Association of hypertension and hyperglycaemia with socioeconomic contexts in resource-poor settings: the Bangladesh Demographic and Health Survey
International Journal of Epidemiology
Oxford University Press
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Harshfield, E., Chowdhury, R., Harhay, M., Bergquist, H., & Harhay, M. (2015). Association of hypertension and hyperglycaemia with socioeconomic contexts in resource-poor settings: the Bangladesh Demographic and Health Survey. International Journal of Epidemiology, 44 1625-1636. https://doi.org/10.1093/ije/dyv087
BACKGROUND: Cardiovascular diseases and risk factors are disproportionally concentrated among the socioeconomically disadvantaged in high-income countries; however, this relationship is not well-understood or documented in resource-limited countries. METHODS: We analysed data from the 2011 Bangladesh Demographic and Health Survey to estimate age-, sex- and location-adjusted differences in blood pressure and blood glucose outcomes by categories of a standardized wealth index and education levels. Body mass index (BMI) was examined as a secondary outcome and also assessed as a potential confounder. RESULTS: There was strong evidence that the prevalence of hypertension was higher among Bangladeshi women than among men (33.6% vs 19.6%, P < 0.001), whereas the overall prevalence of hyperglycaemia was 7.1% with no evidence of sex differences. The likelihood of having hypertension was more than double for individuals in the highest vs lowest wealth quintile [odds ratio (OR) for men: 2.82, 95% confidence interval (CI): 2.32-3.44; OR for women: 2.25, 95% CI: 1.90-2.67], and for individuals with the highest level of education attained vs those with no education (OR for men: 2.55, 95% CI: 2.06-3.16; OR for women: 1.42, 95% CI: 0.99-2.03). Likewise, the likelihood of having hyperglycaemia was more than four times higher in the wealthiest compared with the poorest individuals (OR for men: 6.48, 95% CI: 5.11-8.22; OR for women: 4.77, 95% CI: 3.72-6.12), and in individuals with the highest level of education attained vs those with no education (OR for men: 4.68, 95% CI: 3.56-6.15; OR for women: 5.02, 95% CI: 3.30-7.64). There were no appreciable differences in these trends when stratified by geographical location. BMI did not attenuate these associations and exhibited similarly positive associations with education and wealth. CONCLUSIONS: Increasing levels of wealth and educational attainment were associated with an increased likelihood of having hypertension and hyperglycaemia in Bangladesh.
Cardiovascular disease, demographic health surveys, hyperglycaemia, hypertension, socioeconomic, Adult, Bangladesh, Blood Glucose, Blood Pressure, Body Mass Index, Female, Health Surveys, Humans, Hyperglycemia, Hypertension, Logistic Models, Male, Middle Aged, Odds Ratio, Risk Factors, Rural Population, Sex Factors, Socioeconomic Factors, Urban Population
This work was partially supported by the National Institute of Diabetes and Digestive and Kidney Diseases from the United States National Institutes of Health (grant F32DK096758‐01 to M.N.H.) and from the National Cancer Institute, United States National Institutes of Health (grant R01CA159932 supporting M.O.H.).
External DOI: https://doi.org/10.1093/ije/dyv087
This record's URL: https://www.repository.cam.ac.uk/handle/1810/263160