Cardiovascular diseases and type 2 diabetes in Bangladesh: a systematic review and meta-analysis of studies between 1995 and 2010

Nazmus Saquib, Juliann Saquib, Tahmeed Ahmed, Masuma Akter Khanam, Mark R Cullen, Nazmus Saquib, Juliann Saquib, Tahmeed Ahmed, Masuma Akter Khanam, Mark R Cullen

Abstract

Background: Belief is that chronic disease prevalence is rising in Bangladesh since death from them has increased. We reviewed published cardiovascular (CVD) and Type 2 Diabetes Mellitus (T2DM) studies between 1995 and 2010 and conducted a meta-analysis of disease prevalence.

Methods: A systematic search of CVD and T2DM studies yielded 29 eligible studies (outcome: CVD only = 12, T2DM only = 9, both = 8). Hypertension (HTN) was the primary outcome of CVD studies. HTN and T2DM were defined with objective measures and standard cut-off values. We assessed the study quality based on sampling frame, sample size, and disease evaluation. Random effects models calculated pooled disease prevalence (95% confidence interval) in studies with general population samples (n = 22).

Results: The pooled HTN and T2DM prevalence were 13.7% (12.1%-15.3%) and 6.7% (4.9%-8.6%), respectively. Both diseases exhibited a secular trend by 5-year intervals between 1995 and 2010 (HTN = 11.0%, 12.8%, 15.3%, T2DM = 3.8%, 5.3%, 9.0%). HTN was higher in females (M vs. F: 12.8% vs.16.1%) but T2DM was higher in males (M vs. F: 7.0% vs. 6.2%) (non-significant). Both HTN and T2DM were higher in urban areas (urban vs. rural: 22.2% vs. 14.3% and 10.2% vs. 5.1% respectively) (non-significant). HTN was higher among elderly and among working professionals. Both HTN and T2DM were higher in 'high- quality' studies.

Conclusions: There is evidence of a rising secular trend of HTN and T2DM prevalence in Bangladesh. Future research should focus on the evolving root causes, incidence, and prognosis of HTN and T2DM.

Figures

Figure 1
Figure 1
Consort diagram.
Figure 2
Figure 2
Map of Bangladesh: Study locations.
Figure 3
Figure 3
Forest Plot of (A) Hypertension (HTN) [ [10]-[12],[14],[15],[18],[20],[23]-[26],[37],[38]] and (B) Type 2 diabetes mellitus (T2DM) [ [10],[14],[16],[20],[22],[24],[25],[30-34][35]-[36]] studies published between 1995 and 2010. All studies (HTN = 13, T2DM = 14) selected samples from the general adult population. Pooled estimates (red) and 95% CI were calculated with random effect models.
Figure 4
Figure 4
Pooled estimates of Hypertension (HTN) and Type 2 diabetes mellitus (T2DM) by (A) 5-year intervals: 1995–2000, 2001–2005, and 2006–2010 and (B) study quality: poor, moderate, and high. All studies (HTN = 13, T2DM = 14) selected samples from the general adult population. Estimates and 95% CI were calculated with random effect models.

References

    1. Karar ZA, Alam N, Streatfield PK. Epidemiological transition in rural Bangladesh, 1986–2006. Global Health Action. 2009;2:1–9.
    1. Laskar SI. Urbanization in Bangladesh: some contemporary observations. Bangladesh Dev Stud. 1996;24:207–216.
    1. Dewan AM, Yamaguchi Y. Land use and land cover change in Greater Dhaka, Bangladesh: Using remote sensing to promote sustainable urbanization. Applied Geography. 2009;29:390–401. doi: 10.1016/j.apgeog.2008.12.005.
    1. Alam JBM, Alam MJB, Rahman MH, Khan SK, Munna GM. Unplanned urbanization: Assessment through calculation of environmental degradation index. International Journal of Environmental Science and Technology. 2006;3:119–130.
    1. Islam N, Ullah GMS. Factors affecting consumers’ preferences on fast food items in Bangladesh. Journal of Applied Business Research. 2010;26:131–147.
    1. Chowdhury T, Imran M. Working Papers. Kathmandu, Nepal: Economics SANfDaE ed; 2010. Morbidity costs of vehicular air pollution: Examining Dhaka city in Bangladesh.
    1. Khanam PA, Mahtab H, Ahmed AU, Sayeed MA, Khan AKA. In Bangladesh Diabetes Starts Earlier Now than 10 Years Back: A BIRDEM Study. Ibrahim Med Coll J. 2008;2:1–3.
    1. Joshi P, Islam S, Pais P, Reddy S, Dorairaj P, Kazmi K, Pandey MR, Haque S, Mendis S, Rangarajan S, Yusuf S. Risk factors for early myocardial infarction in South Asians compared with individuals in other countries. JAMA. 2007;297:286–294. doi: 10.1001/jama.297.3.286.
    1. Bleich SN, Koehlmoos TL, Rashid M, Peters DH, Anderson G. Noncommunicable chronic disease in Bangladesh: Overview of existing programs and priorities going forward. Health Policy. 2010. epub Oct. 22.
    1. Abu Sayeed M, Banu A, Khan AR, Hussain MZ. Prevalence of diabetes and hypertension in a rural population of Bangladesh. Diabetes Care. 1995;18:555–558. doi: 10.2337/diacare.18.4.555.
    1. Rahman M, Tondel M, Ahmad SA, Chowdhury IA, Faruquee MH, Axelson O. Hypertension and arsenic exposure in Bangladesh. Hypertension. 1999;33:74–78. doi: 10.1161/01.HYP.33.1.74.
    1. Zaman MM, Rouf MA. Prevalence of hypertension in a Bangladeshi adult population. J Hum Hypertens. 1999;13:547–549. doi: 10.1038/sj.jhh.1000838.
    1. Hypertension Study Group. Prevalence, awareness, treatment and control of hypertension among the elderly in Bangladesh and India: a multicentre study. Bull World Health Organ. 2001;79:490–500.
    1. Zaman MM, Yoshiike N, Rouf MA, Syeed MH, Khan MR, Haque S, Mahtab H, Tanaka H. Cardiovascular risk factors: distribution and prevalence in a rural population of Bangladesh. J Cardiovasc Risk. 2001;8:103–108. doi: 10.1097/00043798-200104000-00007.
    1. Sayeed MA, Banu A, Haq JA, Khanam PA, Mahtab H, Azad Khan AK. Prevalence of hypertension in Bangladesh: effect of socioeconomic risk factor on difference between rural and urban community. Bangladesh Med Res Counc Bull. 2002;28:7–18.
    1. Sayeed MA, Mahtab H, Akter Khanam P, Abdul Latif Z, Keramat Ali SM, Banu A, Ahren B, Azad Khan AK. Diabetes and impaired fasting glycemia in a rural population of Bangladesh. Diabetes Care. 2003;26:1034–1039. doi: 10.2337/diacare.26.4.1034.
    1. Sayeed MA, Mahtab H, Khanam PA, Begum R, Banu A, Azad Khan AK. Diabetes and hypertension in pregnancy in a rural community of Bangladesh: a population-based study. Diabet Med. 2005;22:1267–1271. doi: 10.1111/j.1464-5491.2005.01600.x.
    1. Chen Y, Factor-Litvak P, Howe GR, Parvez F, Ahsan H. Nutritional influence on risk of high blood pressure in Bangladesh: a population-based cross-sectional study. Am J Clin Nutr. 2006;84:1224–1232.
    1. Mamun AA, Padmadas SS, Khatun M. Maternal health during pregnancy and perinatal mortality in Bangladesh: evidence from a large-scale community-based clinical trial. Paediatr Perinat Epidemiol. 2006;20:482–490. doi: 10.1111/j.1365-3016.2006.00752.x.
    1. Zaman MM, Ahmed J, Choudhury SR, Numan SM, Parvin K, Islam MS. Prevalence of Ischemic heart disease in a rural population of Bangladesh. Indian Heart Journal. 2007;59:239–241.
    1. Ahmed S, Shirin S, Mohsena M, Parvin N, Sultana N, Sayed S, Mahzabeen R, Akter M, Sayeed MA. Geriatric health problems in a rural community in Bangladesh. Ibrahim Med Coll J. 2007;1:17–20.
    1. Sayeed MA, Mahtab H, Khanam PA, Latif ZA, Banu A, Khan AK. Prevalence of diabetes and impaired fasting glucose in urban population of Bangladesh. Bangladesh Med Res Counc Bull. 2007;33:1–12.
    1. Ahmed S, Mohsena M, Shirin S, Parvin N, Sultana N, Mahzabeen R, Akter M, Sayeed S, Sayeed MA. Nutritional status, hypertension, proteinuria and glycosuria amongst the women of rural Bangladesh. Ibrahim Med Coll J. 2008;2:21–24.
    1. Van Minh H, Ng N, Juvekar S, Razzaque A, Ashraf A, Hadi A, Soonthornthada K, Bich TH, Kanungsukkasem U, Byass P. Self-reported prevalence of chronic diseases and their relation to selected sociodemographic variables: A study in INDEPTH Asian sites, 2005. Preventing Chronic Disease: Public Health Research, Practice, and Policy. 2008;5:1–9.
    1. Sayeed S, Banu A, Khanam PA, Alauddin S, Makbul S, Begum T, Mahtab H, Sayeed MA. Prevalence of metabolic syndrome in three urban communities of Dhaka City. Ibrahim Med Coll J. 2008;2:44–48.
    1. Van Minh H, Soonthornthada K, Ng N, Juvekar S, Razzaque A, Ashraf A, Ahmed SM, Bich TH, Kanungsukkasem U. Blood pressure in adult rural INDEPTH population in Asia. Global Health Action. 2009;NCD supplement:60–67.
    1. Ahsan S, Haque KMHS, Salman M, Bari AS, Nahar H, Ahmed MK, Hoque H, Rahman MM, Hossain MA, Sultan MAU. Detection of ischaemic heart disease with risk factors in different categories of employees of University Grants Commission. University Heart Journal. 2009;5:20–23.
    1. Das S, Dutta PK. Chronic Kidney Disease Prevalence among Health Care Providers in Bangladesh. Mymensingh Med J. 2010;19:415–421.
    1. Moni MA, Rahman MA, Haque MA, Islam MS, Ahmed K. Blood pressure in relation to selected anthropometric measurements in senior citizens. Mymensingh Med J. 2010;19:254–258.
    1. Abu Sayeed M, Ali L, Hussain MZ, Rumi MA, Banu A, Azad Khan AK. Effect of socioeconomic risk factors on the difference in prevalence of diabetes between rural and urban populations in Bangladesh. Diabetes Care. 1997;20:551–555. doi: 10.2337/diacare.20.4.551.
    1. Sayeed MA, Hussain MZ, Banu A, Rumi MA, Azad Khan AK. Prevalence of diabetes in a suburban population of Bangladesh. Diabetes Res Clin Pract. 1997;34:149–155. doi: 10.1016/S0168-8227(96)01337-X.
    1. Rahim MA, Vaaler S, Keramat Ali SM, Khan AK, Hussain A, Nahar Q. Prevalence of type 2 diabetes in urban slums of Dhaka, Bangladesh. Bangladesh Med Res Counc Bull. 2004;30:60–70.
    1. Abu Sayeed M, Mahtab H, Akter Khanam P, Abul Ahsan K, Banu A, Rashid AN, Azad Khan AK. Diabetes and impaired fasting glycemia in the tribes of Khagrachari hill tracts of Bangladesh. Diabetes Care. 2004;27:1054–1059. doi: 10.2337/diacare.27.5.1054.
    1. Hussain A, Vaaler S, Sayeed MA, Mahtab H, Ali SM, Khan AK. Type 2 diabetes and impaired fasting blood glucose in rural Bangladesh: a population-based study. Eur J Public Health. 2007;17:291–296. doi: 10.1093/eurpub/ckl235.
    1. Rahman MM, Rahim MA, Nahar Q. Prevalence and risk factors of type 2 diabetes in an urbanizing rural community of Bangladesh. Bangladesh Med Res Counc Bull. 2007;33:48–54.
    1. Rahim MA, Khan AK, Ali SM, Nahar Q, Shaheen A, Hussain A. Glucose tolerance in a rural population of Bangladesh. Int J Diabetes Dev Ctries. 2008;28:45–50. doi: 10.4103/0973-3930.43098.
    1. Sayeed MA, Mahtab H, Latif ZA, Khanam PA, Ahsan KA, Banu A, Azad Khan AK. Waist-to-height ratio is a better obesity index than body mass index and waist-to-hip ratio for predicting diabetes, hypertension and lipidemia. Bangladesh Med Res Counc Bull. 2003;29:1–10.
    1. Sayeed MA, Banu A, Khanam PA, Mahtab H, Khan AK. Risk of obesity for hypertension differs between diabetic and non-diabetic subjects. Ibrahim Med Coll J. 2007;1:1–6.
    1. Neyeloff JL, Fuchs SC, Moreira LB. Meta-analyses and Forest plots using a microsoft excel spreadsheet: step-by-step guide focusing on descriptive data analysis. BMC Res Notes. 2012;5:52. doi: 10.1186/1756-0500-5-52.
    1. Borch-Johnsen K. The new classification of diabetes mellitus and IGT: a critical approach. Exp Clin Endocrinol Diabetes. 2001;109(Suppl 2):S86–S93. doi: 10.1055/s-2001-18572.
    1. Gavin JR, Alberti KGMM, Davidson MB, DeFronzo RA, Drash A, Gabbe SG, Genuth S, Harris MI, Kahn R, Keen H, Knowler WC, Lebovitz H, Maclaren NK, Palmer JP, Raskin P, Rizza RA, Stern MP. Report of the Expert Committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003;26:5–20.
    1. Development Economics Data Group: Shaida Badiee Director. World Development Indicators. Washington DC: The World Bank; 2011. pp. 1–215. P 118.
    1. Sacks DB, Bruns DE, Goldstein DE, Maclaren NK, McDonald JM, Parrott M. Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Clin Chem. 2002;48:436–472.
    1. Roglic G, Resnikoff S, Strong K, Unwin N. Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia. Geneva, Switzerland: World Health Organization; 2006. pp. 1–50.
    1. Srinath Reddy K, Shah B, Varghese C, Ramadoss A. Responding to the threat of chronic diseases in India. Lancet. 2005;366:1744–1749. doi: 10.1016/S0140-6736(05)67343-6.
    1. Gupta R. Trends in hypertension epidemiology in India. J Hum Hypertens. 2004;18:73–78. doi: 10.1038/sj.jhh.1001633.
    1. Ghaffar A, Reddy KS, Singhi M. Burden of non-communicable diseases in South Asia. BMJ. 2004;328:807–810. doi: 10.1136/bmj.328.7443.807.
    1. Gupta R. Burden of coronary heart disease in India. Indian Heart J. 2005;57:632–638.
    1. Shera AS, Basit A, Fawwad A, Hakeem R, Ahmedani MY, Hydrie MZ, Khwaja IA. Pakistan National Diabetes Survey: prevalence of glucose intolerance and associated factors in the Punjab Province of Pakistan. Prim Care Diabetes. 2010;4:79–83. doi: 10.1016/j.pcd.2010.01.003.
    1. Mahar PS, Awan MZ, Manzar N, Memon MS. Prevalence of type-II diabetes mellitus and diabetic retinopathy: the Gaddap study. J Coll Physicians Surg Pak. 2010;20:528–532.
    1. Sharma SK, Ghimire A, Radhakrishnan J, Thapa L, Shrestha NR, Paudel N, Gurung KRM, Budathoki A, Baral N, Brodie D. Prevalence of hypertension, obesity, diabetes, and metabolic syndrome in Nepal. Int J Hypertens. 2011;2011:821971.
    1. Kumar S, Mishra CP. Prevalence and spectrum of hypertension in a rural area. Kathmandu Univ Med J (KUMJ) 2008;6:181–183.
    1. Wijewardene K, Mohideen MR, Mendis S, Fernando DS, Kulathilaka T, Weerasekara D, Uluwitta P. Prevalence of hypertension, diabetes and obesity: baseline findings of a population based survey in four provinces in Sri Lanka. Ceylon Med J. 2005;50:62–70.
    1. Goyal A, Yusuf S. The burden of cardiovascular disease in the Indian subcontinent. Indian J Med Res. 2006;124:235–244.
    1. Quasem I, S.Shetye M, Alex SC, Nag AK, Sarma PS, Thankappan KR, Vasan RS. Prevalence, awareness, treatment and control of hypertension among the elderly in Bangladesh and India: a multicentre study. Bulletin of the World Health Organization. 2001;79:490–500.
    1. Rahman MA, Zaman MM. Smoking and smokeless tobacco consumption: possible risk factors for coronary heart disease among young patients attending a tertiary care cardiac hospital in Bangladesh. Public Health. 2008;122:1331–1338. doi: 10.1016/j.puhe.2008.05.015.
    1. Ashraf A, Quaiyum M, Ng N, Van Minh H, Razzaque A, Masud Ahmed S, Hadi A, Juvekar S, Kanungsukkasem U, Soonthornthada K, Huu Bich TH. Self-reported use of tobacco products in nine rural INDEPTH Health and Demographic Surveillance Systems in Asia. Global Health Action. 2009;2:19–27.
    1. Kanungsukkasem U, Ng N, Van Minh H, Razzaque A, Ashraf A, Juvekar S, Masud Ahmed S, Huu Bich T. Fruit and vegetable consumption in rural adults population in INDEPTH HDSS sites in Asia. Global Health Action. 2009;2:35–43.
    1. Ng N, Hakimi M, Van Minh H, Juvekar S, Razzaque A, Ashraf A, Ahmed SM, Kanungsukkasem U, Soonthornthada K, Bich TH. Prevalence of physical inactivity in nine rural INDEPTH Health and Demographic Surveillance Systems in five Asian countries. Global Health Action. 2009;2:44–53.
    1. Zaman MM, Yoshiike N. Prevalence of overweight defined by body mass index in a rural adult population of Bangladesh. J Health Popul Nutr. 2003;21:162–163.
    1. Streatfield PK, Karar ZA. Population challenges for Bangladesh in the coming decades. J Health Popul Nutr. 2008;26:261–272.
    1. Khan A, Mojumder SK, Kovats S, Vineis P. Saline contamination of drinking water in Bangladesh. Lancet. 2008;371:385.
    1. Haque SA. Salinity problems and crop production in coastal regions of Bangladesh. Pak J Bot. 2006;38:1359–1365.

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj