In rural Bangladesh, twenty six percent of the people aged 40 years or above are suffering from hypertension, and, of them, 21.5 percent have suffered strokes, says a new study on Bangladesh, Sri Lanka and Pakistan.
The rate of stroke among the hypertensive patients are 10 and 11 percent in Sri Lanka and Pakistan, respectively, which means that Bangladeshis suffer the highest rate of strokes among three South Asian countries.
A stroke is a medical condition that causes partial death of cells in the brain. There are two main types of stroke: an ischemic stroke caused by a blockage and a hemorrhagic stroke caused by the rupture of a blood vessel.
“Strokes are fatal. Many die due to strokes, and those surviving face disabilities of sorts – either their speech is impaired or parts of their body are paralysed, which induces non-productivity,” said Dr Aliya Naheed, a scientist in icddr,b, on the eve of World Hypertension Day which is observed on May 17 since 2006.
The study “Control of Blood Pressure and Risk Attenuation” was conducted in rural Bangladesh, Sri Lanka, and Pakistan, between April 2016 and March 2017. A total of 11,510 individuals aged 40 or older were screened.
Of them, 4,442 people from 10 upazilas under Tangail and Munshiganj came under the study, who could be considered national representatives, said Dr Naheed, who led the regional study for Bangladesh.
Duke-NUS Medical School, Singapore; Aga Khan University of Pakistan; University of Kelaniya, Sri Lanka and icddr,b in Bangladesh jointly conducted the research published by Oxford University Press on behalf of American Journal of Hypertension Ltd in April this year.
According to the study, 20 percent of the people in Bangladesh are suffering from hypertension, 18.8 in Pakistan and 37 in Sri Lanka. The percentage of people with uncontrolled hypertension is 71 in Pakistan, 56.5 in Sri Lanka and 53 in Bangladesh.
Aliya Naheed, head of the Initiative for Non-communicable Diseases (NCD) at the icddr,b, said, “It is mysterious that the stroke rate in Bangladesh is higher, even though uncontrolled hypertension rate is the lowest among the three countries.”
It is high time that the health system in the country is strengthened for further research which may be required to find the factors leading to a higher rate of strokes in Bangladesh, she told The Daily Star.
She added that an unhealthy diet -- high consumption of sugar, salt, cigarette, tobacco, alcohol; physical inactivity, obesity, and genetic factors are responsible for hypertension, which is linked to strokes.
Being single compared to married was associated with higher odds of uncontrolled blood pressure, said the study.
The number of antihypertensive medications used was lowest in Pakistan followed by Bangladesh.
“Unfortunately, there is no universal health coverage in Pakistan or Bangladesh; antihypertensive medications are not free in either country, where more than 80 percent of expenditure on medications has been reported to be out-of-pocket,” the study says.
On the other hand, selected generic antihypertensive medications are provided free-of-cost in the public healthcare sector in Sri Lanka, it said.
Aliya Naheed said training of health personnel at the union and upazila levels on screening and appropriate medication can help in reducing the risks of hypertension and stroke.
At the same time, it is important that people go through regular health screening, maintain a healthy diet and exercise regularly, she said.