Association of hypertension and hyperglycaemia with socioeconomic contexts in resource-poor settings: the Bangladesh Demographic and Health Survey

Harshfield, Eric L.; Chowdhury, Rajiv; Harhay, Meera N.; Bergquist, Henry; Harhay, Michael O.

doi:10.1093/ije/dyv087

Cited by 43 publications

(64 citation statements)

References 38 publications

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“…12,23 In contrast to this evidence, our study shows that the prevalence of hypertension was greater among people with higher SES groups, which is consistent with recent studies conducted in LMICs, 24–26 particularly in South Asia. 15,27 Substantial differences between male and female were observed in the association between SES and hypertension, which is consistent with previous studies in developed countries. 15,28,29…”

Section: Discussionsupporting

confidence: 91%

“…15,27 Substantial differences between male and female were observed in the association between SES and hypertension, which is consistent with previous studies in developed countries. 15,28,29…”

Section: Discussionsupporting

confidence: 91%

“…Three indicators such as education levels, wealth quintiles, and employment status are most commonly used in several studies to assess the SES of a participant,. 12, 15 However, we omitted employment status from our assessment of SES and subsequent analyses due to a large number of missing values as the majority of the women in South Asia are not involved in formal employment. The NDHS 2016 provided data for a derived wealth quintile using the principal component analysis taking scores of a household’s durable and nondurable assets.…”

Section: Methodsmentioning

confidence: 99%

“…For instance, the prevalence of hypertension is higher among low SES group in developed countries, 12,13 while it is substantially higher among high SES groups in LMICs. 14,15…”

Section: Introductionmentioning

confidence: 99%

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Socioeconomic Differentials in Hypertension based on JNC7 and ACC/AHA 2017 Guidelines Mediated by Body Mass Index: Evidence from Nepal Demographic and Health Survey

Rana

Ahmmad

Sen

et al. 2019

Preprint

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27Background: Unlike developed countries; higher socioeconomic status (SES, education, and 28 wealth) is associated with hypertension in low and middle-income countries (LMICs) with 29 limited evidence. We examined the associations between SES and hypertension in Nepal and 30 the extent to which these associations vary by sex and urbanity. The body mass index (BMI) 31 was examined as a secondary outcome and assessed as a potential mediator. , using a multistage stratified 34 sampling technique. Participants aged 15 years or older from selected households were 35 interviewed with an overall response rate of 97%. Main outcomes were hypertension and 36 normal blood pressure defined by the widely used Seventh Report of the Joint National 37 Committee (JNC 7), and the American College of Cardiology/American Heart Association 38 (ACC/AHA) 2017. 39Results: The prevalence of hypertension was higher in Nepalese men than women. The 40 likelihood of having hypertension was more than double for individuals in the highest versus 41 lowest wealth quintiles [men: OR 2.13, 95% CI 1.60-2.85); women: OR 2.54, 95% CI 2.00-42 3.24] and for individuals with the higher education versus no education [men: OR 2.38, 95% 43 CI 1.75-3.23; women: OR 1.63, 95% CI 1.18-2.25]. The associations between SES and 44 hypertension were different by sex and urbanity. These associations were mediated by BMI. 45 Conclusions: Higher SES was positively associated with the higher likelihood of having 46 hypertension in Nepal according to both JNC 7 and ACC/AHA 2017 guidelines. These47 associations were mediated by BMI, which may help to explain broader socioeconomic 48 differentials in CVD and related risk factors, particularly in terms of education and wealth. Our 49 study suggests that the mediating factor of BMI should be tackled to diminish the risk of CVD 50 in people with higher SES in LMICs. Introduction 56 57 Hypertension is a growing public health problem in low and middle-income countries 58 (LMICs) 1 with concurrent risks of cardiovascular and kidney diseases. 2 A review warned that 59 although about three-quarters of people with hypertension (639 million people) live in LMICs, 60 there is no improvement in awareness or control rates. 1 Hypertension is a major contributor to 61 death and disability in South Asian countries, including Nepal with a low level of control and 62 awareness. 3-6 The World Health Organization (WHO) implemented `STEP-wise approach to 63 surveillance' (STEPS) using nationally representative sample in 2008 and 2013 reported an 64 increasing trend of prevalence of hypertension among 15-69 years Nepalese population ranging 65 from 21.5% in 2008 to 26.0% in 2013. 7,8 Based on the recent Nepal Demographic and Health 66 Survey (NDHS) 2016, Kibria and colleagues reported that the estimated prevalence of 67 hypertension in Nepal using the widely used Seventh Report of the Joint National Committee 68 (JNC 7) guideline 9 was 21.2%, and the corresponding prevalence was 44.2% when using a 69 new hypertension guideline rec...

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

“…For instance, the prevalence of hypertension is higher among low SES group in developed countries, 12,13 while it is substantially higher among high SES groups in LMICs. 14,15…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Socioeconomic Differentials in Hypertension based on JNC7 and ACC/AHA 2017 Guidelines Mediated by Body Mass Index: Evidence from Nepal Demographic and Health Survey

Rana

Ahmmad

Sen

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…Studies that previously investigated prevalence and risk factors for hypertension in Nepal and other countries have found that these vary according to age, sex, body weight, race/ethnicity, place of residence, marital status, education level, socio‐economic status, and concomitant diseases such as diabetes, dyslipidemia, or stress . Furthermore, due to similar restrictions for assessing prevalence from a nationally representative dataset, studies investigating the determinants of pre‐hypertension or hypertension in Nepal are also limited by a shortage in recently collected data and the availability of only small‐scale studies mainly conducted in a community or a particular region .…”

Section: Introductionmentioning

confidence: 99%

Prevalence and associated factors of pre‐hypertension and hypertension in Nepal: Analysis of the Nepal Demographic and Health Survey 2016

Kibria

Swasey

Sharmeen

et al. 2018

Health Science Reports

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Objectives: Hypertension is the leading risk factor for cardiovascular diseases and develops faster among pre-hypertensive individuals. However, there is a lack of nationally representative studies that investigate the prevalence and determinants of these two conditions in many developing countries, including Nepal. This study investigates the prevalence and determinants of pre-hypertension and hypertension in Nepal. Results: A total of 14 857 individuals (6247 males and 8610 females) aged ≥15 years who had their blood pressure measured during the survey were included in this study. MethodsThe prevalence for pre-hypertension and hypertension were 26.0% (95% CI: 25.3-26.3, n = 3856) and 19.5% (95% CI: 18.8-20.2, n = 2899), respectively. The prevalence of both conditions was greater among males. In multivariable analyses, older age, male sex, higher body mass index, and residents of Provinces 4 and 5 had significantly increased odds of pre-hypertension and hypertension (P < .05). Additionally, higher education level was found to be positively associated with hypertension. Conclusions:The combined higher prevalence of pre-hypertension and hypertension indicates that nearly half (45.5%) of the respondents are at a greater risk of cardiovascular and other non-communicable diseases due to these two conditions.Older people, males, obese people, and individuals living in Provinces 4 and 5 require more awareness to control blood pressure levels. KEYWORDSdeterminants, hypertension, NDHS 2016, Nepal, pre-hypertension, prevalenceThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Estimated Change in Prevalence of Hypertension in Nepal Following Application of the 2017 ACC/AHA Guideline

Kibria

Swasey

et al. 2018

JAMA Netw Open

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Key Points Question What is the change in prevalence of hypertension among adults in Nepal due to lowering the blood pressure threshold in the 2017 American College of Cardiology/American Heart Association (ACC/AHA) hypertension guideline? Findings Using data from the nationally representative 2016 Nepal Demographic and Health Survey, the estimated prevalence of hypertension was 44.2% according to the 2017 ACC/AHA guideline, 23% higher than the estimate under previous guidelines (21.2%). Meaning The new estimates suggest that nearly half of adults in Nepal may have hypertension; these results support the need for public health programs to increase awareness and minimize complications of hypertension.

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Association of hypertension and hyperglycaemia with socioeconomic contexts in resource-poor settings: the Bangladesh Demographic and Health Survey

Abstract: Increasing levels of wealth and educational attainment were associated with an increased likelihood of having hypertension and hyperglycaemia in Bangladesh.

Cited by 43 publications

References 38 publications

Socioeconomic Differentials in Hypertension based on JNC7 and ACC/AHA 2017 Guidelines Mediated by Body Mass Index: Evidence from Nepal Demographic and Health Survey

Socioeconomic Differentials in Hypertension based on JNC7 and ACC/AHA 2017 Guidelines Mediated by Body Mass Index: Evidence from Nepal Demographic and Health Survey

Prevalence and associated factors of pre‐hypertension and hypertension in Nepal: Analysis of the Nepal Demographic and Health Survey 2016

Estimated Change in Prevalence of Hypertension in Nepal Following Application of the 2017 ACC/AHA Guideline

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