Clinical and biochemical characterization of high risk and not high risk for cardiovascular disease adults in a population from peripheral region of Bangladesh

Abstract

BackgroundA group of 63708 Bangladeshi adults from a rural area were screened in 2011–12 for cardiovascular diseases (CVD) risk using a questionnaire based tool developed as part of the ‘WHO CVD-RISK Management Package for low-and medium resource setting’. In the current study participants who were found to be high risk and a sample of the not high risk participants from the screening were further characterized clinically and biochemically to explore the burden and determinants of CVD risk factors in a remote rural Bangladeshi population.MethodsThe high risk participants comprised all 1170 subjects who screened positive in 2011–12 and the not high risk group comprised 563 randomly sampled participants from the 62538 who screened negative. Socio-demographic, behavioral, anthropometric, clinical and biochemical data (glucose and lipids) were collected by standardized procedures. Body Mass Index (BMI) was classified following Asian BMI criteria. Data was analyzed using univariable and multivariable methods.ResultsOn univariable analysis in high risk and not high risk participants respectively, age in years (M ± SD) was 50 ± 11 for both groups, ratio of male: female was 40:60 and 66:44, current smoking 28.5 % and 50.6 %; smokeless tobacco use 37.1 % and 34.8 %; overweight and obesity measured by body mass index (BMI) was 39.1 % and 20.5 %; high waist circumference (WC) 36.1 % and 11.9 %; high waist to hip ratio (WHR) 53.8 % and 26.3 %; and with high waist to height ratio (WHtR) 56.4 % and 28.4 %, existence of hypertension (HTN) was 15.8 % and 3.6 %, pre-HTN 43.8 % and 12.1 %, diabetes (DM) 14.0 % and 10.5 %, pre-DM 16.9 % and 12.1 % and dyslipidaemia 85.8 % and 89.5 %. In multivariable logistic regression analysis female sex, BMI, WC, WHR and WHtR, HTN and dyslipidaemia remain significantly more common among high risk participants (p < 0.05 and p < 0.001).ConclusionsThe prevalence of clinical and biochemical risk factors of CVDs are quite high even in this rural population and this may be related to the socioeconomic and cultural transition in Bangladeshi society. Surprisingly more of the high risk group was female and there were fewer smokers. Obesity and hypertension were more frequent in high risk participants.

Profile of stroke patients treated at a rehabilitation centre in Bangladesh

“…These findings support the study by Hossain et al which found that most patients treated for stroke in Bangladeshi tertiary level hospitals came from urban areas [ 15 ]. Fatema et al suggests that the prevalence of cardiovascular disease in urban areas is a potential reason for an increase in this demographic [ 16 ]. It can be assumed that educated individuals, living in urban areas and with an occupation which is less physically active, adopt additional poor lifestyle choices such as smoking.…”

Application of two versions of the WHO/international society of hypertension absolute cardiovascular risk assessment tools in a rural Bangladeshi population

“…The selection of participants for the study has been described previously. 17 Briefly, a prospective cohort of (190 471) residents in a rural area of Bangladesh was established in 2008 as part of the ‘BADAS-ORBIS Eye Care Project’. The main objective was designed to generate epidemiological data on the burden of diabetic retinopathy and associated risk factors.…”

Hypertension and diabetes prevalence among adults with moderately increased BMI (23·0–24·9 kg/m2): findings from a nationwide survey in Bangladesh

“…A recent study reported underweight (BMI<18·5 kg/m 2 ), overweight (BMI=23·0–24·9 kg/m 2 ) and obesity (BMI≥25·0 kg/m 2 ) prevalence as 14, 18 and 26 %, respectively, in rural Bangladeshi adults, with no significant sex difference ( 20 ) . Another study in a rural area in Bangladesh found about 33 % of the adults had BMI≥23·0 kg/m 2 and an undernutrition prevalence of 21 %, indicating a transition in lifestyle even among the rural population of Bangladesh ( 21 ) .…”

“…Another study in a rural area in Bangladesh found about 33 % of the adults had BMI ≥ 23·0 kg/m 2 and an undernutrition prevalence of 21 %, indicating a transition in lifestyle even among the rural population of Bangladesh (21) . We found one-third of the females were overweight (BMI ≥ 23·0 kg/m 2 ), significantly more than males (20 %).…”