Cited by 54Blood Pressure and Hypertension StudiesSodium Intake and HealthHealth Promotion and Cardiovascular Prevention

Awareness and control of hypertension in Bangladesh: follow-up of a hypertensive cohort

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Alam, Dewan Shamsul, Chowdhury, Muhammad Ashique Haider, Siddiquee, Ali Tanweer, Ahmed, Shyfuddin, Niessen, Louis Wilhelmus·2014·BMJ Open

Abstract

Objectives: To assess the effect of awareness and advice to seek care on blood pressure (BP) control among patients with hypertension in Bangladesh. Design: Longitudinal study. Setting: The study was carried out in icddr,b surveillance sites at rural Matlab in Chandpur district and semi-urban Kamalapur in Dhaka, Bangladesh. Participants: Randomly selected men and non-pregnant women aged 20 years or older without any acute illness or history of any vascular events such as stroke or acute myocardial infarction. Main outcome measure: Hypertension was defined as systolic BP (SBP) ≥140 and/or diastolic BP (DBP) ≥90 mm Hg or as self-reported hypertension under medication. We advised patients to seek care from a qualified provider and to adopt a healthy lifestyle. We compared changes in BP from baseline to follow-up at around 6 months. Results: Overall, 17.1% (n=287) of participants had hypertension at baseline with significantly higher prevalence in the semi-urban than in the rural population (23.6% vs 10.8%; p<0.001); half were unaware of their condition. At follow-up, 83% (n=204) reported a visit to any healthcare provider. In the semi-urban area, a higher proportion of patients visited medically qualified practitioners than in the rural area (76.7% vs 36.6%, p<0.000). SBP (−3.3±20.7 mm Hg; p<0.01) and DBP (−2.0±13.0 mm Hg; p<0.02) were lower at follow-up. Those who visited medically qualified practitioners had significant SBP (−3.9±22.4 mm Hg; p<0.03) and DBP (−2.7±14.1 mm Hg; p<0.02) reduction. BP reduction did not reach statistical significance among those visiting a pharmacist or their village doctors. Overall, half of the patients with hypertension achieved the BP control goal (BP<140/90 mm Hg). Conclusions: Awareness and simple health messages increase provider visit, reduce blood pressure and improve BP control in hypertensive Bangladeshis. Longer-term follow-up is required to verify the sustainability.

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Authors
Alam, D. S., Chowdhury, M. A. H., Siddiquee, A. T., Ahmed, S., & Niessen, L. W.
Affiliations
  • International Centre for Diarrhoeal Disease Research (BD)
  • Johns Hopkins University (US)
Corresponding author
Alam, Dewan Shamsul
Venue
BMJ Open
Publisher
BMJ
Published
2014-12
Volume
4
Issue
12
Pages
e004983
ISSN
2044-6055 (ISSN-L)
OpenAlex
W2099729968
Cited by
54
References
35
Citations by year
2026: 2 · 2025: 1 · 2024: 4 · 2023: 4 · 2022: 3 · 2021: 12 · 2020: 6 · 2019: 5 · 2018: 1 · 2017: 9 · 2016: 3 · 2015: 3
FWCI
3.44
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
  • U.S. Department of Health and Human Services
  • International Centre for Diarrhoeal Disease Research, Bangladesh
  • National Institutes of Health
  • U.S. Public Health Service (HHSN26820900032C)
  • National Heart, Lung, and Blood Institute
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
Keywords
hypertension, hypertension awareness, blood pressure control, health-seeking behavior, health advice, urban-rural differences, village doctors, healthy lifestyle, Bangladesh
MeSH terms
Adult, Antihypertensive Agents, Awareness, Bangladesh, Blood Pressure, Female, Follow-Up Studies, Health Promotion, Health Services, Humans, Hypertension, Life Style, Longitudinal Studies, Male, Medicine, Traditional, Middle Aged, Patient Acceptance of Health Care, Pharmacists, Rural Population, Urban Population, Health Behavior, Blood Pressure Monitoring, Ambulatory

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