Education, BMI, wealth index, diabetes status, and division were identified as the principal determinants of hypertension stages in Bangladesh, with obesity associated with 5.3 times higher odds of severe hypertension in 2022.
Obesity was a strong and consistent predictor of severe hypertension in Bangladesh across both survey years.
Secondary education was associated with higher odds of controlled hypertension in 2022.
Seven significant covariates were identified as influencing hypertension stages in both BDHS 2017/18 and 2022 after adjusting for age and gender.
Wealth index showed a changing association with hypertension stages over time between the two survey periods.
Marital status showed a changing association with hypertension stages over time, with divorced respondents having significantly higher risk of severe hypertension in 2022.
Geographic division was identified as a principal determinant of hypertension stages in Bangladesh in 2022.
Diabetes status was identified as a principal determinant of hypertension stages in the 2022 Bangladesh survey.
This research analyzed data from two large national health surveys in Bangladesh — one conducted in 2017/18 with over 12,000 participants and one in 2022 with nearly 14,000 participants — to understand what factors are associated with different stages of high blood pressure (hypertension) and how those associations may have changed over time. The researchers used statistical models and a newer artificial intelligence technique (called SHAP analysis) to rank which factors most strongly predicted whether someone had controlled, mild, or severe hypertension. Both approaches consistently pointed to education level, body weight (BMI), household wealth, diabetes, and geographic region as the most important predictors of hypertension stage in 2022. Some specific findings stand out: people with obesity had more than five times the odds of having severe hypertension compared to those without obesity in 2022, and having a secondary education was linked to somewhat higher odds of having controlled (managed) hypertension. Wealthier households were associated with higher rates of mild and controlled hypertension. Notably, divorced individuals showed a significantly elevated risk of severe hypertension in 2022, a pattern that was not as apparent in the earlier survey, suggesting that social circumstances can shift in their health relevance over time. This research suggests that efforts to address high blood pressure in Bangladesh should not use a one-size-fits-all approach. Instead, public health programs may need to be tailored to specific geographic regions and socioeconomic groups. The changing patterns between the two surveys also indicate that factors influencing hypertension risk can evolve over relatively short periods, meaning that regular monitoring and updated policy responses are important for managing this widespread health condition.
Roy T, Zaman M, Pollob A, Asadujjaman M, Abedin M, Islam M, et al.. (2026). Comparative Analysis of Hypertension Stages Prevalence and Associated Factors in Bangladesh: Evidence From BDHS 2017-18 and 2022.. Journal of clinical hypertension (Greenwich, Conn.). https://doi.org/10.1111/jch.70358