Undiagnosed Isolated Systolic and Diastolic Hypertension Subtypes and Their Correlates in Bangladesh: A Nationwide Survey

Abstract

Objectives: This study was performed to identify the distribution of undiagnosed isolated hypertension subtypes and their correlates amongst adults aged 35 years and older in Bangladesh using data from the Bangladesh Demography and Health Survey 2011. Methods: Out of a total of 17,964 selected households, 7,880 were included in the final analysis for this study. Systolic and diastolic blood pressure (BP) were measured 3× at 10-minute intervals. Hypertension subtypes were defined for individuals not under antihypertensive treatment as systolic-diastolic hypertension (SDH): systolic BP (SBP) ≥ 140 mm Hg and diastolic BP (DBP) ≥ 90 mm Hg; isolated diastolic hypertension (IDH): SBP < 140 mm Hg and DBP ≥ 90 mm Hg, and isolated systolic hypertension (ISH): SBP ≥140 mm Hg and DBP < 90 mm Hg. Results: The predominant hypertension subtypes were SDH and IDH [5.2%; 95% confidence interval (CI): 4.7-5.1] followed by ISH (3.8%; 95% CI: 3.4-4.2). Multiple logistic regression showed that age and gender were significant predictors of ISH. SDH was associated with females [odds ratio (OR): 1.8; 95% CI: 1.3- 2.6], the older age group (OR-7.4; 95% CI: 4.3-12.7), and overweight or obese individuals (OR: 1.6; 95% CI: 1.1-2.4). Non-manual work (OR: 1.5; 95% CI: 1.0-2.0]) and being overweight or obese (OR: 1.9; 95% CI: 1.4-2.8) were factors associated with IDH. Conclusion: ISH, IDH and SDH represent salient subtypes of hypertension in Bangladesh. To identify preventive intervention for averting adverse cardiovascular events, further research is needed.