PS 06-02 Gender differences in hypertension awareness, antihypertensive use and blood pressure control in Bangladeshi adults

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Objective:Bangladesh is facing an epidemiological transition with a growing burden of non-communicable diseases. Traditionally hypertension and associated complications in women receive less recognition and there is a dearth of related publications. The study aims to explore gender differences in high blood pressure awareness and antihypertensive use in Bangladeshi adults at the community level. Another objective is to identify factors associated with uncontrolled hypertension among antihypertensive users.Design and Method:Data from the most recent Bangladesh Demographic and Health Survey (BDHS 2011) was analysed. From a nationally representative sample of 3,871 males and 3,960 females, aged ≥ 35 years, blood pressure and related information were collected following WHO guidelines. Logistic regression models were used to estimate adjusted odds ratio (AOR) for factors affecting blood pressure awareness, antihypertensive use and uncontrolled hypertension among those taking antihypertensive, separately for males and females. All analyses were weighted considering sampling design.Results:Women were more likely to have their blood pressure measured (76% vs. males 71%, p < 0.001), and “aware” about own high blood pressure (45% vs. males 37%, p < 0.001). No gender difference was observed in antihypertensive use (females 67%, males 65%, p = 0.39). Non-working females were less likely to get antihypertensive (67% vs. non-working males 77%, p < 0.05). Poor women were worse off compared to poor males. One-in-three (28%) antihypertensive users had stage 2 hypertension (SBP ≥160/DBP ≥ 100 mmHg). Female sex, older age, increased wealth, higher BMI and certain geographical regions were significantly associated with poor blood pressure control among antihypertensive users.Conclusions:Blood pressure check-up and hypertension awareness were higher among women but did not translate into better antihypertensive medication practice compared to men. Gender disadvantage and inequity observed in antihypertensive use. Policy makers should explore uncontrolled hypertension burden, gender gap and geographical variations in the country.

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