title: Clinical and biochemical characterization of high risk and not high risk for cardiovascular disease adults in a population from peripheral region of Bangladesh.
abstract: BACKGROUND
  A group of 63708 Bangladeshi adults from a rural area were screened in 2011-12 for cardiovascular diseases (CVD) risk using a questionnaire based tool developed as part of the 'WHO CVD-RISK Management Package for low-and medium resource setting'. In the current study participants who were found to be high risk and a sample of the not high risk participants from the screening were further characterized clinically and biochemically to explore the burden and determinants of CVD risk factors in a remote rural Bangladeshi population.
  
  
  METHODS
  The high risk participants comprised all 1170 subjects who screened positive in 2011-12 and the not high risk group comprised 563 randomly sampled participants from the 62538 who screened negative. Socio-demographic, behavioral, anthropometric, clinical and biochemical data (glucose and lipids) were collected by standardized procedures. Body Mass Index (BMI) was classified following Asian BMI criteria. Data was analyzed using univariable and multivariable methods.
  
  
  RESULTS
  On univariable analysis in high risk and not high risk participants respectively, age in years (M ± SD) was 50 ± 11 for both groups, ratio of male: female was 40:60 and 66:44, current smoking 28.5% and 50.6%; smokeless tobacco use 37.1% and 34.8%; overweight and obesity measured by body mass index (BMI) was 39.1% and 20.5%; high waist circumference (WC) 36.1% and 11.9%; high waist to hip ratio (WHR) 53.8% and 26.3%; and with high waist to height ratio (WHtR) 56.4% and 28.4%, existence of hypertension (HTN) was 15.8% and 3.6%, pre-HTN 43.8% and 12.1%, diabetes (DM) 14.0% and 10.5%, pre-DM 16.9% and 12.1% and dyslipidaemia 85.8% and 89.5%. In multivariable logistic regression analysis female sex, BMI, WC, WHR and WHtR, HTN and dyslipidaemia remain significantly more common among high risk participants (p < 0.05 and p < 0.001).
  
  
  CONCLUSIONS
  The prevalence of clinical and biochemical risk factors of CVDs are quite high even in this rural population and this may be related to the socioeconomic and cultural transition in Bangladeshi society. Surprisingly more of the high risk group was female and there were fewer smokers. Obesity and hypertension were more frequent in high risk participants.
authors.affiliation: Department of Epidemiology, Bangladesh University of Health Sciences (BUHS), 125/1, Darus Salam, Mirpur, Dhaka, 1216, Bangladesh. kaniz_dina@yahoo.com.|The School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, NSW 2052, Australia. kaniz_dina@yahoo.com.
authors.forename: Kaniz
authors.initials: K
authors.lastname: Fatema
authors.affiliation: The School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, NSW 2052, Australia. n.zwar@unsw.edu.au.
authors.forename: Nicholas Arnold
authors.initials: NA
authors.lastname: Zwar
authors.affiliation: Department of Biochemistry, BUHS, 125/1 Darus Salam, Mirpur, Dhaka, 1216, Bangladesh. zeba5533@gmail.com.
authors.forename: Zebunnesa
authors.initials: Z
authors.lastname: Zeba
authors.affiliation: Centre for Clinical Epidemiology and Biostatistics (CCEB), The School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Newcastle, NSW 2008, Australia. Milton.Hasnat@newcastle.edu.au.
authors.forename: Abul Hasnat
authors.initials: AH
authors.lastname: Milton
authors.affiliation: The School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, NSW 2052, Australia. b.rahman@unsw.edu.au.
authors.forename: Bayzidur
authors.initials: B
authors.lastname: Rahman
authors.affiliation: Department of Molecular and Cell Biology, BUHS, 125/1 Darus Salam, Mirpur, Dhaka, 1216, Bangladesh. vc@buhs-edu.org.
authors.forename: Liaquat
authors.initials: L
authors.lastname: Ali
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry / Q000379:methods; D001459:Bangladesh / Q000453:epidemiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology*; D003920:Diabetes Mellitus / Q000453:epidemiology; D050171:Dyslipidemias; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055105:Waist Circumference; D049629:Waist-Hip Ratio