Association between Cooking Fuels and Hypertension among Women at Reproductive Age in Bangladesh: A Nationally Representative Population Dataset from the BDHS 2017-2018

Abstract

Background: Air pollution, a critical environmental issue, encompasses various pollutants from several sources, including household fuel combustion. This study aimed to explore the association between cooking fuel types and hypertension among Bangladeshi women, using data from the Bangladesh Demographic and Health Survey (BDHS 2017–18). The study focuses on the high prevalence of solid fuel use (e.g., wood, animal dung) for cooking in Bangladeshi households and its potential impact on women’s health, particularly hypertension. Methods: The BDHS data encompassed 5,219 women, with a stratified cluster sampling method used to ensure nationwide representation. The analysis included blood pressure measurements, categorizing participants into normal and hypertensive groups, and identifying cooking fuel type as the primary exposure variable. Covariates such as age, education, residence, body mass index (BMI), household size, wealth index, and stove location were considered in the multivariate model. Results: Age, urban residency, education, wealth, obesity, and cooking fuel use all influence high blood pressure in various ways. Older individuals show a higher prevalence of high blood pressure. Obesity is a significant factor, with obese individuals having more than four times the odds of developing hypertension. The use of solid fuels for cooking is linked to a 13% higher likelihood of hypertension among women of reproductive age. More specifically, using solid fuel for cooking is associated with a 60% higher risk of elevated systolic blood pressure (OR 1.60, 95% CI: 1.21-2.12) and a 70% higher risk of elevated diastolic blood pressure (OR 1.70, 95% CI: 1.30-2.00). Conclusion: The study underscores the health implications of household air pollution in Bangladesh, particularly for women exposed to solid cooking fuels. It highlights the need for public health interventions and policy shifts towards cleaner cooking technologies, especially in low- and middle-income countries. Despite its strengths, including a nationally representative sample and robust statistical analysis, the cross-sectional design limits the ability to infer causality. Future longitudinal studies are necessary to understand the temporal dynamics of cooking fuel use and hypertension. This research is crucial for global health, given the rising prevalence of hypertension and the extensive use of solid fuels in similar socioeconomic contexts.