Association of Socio-demographic Characteristics with Hypertension Awareness, Treatment, and Control in Bangladesh

Abstract The prevalence of hypertension has been rapidly growing in Bangladesh. Despite this burden, there has been limited analysis of the socio-demographic variation of each step of the hypertension cascade of care. This study was a secondary analysis of the 2017-18 Bangladesh Demographic and Health Survey. Four dichotomous outcome variables – hypertension prevalence, awareness among those with hypertension, treatment among those aware, and control among those treated – were analyzed. The variation of each outcome was assessed across socio-demographic factors; the association between socio-demographic characteristics and the four outcomes was analyzed using logistic regression. In Bangladesh, 27.5% [95% CI 26.5, 28.5%] of individuals had hypertension, 42.5% [95% CI 40.5%, 44.5%] of those with hypertension were aware, 87.4% [95% CI 85.3%, 89.5%] of those aware were receiving treatment, and 33.8% [95% CI 30.8%, 36.8%] of those receiving treatment had their blood pressure controlled. Hypertension prevalence and awareness were higher among older individuals, females, and those with higher household wealth. Comparing older to younger individuals, the proportion of treatment among those aware was higher, while control among those treated was lower. In multivariable models stratified by rural/urban community, the impact of education on odds of treatment differed between rural and urban communities. Specific efforts to improve hypertension awareness among individuals who are younger, male, of lower household wealth, and in rural areas are required to address disparities in hypertension care. Socio-demographic variations in hypertension awareness, treatment, and control must be considered to design targeted interventions for each step of the cascade.