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Inequalities in Undiagnosed Hypertension Among Adult Population in Bangladesh: Evidence from a Nationally Representative Survey

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Abstract

Introduction

Bangladesh has experienced a rising trend in hypertension in recent years and women are suffering from this non-communicable disease more than men. About one-fifth of the adult population is suffering from hypertension and almost three-fifth of them are undiagnosed.

Aim

This study aims to assess the prevalence and determinants of undiagnosed hypertension and to examine the extent of socioeconomic inequalities in undiagnosed hypertension among adult Bangladeshi population (≥ 18 years).

Methods

This study used nationally representative Bangladesh Demographic and Health Survey 2017–18 data. Undiagnosed hypertension was defined as having systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg and was never told by the health professionals to lower/control blood pressure. Multiple logistic regression analysis was performed to assess factors associated with undiagnosed hypertension. Further, socioeconomic inequalities in the prevalence of undiagnosed hypertension were estimated using Concentration Index.

Results

Out of total 3196 hypertensive adults, half (50.1%) were undiagnosed. In the adjusted model, older age, overweight/obesity, female gender, richest wealth quintiles had lower odds of being undiagnosed. Overall concentration index showed that poor patients were disproportionately affected by undiagnosed hypertension (Concentration Index: − 0.103, Standard Error (SE) of Concentration Index: 0.024; P value < 0.001). The poor(Q1)-to-rich(Q5) ratio of 1.3 also demonstrates that poorest hypertensive Bangladeshi adults have higher prevalence of undiagnosed hypertension than their richest counterparts.

Conclusion

Awareness building program should be targeted towards adults belong to poor wealth quintiles for checking blood pressure regularly. Hypertension should be diagnosed and treated to prevent further complications.

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Authors and Affiliations

  1. Department of Health Policy and Management, College of Public Health, University of Georgia, Wright Hall 301B, 100 Foster Rd, Athens, GA, 30602, USA

    Mohammad Rifat Haider

  2. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Discovery I, Columbia, SC, 29208, USA

    Rajat Das Gupta

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Corresponding author

Correspondence to Mohammad Rifat Haider.

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Funding

This article received no external funding.

Competing interests

The authors declare that they have no competing interests.

Ethical approval

The institutional review board at ICF (IRB: FWA00000845) and the Bangladesh Medical Research Council (IRB: BMRC/NREC/2016–2019/324) approved the study protocol of BDHS 2017–18. Prior to data collection, informed consent was taken from the participants.

Consent for publication

Not applicable.

Data availability

All the datasets of BDHS 2017–18 are publicly available and can be accessed from the following link: https://dhsprogram.com/methodology/survey/survey-display-536.cfm . Following proper instruction by the DHS program, data are available to download.

Authors’ contributions

MRH had a role in the conception, planning, data acquisition and analysis and writing up of the work, and manuscript development. RDG contributed to literature review, editing, and revision of the final manuscript. All authors have read and approved the final manuscript.

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Haider, M.R., Gupta, R.D. Inequalities in Undiagnosed Hypertension Among Adult Population in Bangladesh: Evidence from a Nationally Representative Survey. High Blood Press Cardiovasc Prev 29, 57–64 (2022). https://doi.org/10.1007/s40292-021-00488-0

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