Changes in prevalence and risk factors of hypertension among adults in Bangladesh: An analysis of two waves of nationally representative surveys

Abstract Objective To examine the change in hypertension prevalence and risk factors among adults in Bangladesh. Methods Cross-sectional analysis was conducted using nationally representative two waves of the Bangladesh Demographic and Health Survey (BDHS) in 2011 and 2018. Survey participants were adults 18 years or older- which included detailed biomarker and anthropometric measurements of 23539 study participants. The change in prevalence of hypertension was estimated, and adjusted odds ratios were obtained using multivariable logistic regression models. Findings From 2011 to 2018, the hypertension prevalence among adults aged ≥35 years increased from 25.84% to 39.40% (p<0.001), with the largest relative increase (97%) among obese individuals. The prevalence of hypertension among women remained higher than men whereas the relative increase among men and women were 75% and 39%, respectively. Regression analysis identified age and BMI as the independent risk factors of hypertension. Other risk factors of hypertension were sex, marital status, education, geographic region, wealth index, and diabetes status in both survey years. Female adults experienced significantly higher hypertension risk in the overall analysis in both survey years, however, in the subgroup analysis gender difference in hypertension risk was not significant in rural 2011 and urban 2018 samples. Conclusion A substantial increase was observed in prevalence of hypertension among Bangladeshi adults and there is no subgroup in which it is decreasing. Population-level approaches directed at adults with hypertension are needed to improve risk factors to prevent hypertension.