SEARCHCOHORTcardiology, epidemiology

cohort·cardiology, epidemiology, public health, geriatrics, internal medicine·PMC10578599

Prevalence and determinants of hypertension among older adults: A comparative analysis of the 6 th and 8 th national health surveys of Bangladesh

PLOS ONE · 9 authors, 4 centres

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TL;DR

This study compared two national health surveys in Bangladesh to see if hypertension rates and their drivers changed between 2011 and 2018.

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The study analyzed data from the 2011 and 2017-18 Bangladesh Demographic and Health Surveys, which measured blood pressure and covariates in adults aged 35 years and older. The age-standardized prevalence of hypertension increased by 10.9 percentage points, from 29.5% in 2011 to 40.4% in 2018. Hierarchical mixed-effects Poisson regression models were used to assess determinants. The analysis found that excessive body weight and awareness of hypertension were major mediators of risk. The population-attributable risk of socioeconomic status (SES) decreased from 21% to 16%, while the risk mediated by excessive body weight and hypertension awareness increased. Limitations include the inability to adjust for lifestyle factors like physical activity and smoking, and the analysis of two different population sets.

STUDY TYPE

cohort

SPECIALTY

cardiology

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ORIGINAL PAPER

PMC10578599

Prevalence and determinants of hypertension among older adults: A comparative analysis of the 6 th and 8 th national health surveys of Bangladesh

PLOS ONE

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ABSTRACT

Background Hypertension is a major public health concern in low-and middle-income countries. A nationwide Health, Population, and Nutrition Sector Development Program in Bangladesh has been shown to be effective in resource-poor settings. This article aims to investigate whether the prevalence and determinants of adult hypertension changed from 2011 to 2018. Methods The determinants of adult hypertension were assessed in 2011 and 2018 data of Bangladesh Demographic and Health surveys. These two surveys included both men and women over the age of 34 years and measured their blood pressure, weight, height, and other covariates. For both surveys, we estimated the age-standard prevalence of hypertension and relative, attributable and mediated risk of determinants of hypertension using hierarchical mixed-effects sequential Poisson regression models. Results The prevalence of adult hypertension increased by 10.9% from 29.5% in 2011 to 40.4% in 2018. The nationwide awareness program on the Health, Population and Nutrition Sector changed the risks associated with hypertension determinants over the years. During 2011, Socio-economic status (SES) was a major distal determinant of adult hypertension, explaining 21% of population-attributable risk (ART). However, other factors accounted for 90% of risk, mainly by excessive body weight (51%) and awareness of hypertension (39%). In contrast, SES only explained 16% of ART risk, with 97% of the risk mediated by excessive body weight (55%) and awareness of hypertension (41%). Conclusion The study results highlight that hypertension among older adult was significantly increased over the six-year period. Specially, the socio-economic status, awareness of hypertension and excessive body weight were the significant determinants. Being awareness of hypertension and excessive body weight changed the causal pathways of socio-economic status. The results also highlight the value of studying the effect of non-communicable disease awareness programs to enhance our comprehension of factors influencing health.

CITATION EXPORT

Probir Kumar Ghosh, Md. Golam Dostogir Harun, Ireen Sultana Shanta et al.. Prevalence and determinants of hypertension among older adults: A comparative analysis of the 6th and 8th national health surveys of Bangladesh. PLOS ONE. (2023). https://doi.org/10.1371/journal.pone.0292989

AUTHORS

9 · 4 CENTRES

Probir Kumar Ghosh, Md. Golam Dostogir Harun, Ireen Sultana Shanta, Ausraful Islam, Kaniz Khatun E. Jannat, Haider Mannan, Mpho Keetile, Mpho Keetile, Mpho Keetile

1 International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
2 Doctoral student, School of Health Sciences, Western Sydney University, Sydney, NSW, Australia
3 Translation Health Research Institute, Western Sydney University, Campbelltown Campus, Sydney, NSW, Australia
University of Botswana, BOTSWANA

EDITOR / REVIEWER

Mpho Keetile