Prevalence of cardiovascular disease risk factors among adults in slum of Dhaka city

Abstract

Background: Cardiovascular disease (CVD) is one of the leading causes of death worldwide and hypertension is the leading modifiable risk factor for cardiovascular mortality. Slum living communities are increasingly adopting urban lifestyles and becoming more vulnerable to risk of developing CVD. Few studies have so far focused on this aspect. Objective: The aim of this study was to estimate the prevalence of risk factors of cardiovascular disease among adults in a slum of Dhaka city. Methods: It was a cross sectional survey conducted on conveniently selected 461 people at Agargaon slum area and this area was selected purposively. Face to face interview was taken by using structured questionnaire. Results: Total 461 adult slum people were studied, of them males were 241(52.3%) and females were 220(47.7%). Mean age of the respondents was 43.04 (SD±8.86) years. More than half of study subjects (57%) had no formal education. Majority of the females (81.8%) were house hold worker. About one third (32.8%) males were small businessmen; day laborer was about 12%. Driver and rickshaw pullers were all males, 12% and 7.5% respectively. The mean monthly family income of the respondents was 13754 (SD±4592) taka. Overall prevalence of smoking tobacco and smokeless tobacco use was 39.3% and 47.5% respectively. Based on MET minutes/week, 36.2% of the study subjects fell into low physical activity category. Most of the METs of women were contributed by moderate activities. Almost ninety per cent study subjects (89.6%) were lifetime abstainer of alcohol. None of the study subjects consumed adequate fruit or vegetables on an average day. Nine percent male consumed more than recommended level of oil daily, whereas it was 35.2% in case of female. Mean salt consumption per day was 13.2 (SD± 3.79) grams, which was more than double of the recommended level and 99% participants consume salt in excess of their normal requirement. Mean BMI of respondents was 22.37 (SD±2.92). Prevalence of overweight and obesity was 15.6%. Mean waist circumferences was 79.83 (SD±7.71) cm. The prevalence of high waist circumference was significantly higher in females than in males (45.5% versus 12.4%). Overall prevalence of hypertension was 14.8% and the rates among male and female were 16.6% and 12.7% respectively. The mean systolic blood pressure of male and female was 117.43 (SD±14.69) mmHg and 112.52 (SD±13.28) mmHg. A little less than one third (26.7%) of the study subjects never measured their blood pressure. Among the currently diagnosed hypertensive, 64.7% were unaware of their high blood pressure. More than one third (37.5%) of subjects who were on antihypertensive treatment, had blood pressure within normal level. Around 87.6% of participants never measured their blood glucose and about 5% of the people were previously diagnosed to have diabetes. Statistical significant association was found between hypertension and advancing age, higher monthly family income, increased BMI, low physical activity, smokeless tobacco use, diabetes and increased waist circumference in male sex. Logistic regression showed increased risk of hypertension among male sex, higher age group, high income group, smokeless tobacco use, low physical activity, high BMI and high waist circumference. Conclusion: The study population showed high prevalence of hypertension and other cardiovascular disease risk factors like both smoking and smokeless tobacco use, low physical activity with very minimum exercise and a considerable amount of time of sedentary activity, very minimum fruit and vegetable intake with very high salt intake. Majority of hypertensive patients were unaware about their hypertension status. There is need for greater awareness of hypertension and other cardiovascular disease risk factors in this population.