Abstract
BackgroundHypertension, itself being a major chronic condition, is one of the most significant risk factors for premature cardiovascular diseases and mortality. Hypertension is responsible for 13% of global deaths and three-quarters of the world’s hypertensive population reside in low- and middle-income countries. Bangladesh is one of those countries that experiencing an epidemiological transition from communicable to non-communicable diseases, a nutritional transition from a traditional diet to process and fast food, and an increase in a sedentary lifestyle, resulting in increased hypertension prevalence. We carried out a systematic review and meta-analysis to identify existing research on hypertension prevalence in Bangladesh, summarize findings and assess its temporal change.MethodsWe searched MEDLINE, EMBASE and PubMed and relevant references to identify studies on the prevalence of hypertension in Bangladesh. We used Random-effects meta-analysis to pool the prevalence estimates and performed subgroup analyses. We assessed heterogeneity, a trend in prevalence of hypertension and publication bias in selected studies.ResultsOur search initially identified 735 articles and after removing duplicates, reviewing titles and abstracts, and screening full texts, 53 studies were finally selected. The studies comprised 305,432 subjects and reported overall, gender-specific, geographical location specific and criteria specific prevalence of hypertension. We identified the range of hypertension prevalence is from 1.10% to 75.0% and the overall weighted pooled prevalence of hypertension is 20.0%. An extremely high heterogeneity (I2 = 99.53%; Cochran Q-statistic p < 0.001) was observed in the prevalence of hypertension. Consequently, we performed subgroup analysis based on gender, age group and geographical location of the study participants, the cut-off level used to define hypertension, and the types of hypertension reported and presented our findings accordingly. An overall increasing trend of hypertension prevalence is also observed.ConclusionsThe prevalence of hypertension is high and rising in Bangladesh. Strategies targeting prevention are required to mitigate a further increase in the prevalence and reduce the morbidity and mortality associated with it.
Highlights
Hypertension, itself being a major chronic condition, is one of the most significant risk factors for premature cardiovascular diseases and mortality [1]
Study selection We identified 720 studies on the prevalence of hypertension in Bangladesh through electronic search and a further 15 potentially relevant studies through a grey literature search
Of the 89 articles full text screened, 36 were excluded for the following reasons: 14 were conducted on subjects with diseases, 7 were review articles, 2 studies assessed the association with hypertension, 8 studies conducted on Bangladeshi immigrants living abroad, 1 was carried out on children and 4 were duplicate studies
Summary
Hypertension, itself being a major chronic condition, is one of the most significant risk factors for premature cardiovascular diseases and mortality [1]. Defined as a persistent elevation of blood pressure (BP) beyond 130/80 mmHg [2], hypertension is directly related to the development of several fatal conditions such as stroke, coronary artery disease, heart failure, atrial fibrillation, and peripheral vascular disease [3]. Hypertension has been attributed to be responsible for 13% of global deaths [7]. Hypertension, itself being a major chronic condition, is one of the most significant risk factors for premature cardiovascular diseases and mortality. Bangladesh is one of those countries that experiencing an epidemiological transition from communicable to non-communicable diseases, a nutritional transition from a traditional diet to process and fast food, and an increase in a sedentary lifestyle, resulting in increased hypertension prevalence. We carried out a systematic review and meta-analysis to identify existing research on hypertension prevalence in Bangladesh, summarize findings and assess its temporal change
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