title: Undiagnosed hypertension in a rural district in Bangladesh: The Bangladesh Population-based Diabetes and Eye Study (BPDES).
abstract: Hypertension is mainly asymptomatic and remains undiagnosed until the disease progresses. The objective of the study was to determine the prevalence of and risk factors for hypertension in rural Bangladesh. Using a population-based cluster random sampling strategy, 3096 adults aged ⩾30 years were recruited from a rural district in Bangladesh. Data collected included two blood pressure (BP) measurements, fasting blood glucose, socio-demographic and anthropometric measurements. Hypertension was defined as systolic BP (SBP) ⩾140 mm Hg or diastolic BP (DBP) ⩾90 mm Hg or self-reported diagnosed hypertension. Logistic regression techniques were used for data analyses. The crude prevalence of hypertension was 40% (95% confidence interval (CI) 38-42%) of which 82% were previously undiagnosed. People from lower socio-economic status (SES) had a significantly higher percentage of undiagnosed hypertension compared with people with higher SES (P<0.001). There was no significant gender difference in severity of hypertension. Males with higher education level compared with no education had a higher prevalence of hypertension (odds ratio 2.34, 95% CI 1.49-3.69). Older age and waist circumference in both genders, and diabetes, lack of physical activity in females were found to be associated with higher prevalence of hypertension. Our research suggests the prevalence of undiagnosed hypertension was higher in the rural area in Bangladesh than that reported from the rural area in neighbouring India and China. Lower SES was associated with a higher risk of undiagnosed hypertension. Public health programs at the grass-roots level must emphasise the provision of primary care and preventive services in managing this non-communicable disease.
authors.affiliation: Department of Statistics, Data Science and Epidemiology, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia.|Organisation for Rural Community Development, Dariapur, Narail, Bangladesh.
authors.forename: F M A
authors.initials: FM
authors.lastname: Islam
authors.affiliation: Organisation for Rural Community Development, Dariapur, Narail, Bangladesh.|The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Perth, Western Australia, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Bhuiyan
authors.affiliation: Organisation for Rural Community Development, Dariapur, Narail, Bangladesh.|Centre for Eye Research Australia, The Royal Victorian Eye and Ear Hospital, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Chakrabarti
authors.affiliation: Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
authors.forename: M A
authors.initials: MA
authors.lastname: Rahman
authors.affiliation: The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Perth, Western Australia, Australia.
authors.forename: Y
authors.initials: Y
authors.lastname: Kanagasingam
authors.affiliation: School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn campus, Hawthorn, Victoria, Australia.|School of Population Health, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: J E
authors.initials: JE
authors.lastname: Hiller
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001459:Bangladesh / Q000453:epidemiology; D001794:Blood Pressure; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012423:Rural Health; D057185:Sedentary Behavior; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D055105:Waist Circumference