Prevalence and correlates of cardiometabolic multimorbidity among hypertensive individuals: a cross-sectional study in rural South Asia—Bangladesh, Pakistan and Sri Lanka
Objective To determinate the prevalence and correlates of cardiometabolic multimorbidity (CMM), and their cross-country variation among individuals with hypertension residing in rural communities in South Asia.Design A cross-sectional study.Setting Rural communities in Bangladesh, Pakistan and Sri L...
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BMJ Publishing Group
2019-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/9/e030584.full |
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| author | Aliya Naheed Liang Feng Imtiaz Jehan H Asita de Silva Hamida Farazdaq Samina Hirani Anuradhani Kasturiratne Channa D Ranasinha Md Tauhidul Islam Ali Tanweer Siddiquee Tazeen H Jafar |
| author_facet | Aliya Naheed Liang Feng Imtiaz Jehan H Asita de Silva Hamida Farazdaq Samina Hirani Anuradhani Kasturiratne Channa D Ranasinha Md Tauhidul Islam Ali Tanweer Siddiquee Tazeen H Jafar |
| author_sort | Aliya Naheed |
| collection | DOAJ |
| description | Objective To determinate the prevalence and correlates of cardiometabolic multimorbidity (CMM), and their cross-country variation among individuals with hypertension residing in rural communities in South Asia.Design A cross-sectional study.Setting Rural communities in Bangladesh, Pakistan and Sri Lanka.Participants A total of 2288 individuals with hypertension aged ≥40 years from the ongoing Control of Blood Pressure and Risk Attenuation- Bangladesh, Pakistan and Sri Lanka clinical trial.Main outcome measures CMM was defined as the presence of ≥2 of the conditions: diabetes, chronic kidney disease, heart disease and stroke. Logistic regression was done to evaluate the correlates of CMM.Results About 25.4% (95% CI 23.6% to 27.2%) of the hypertensive individuals had CMM. Factors positively associated with CMM included residing in Bangladesh (OR 3.42, 95% CI 2.52 to 4.65) or Sri Lankan (3.73, 95% CI 2.48 to 5.61) versus in Pakistan, advancing age (2.33, 95% CI 1.59 to 3.40 for 70 years and over vs 40–49 years), higher waist circumference (2.15, 95% CI 1.42 to 3.25) for Q2–Q3 and 2.14, 95% CI 1.50 to 3.06 for Q3 and above), statin use (2.43, 95% CI 1.84 to 3.22), and higher levels of triglyceride (1.01, 95% CI 1.01 to 1.02 per 5 mg/dL increase). A lower odds of CMM was associated with being physically active (0.75, 95% CI 0.57 to 0.97). A weak inverted J-shaped association between International Wealth Index and CMM was found (p for non-linear=0.058), suggesting higher risk in the middle than higher or lower socioeconomic strata.Conclusions CMM is highly prevalent in rural South Asians affecting one in four individuals with hypertension. There is an urgent need for strategies to concomitantly manage hypertension, cardiometabolic comorbid conditions and associated determinants in South Asia. |
| format | Article |
| id | doaj-art-2d6e9c0efeed41d398f7869fef45cd68 |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-09-01 |
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| spelling | doaj-art-2d6e9c0efeed41d398f7869fef45cd682025-08-20T02:49:05ZengBMJ Publishing GroupBMJ Open2044-60552019-09-019910.1136/bmjopen-2019-030584Prevalence and correlates of cardiometabolic multimorbidity among hypertensive individuals: a cross-sectional study in rural South Asia—Bangladesh, Pakistan and Sri LankaAliya Naheed0Liang Feng1Imtiaz Jehan2H Asita de Silva3Hamida Farazdaq4Samina Hirani5Anuradhani Kasturiratne6Channa D Ranasinha7Md Tauhidul Islam8Ali Tanweer Siddiquee9Tazeen H Jafar104 Initiative for Non-communicable Diseases, Health Systems and Population Studies Division, ICDDRB, Dhaka, Bangladesh1 Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore2 Department of Community Health Science, Aga Khan University, Karachi, Pakistan3 Department of Pharmacology, University of Kelaniya Faculty of Medicine, Kelaniya, Sri Lanka5 Department of Family Medicine, Aga Khan University, Karachi, Pakistan2 Department of Community Health Science, Aga Khan University, Karachi, PakistanDepartment of Public Health, Faculty of Medicine, University of Kelaniya, Sri Lanka, Ragama, Sri Lanka3 Department of Pharmacology, University of Kelaniya Faculty of Medicine, Kelaniya, Sri Lanka4 Initiative for Non-communicable Diseases, Health Systems and Population Studies Division, ICDDRB, Dhaka, Bangladesh4 Initiative for Non-communicable Diseases, Health Systems and Population Studies Division, ICDDRB, Dhaka, Bangladesh8 Duke Global Health Institute, Durham, North Carolina, USAObjective To determinate the prevalence and correlates of cardiometabolic multimorbidity (CMM), and their cross-country variation among individuals with hypertension residing in rural communities in South Asia.Design A cross-sectional study.Setting Rural communities in Bangladesh, Pakistan and Sri Lanka.Participants A total of 2288 individuals with hypertension aged ≥40 years from the ongoing Control of Blood Pressure and Risk Attenuation- Bangladesh, Pakistan and Sri Lanka clinical trial.Main outcome measures CMM was defined as the presence of ≥2 of the conditions: diabetes, chronic kidney disease, heart disease and stroke. Logistic regression was done to evaluate the correlates of CMM.Results About 25.4% (95% CI 23.6% to 27.2%) of the hypertensive individuals had CMM. Factors positively associated with CMM included residing in Bangladesh (OR 3.42, 95% CI 2.52 to 4.65) or Sri Lankan (3.73, 95% CI 2.48 to 5.61) versus in Pakistan, advancing age (2.33, 95% CI 1.59 to 3.40 for 70 years and over vs 40–49 years), higher waist circumference (2.15, 95% CI 1.42 to 3.25) for Q2–Q3 and 2.14, 95% CI 1.50 to 3.06 for Q3 and above), statin use (2.43, 95% CI 1.84 to 3.22), and higher levels of triglyceride (1.01, 95% CI 1.01 to 1.02 per 5 mg/dL increase). A lower odds of CMM was associated with being physically active (0.75, 95% CI 0.57 to 0.97). A weak inverted J-shaped association between International Wealth Index and CMM was found (p for non-linear=0.058), suggesting higher risk in the middle than higher or lower socioeconomic strata.Conclusions CMM is highly prevalent in rural South Asians affecting one in four individuals with hypertension. There is an urgent need for strategies to concomitantly manage hypertension, cardiometabolic comorbid conditions and associated determinants in South Asia.https://bmjopen.bmj.com/content/9/9/e030584.full |
| spellingShingle | Aliya Naheed Liang Feng Imtiaz Jehan H Asita de Silva Hamida Farazdaq Samina Hirani Anuradhani Kasturiratne Channa D Ranasinha Md Tauhidul Islam Ali Tanweer Siddiquee Tazeen H Jafar Prevalence and correlates of cardiometabolic multimorbidity among hypertensive individuals: a cross-sectional study in rural South Asia—Bangladesh, Pakistan and Sri Lanka BMJ Open |
| title | Prevalence and correlates of cardiometabolic multimorbidity among hypertensive individuals: a cross-sectional study in rural South Asia—Bangladesh, Pakistan and Sri Lanka |
| title_full | Prevalence and correlates of cardiometabolic multimorbidity among hypertensive individuals: a cross-sectional study in rural South Asia—Bangladesh, Pakistan and Sri Lanka |
| title_fullStr | Prevalence and correlates of cardiometabolic multimorbidity among hypertensive individuals: a cross-sectional study in rural South Asia—Bangladesh, Pakistan and Sri Lanka |
| title_full_unstemmed | Prevalence and correlates of cardiometabolic multimorbidity among hypertensive individuals: a cross-sectional study in rural South Asia—Bangladesh, Pakistan and Sri Lanka |
| title_short | Prevalence and correlates of cardiometabolic multimorbidity among hypertensive individuals: a cross-sectional study in rural South Asia—Bangladesh, Pakistan and Sri Lanka |
| title_sort | prevalence and correlates of cardiometabolic multimorbidity among hypertensive individuals a cross sectional study in rural south asia bangladesh pakistan and sri lanka |
| url | https://bmjopen.bmj.com/content/9/9/e030584.full |
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