Hypertension prevalence and its trend in Bangladesh: evidence from a systematic review and meta-analysis

Mohammad Ziaul Islam Chowdhury, Meshbahur Rahman, Tanjila Akter, Tania Akhter, Arifa Ahmed, Minhajul Arifin Shovon, Zaki Farhana, Nashit Chowdhury, Tanvir C Turin, Mohammad Ziaul Islam Chowdhury, Meshbahur Rahman, Tanjila Akter, Tania Akhter, Arifa Ahmed, Minhajul Arifin Shovon, Zaki Farhana, Nashit Chowdhury, Tanvir C Turin

Abstract

Background: Hypertension, 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.

Methods: We 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.

Results: Our 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.

Conclusions: The 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.

Keywords: Bangladesh; Hypertension; Prevalence; Trend.

Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

© The Author(s) 2020.

Figures

Fig. 1
Fig. 1
PRISMA diagram for the systematic review of studies that evaluated the prevalence of hypertension in Bangladesh
Fig. 2
Fig. 2
The pooled prevalence of hypertension according to the gender of the participants
Fig. 3
Fig. 3
The pooled prevalence of hypertension according to the participant's age group
Fig. 4
Fig. 4
The pooled prevalence of hypertension according to the geographical areas
Fig. 5
Fig. 5
The pooled prevalence of hypertension according to the cut-off level used to define hypertension
Fig. 6
Fig. 6
The pooled prevalence of hypertension according to the types of prevalence reported
Fig. 7
Fig. 7
The overall prevalence of hypertension over time. a. Prevalence of hypertension over time according to the gender of the study participants. b. Prevalence of hypertension over time according to the geographical location of the study participants. c. Prevalence of hypertension over time according to the cut-off level used to define hypertension. d. Prevalence of hypertension over time according to the age group of the study participants
Fig. 8
Fig. 8
Funnel plot for the publication bias of the studies that evaluated the prevalence of hypertension in Bangladesh

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