Hypertension and Diabetes Status Bangladesh Demographic and Health Survey

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1 Hypertension and Diabetes Status 2011 Bangladesh Demographic and Health Survey

2 Methodology and Sampling Total 18,000 households were selected nationwide (207 in urban and 393 in rural areas) One-third of households were selected for blood pressure and blood glucose testing All men and women 35 years and older of each selected household were eligible for measurement This resulted in 4,311 women and 4,524 men eligible for biomarker for hypertension and diabetes

3 Training and Field Work BDHS has 16 interviewing teams, each with 11 members Each team has one health technician to collect biomarker data Health technicians specially trained for 2 weeks by lecture, demonstration, and field practice Survey was implemented from July-December 2011

4 First visit: Eligible individuals were identified for blood pressure and blood glucose level testing. For glucose testing they were asked to fast over night Second visit: Blood glucose testing carried out only if respondents had fasted for 8 hours Test results were shared and respondents with elevated blood glucose level or elevated blood pressure were advised for further testing from a health provider

5 Coverage Rates for Blood Pressure and Blood Glucose Measurement Eligible Women 4,311 % measured for blood pressure 92% % measured for fasting plasma glucose 89% Eligible Men 4,524 % measured for blood pressure 86% % measured for fasting plasma glucose 83%

6 DIABETES

7 Instrument and measurement unit Hemo Cue 201+ blood glucose analyser used Blood glucose was measured in mg/dl Interval of testing blood glucose Blood glucose was collected after 8 hours fasting status as recommended by WHO The blood sample obtained from middle or ring finger of the left hand The first 2 drops of blood were wiped away and the third drop was measured

8 Normal glucose: mmol/l Impaired Fasting Glucose (IFG): mmol/l (Pre-diabetes) Elevated Fasting Plasma Glucose (FPG): 7 mmol/l (Diabetes)

9 % taking medication for diabetes % with elevated blood glucose ( 7 mmol/l) but not taking medication * Definition used here may not be comparable to clinical diagnosis of diabetes

10 Percent of women age 35 and older Prevalence of Diabetes among Women and Men Elevated blood glucose, not taking medication Taking medication for diabetes Women Men 10

11 Prevalence of Diabetes and Pre-diabetes among Women Percent of women age 35 and older Total Urban Rural Diabetes Pre-diabetes 11

12 Prevalence of Diabetes and Pre-diabetes among Men Percent of women age 35 and older Total Urban Rural Diabetes Pre-diabetes 12

13 Prevalence of Diabetes among Women and Men by Nutritional Status Percent of women and men age 35 and older Thin (BMI < 18.5) Normal (BMI ) Overweight (BMI ) Women Men

14 Diabetes after Medication Percent of women and men age 35 and older taking medication by diabetes status Under control Not under control Women Men

15 HYPERTENSION

16 Methods of Testing Blood Pressure BP was measured in mmhg with LIFE SOURCE UA-767 Plus Blood Pressure Monitor BP was taken 3 times for an individual at 10 minute intervals The average of the 2nd and 3rd measurements was used to report respondent s BP following internationally recommended categories (WHO, 1999)

17 Not elevated blood pressure values Normal: BP <140 mm Hg SBP or <90 mm Hg DBP Elevated blood pressure values Moderately elevated: BP mm Hg SBP or mm Hg DBP Highly elevated: BP 160 mm Hg SBP or 100 mm Hg DBP

18 % taking medication for blood pressure (BP) % measured highly elevated BP (BP 160+mmHg SBP or 100+mm Hg DBP) but not taking medication % measured moderately elevated BP (BP mm Hg SBP or mm Hg DBP) but not taking medication * Definition used here may not be comparable to clinical diagnosis

19 Prevalence of Hypertension among Women and Men Percent of women age 35 and older Moderately elevated BP, not taking medication Highly elevated BP, not taking medication Taking medication for BP Women Men 19

20 Prevalence of Hypertension among Women and Men by Residence Percent of women age 35 and older 40 Urban Rural Women Men 20

21 Prevalence of Hypertension among Women and Men by Nutritional Status Percent of women age 35 and older Thin (BMI< 18.5) Normal (BMI ) Overweight (BMI ) Women Men 21

22 Hypertension after Medication Percent of women and men age 35 and older taking BP medication by hypertension status BP under control BP not under control Women Men

23 About one in three women age 35 and older have hypertension, and less than half are taking medication. Among women taking medicine, almost 60% still had high BP. Men have lower rate of hypertension than women, but medication pattern is similar. Prevalence of hypertension is higher in urban areas. Risk of hypertension increases with BMI.

24 11% of women and men age 35 and older have diabetes or are taking medication. Among women under medication, almost 57% had elevated plasma glucose. Diabetes is more common in urban than in rural areas. Women and men who are overweight are more likely to have diabetes.

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