diabetes was significantly higher among the person with higher educational level than those without formal schooling.…”