( A cross-sectional study in selected areas of four city corporations in Bangladesh)
Background: To address the unmet
need for public health initiatives in urban areas, the 'Strengthening Urban Public
Health System project' is being implemented by Save the Children in 12 City
Corporations (CC). Under this project, a study was conducted on hypertension and
obesity load in selected areas of Cumilla, Mymensingh, Narayanganj, and Rangpur
city corporations with the support of health teams and under the guidance of
respective Mayors.
Objectives: To determine the prevalence of Hypertension and
Obesity and their associated risk factors in urban areas of Bangladesh.
Methodology: During the study, a total of 48,644 people were
selected by convenient sampling and were screened to measure blood pressure and
obesity status using the BMI scale. Data regarding the socioeconomic
information and associated risk factors like family history of hypertension,
smoking and food habits, physical activity, etc. were also collected through a
semi-structured questionnaire with informed consent of the respondents. Following
the American Medical Association (AMA) definition of hypertension participants
were classified into three categories e.g. normal, pre-hypertensive, and
hypertensive whereas using the WHO's anthropometric guideline, they were
grouped into four categories based on the BMI value- underweight, normal,
overweight, and obese. Another subset of 1040 participants (also selected following convenient sampling) were
interviewed regarding the knowledge and
practice related to hypertension, obesity and risk factors, etc.
Results: Nearly 23% of the participants were identified as
hypertensive, while about 14% of them were pre-hypertensive. Prevalence was
slightly higher among men (24%) than women (22%) and those aged 61 years or
older (29%). Approximately 8% of the participants were found to be obese, and another
28% were overweight. The prevalence of obesity and overweight was higher among women
(10% obese and 29% overweight) than among men (7% Obese and 27% overweight). Prevalence
of hypertension was found to be highest (34%) in Rangpur City Corporation and
lowest (16%) in Cumilla City Corporation whereas obesity was higher (10%) in
Rangpur City Corporation and lower (6.5%) in Mymensingh City Corporation.
The association between
BMI status and hypertension was found to be statistically significant, and the
odds ratio progressively rose as the BMI value increased. Obese participants had
odds that were 2.05 [COR: 95%] times greater than those in the normal BMI group.
During the pre-screening knowledge check survey, about 78% of the participants
answered correctly about the high blood pressure range between 100-160. In the
post-screening survey conducted after about two weeks, this proportion
increased to 95%. only 73% of the
participants knew about the complications of hypertension and obesity in the
pre-screening but in the post-screening survey, this proportion increased to 96%.
Conclusion: Since the prevalence of hypertension and
pre-hypertension varies between different geographical locations and
socio-demographic characteristics, different types and levels of intervention
need to be planned for the different locations and groups. Community-based
screening should be carried out for early detection of hypertension and obesity
status in adults and it should be scaled up in other city corporations as well
as in rural areas.
Keywords: Body Mass Index, Prevalence,
Hypertension, Overweight/Obesity, Public Health Programs.
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