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Clustering of hypertension, diabetes and overweight/obesity according to socioeconomic status among Bangladeshi adults

Published online by Cambridge University Press:  09 March 2020

Gulam Muhammed Al Kibria*
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
Mohammad Rashidul Hashan
Affiliation:
Dhaka Medical College Hospital, Dhaka, Bangladesh
Md Mahbub Hossain
Affiliation:
Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station, TX-77483, USA
Sojib Bin Zaman
Affiliation:
Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
Christina A. Stennett
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
*
*Corresponding author. Email: [email protected]

Abstract

The prevalences of hypertension, diabetes and overweight/obesity are increasing in most developing countries, including Bangladesh. Although earlier studies have investigated the factors associated with these three conditions, little is known about whether socioeconomic status is associated with their co-existence. This cross-sectional study analysed data from the 2011 Bangladesh Demographic and Health Survey. An individual was considered hypertensive, diabetic and overweight/obese if their systolic/diastolic blood pressure, fasting plasma glucose concentration, and body mass index were ≥130/80 mmHg, ≥7 mmol/l and ≥23 kg/m2, respectively. Furthermore, individuals who reported taking anti-hypertensive and anti-diabetic drugs were also considered as hypertensive and diabetic, respectively. Two socioeconomic variables were investigated: education level and household wealth quintile. Descriptive analyses and multilevel logistic regression were conducted. Among the 7932 respondents (50.5% female) aged ≥35 years, the prevalences of hypertension, diabetes, overweight/obesity, any one condition and the co-existence of the three conditions were 48.0%, 11.0%, 25.3%, 60.9% and 3.6%, respectively. In adjusted analysis, individuals with secondary (adjusted odds ratio [AOR]: 1.8, 95% confidence interval [CI]: 1.2–2.8) and college or above (AOR: 3.6; 95% CI: 2.2–5.7) education levels had higher odds of the co-existence of all three conditions compared with those with no formal education. Similarly, compared with the poorest wealth quintile, the richer (AOR: 4.6; 95% CI: 2.2–9.4) and richest (AOR: 11.8; 95% CI: 5.8–24.1) wealth quintiles had higher odds of co-existence of these three conditions. Education and wealth quintile also showed significant relationships with each of the three conditions separately. In conclusion, in Bangladesh, hypertension, diabetes and overweight/obesity are associated with indicators of higher socioeconomic status. These findings highlight the importance of developing healthy lifestyle interventions (e.g. physical exercise and dietary modification) targeting individuals of higher socioeconomic status to minimize the burden of these non-communicable diseases.

Type
Research Article
Copyright
© The Author(s) 2020. Published by Cambridge University Press

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