Introduction Bangladesh is one of the countries where the prevalence of non-communicable diseases (NCDs) such as hypertension is rising due to rising living standards, sedentary lifestyles, and epidemiological transition. Among the NCDs, hypertension is a major risk factor for CVD, accounting for half of all coronary heart disease worldwide. However, detailed research in this area has been limited in Bangladesh. The objective of the study was to estimate changes in the prevalence and risk factors of hypertension among Bangladeshi adult population. The study also sought to identify socioeconomic status-related inequality of hypertension prevalence in Bangladesh. Methods Cross-sectional analysis was conducted using nationally representative two waves of the Bangladesh Demographic and Health Survey (BDHS) in 2011 and 2017–18. Survey participants were adults 18 years or older- which included detailed biomarker and anthropometric measurements of 23539 participants. The change in prevalence of hypertension was estimated, and adjusted odds ratios were obtained using multivariable survey logistic regression models. Further, Wagstaff decomposition method was also used to analyze the relative contributions of factors to hypertension. Results 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 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 had significantly higher hypertension risk in both survey years in the overall analysis in, however, in the subgroup analysis, the gender difference in hypertension risk was not significant in rural 2011 and urban 2018 samples. Decomposition analysis revealed that the contributions of socio-economic status related inequality of hypertension in 2011 were46.58% and 20.85% for wealth index and BMI, respectively. However, the contributions of wealth index and BMI have shifted to 12.60% and 55.29%, respectively in 2018. Conclusion The prevalence of hypertension among Bangladeshi adults has increased significantly, and there is no subgroup where it is decreasing. Population-level approaches directed at high-risk groups (overweight, obese) should be implemented thoroughly. We underscore prevention strategies by following strong collaboration with stakeholders in the health system of the country to adopt healthy lifestyle choices.

Objective/research questionTo investigate the change in the prevalence and risk factors of diabetes among adults in Bangladesh between 2011 and 2018.DesignThe study used two waves of nationally representative cross-sectional data extracted from the Bangladesh Demographic and Health Surveys in 2011 and 2017–2018.SettingBangladesh.Participants14 376 adults aged ≥35 years.Primary outcomeDiabetes mellitus (type 2 diabetes).ResultsFrom 2011 to 2018, the diabetes prevalence among adults aged ≥35 years increased from 10.95% (880) to 13.75% (922) (p<0.001), with the largest-relative increase (90%) among obese individuals. Multivariable logistic regression analysis identified age and body mass index (BMI) were the key risk factors for diabetes. Adults who were overweight or obese were 1.54 times (adjusted OR (AOR): 1.54, 95% CI: 1.20 to 1.97) more likely to develop diabetes than normal-weight individuals in 2011, and 1.22 times (AOR: 1.22, 95% CI: 1.00 to 1.50) and 1.44 times (AOR: 1.44, 95% CI: 1.13 to 1.84) more prone to develop diabetes in 2018. Other significant risk factors for diabetes were marital status, education, geographical region, wealth index and hypertension status in both survey years.ConclusionA high prevalence of diabetes was observed and it has been steadily increasing over time. To enhance diabetes detection and prevention among adults in Bangladesh, population-level interventions focusing on health education, including a healthy diet and lifestyle, are required.

The cardiovascular system mainly involves blood circulation to transport oxygen, nutrients and metabolic compounds throughout the body. The blood is also used to transport different endocrine hormones (for example, insulin) from the pancreas to various cells in response to blood glucose levels. Unfortunately, any imbalance in glucose and insulin levels may help to develop diabetes mellitus (DM) and increase the risk of developing cardiovascular diseases (CVD) complications such as atherosclerosis, hypertension, and myocardial infarction. Obesity plays a crucial role in developing atherosclerotic plaques and other cardiovascular diseases. It is also responsible for the inappropriate secretion of endocrine factors, resulting in metabolic impairment of insulin target tissues and eventually failure of insulin-producing β-cells. It has been found that 65% of diabetic patients develop cardiovascular problems. Therefore, to know the underlying etiological factors, it is essential to study the molecular mechanisms behind cardiovascular complications from diabetes. Understanding the mechanisms and biomarkers of heart disease in diabetes research can bridge the knowledge gap between diabetes and cardiovascular diseases.