Health science reports · 2026
Comparative Study of Hypertension Prevalence, Health-Related Quality of Life, and Healthcare Barriers Among Diabetic and Non-Diabetic Populations in Urban Slums of Bangladesh: A Community-Based Comparative Cross-Sectional Study.
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Maruf Md Fakhrul Islam, Omi Nishat Tamanna, Mubarak Mahfuza
Аннотация
BACKGROUND AND AIMS: The double burden of diabetes and hypertension is a growing public health concern in Bangladesh's urban slums, where healthcare access and health-related quality of life (HRQoL) remain limited. This study compared hypertension prevalence, HRQoL, and healthcare barriers between adults with and without self-reported diabetes, and identified factors independently associated with hypertension and HRQoL in this population.
METHODS: A community-based comparative cross-sectional study was conducted from June to August 2025 in five purposively selected urban slums of Dhaka. Using simple random sampling, 400 adults aged ≥ 45 years (200 with self-reported diabetes, 200 without) were recruited. Data were collected using the validated Bengali WHO STEPS questionnaire and the EQ-5D-5L instrument. Multivariable logistic regression identified factors independently associated with self-reported hypertension (the primary, prespecified outcome), with diabetes status entered as the key exposure variable, and multivariable linear regression examined factors associated with the EQ-5D-5L index score.
RESULTS: Hypertension was more prevalent among participants with diabetes (121/200, 60.5%) than without (46/200, 23.0%; χ 2 = 57.8, p < 0.001). After adjustment, diabetes remained the strongest independent correlate of hypertension (adjusted odds ratio [aOR] 3.82, 95% CI 2.46-5.93, p < 0.001), alongside older age, higher body mass index, smoking, and non-manual occupation. Diabetic participants had significantly lower EQ-5D-5L index scores (0.72 ± 0.18 vs. 0.85 ± 0.12, p < 0.001); this association persisted after adjustment (β = -0.081, 95% CI - 0.104 to -0.058, p < 0.001). Among participants with diabetes, financial constraints were the leading healthcare barrier (167/200, 83.5%).
CONCLUSION: Diabetes is strongly and independently associated with hypertension and impaired HRQoL among older adults in Dhaka's urban slums. Financial constraints dominate healthcare access barriers. Equity-focused, integrated NCD interventions targeting this vulnerable population are urgently needed.
METHODS: A community-based comparative cross-sectional study was conducted from June to August 2025 in five purposively selected urban slums of Dhaka. Using simple random sampling, 400 adults aged ≥ 45 years (200 with self-reported diabetes, 200 without) were recruited. Data were collected using the validated Bengali WHO STEPS questionnaire and the EQ-5D-5L instrument. Multivariable logistic regression identified factors independently associated with self-reported hypertension (the primary, prespecified outcome), with diabetes status entered as the key exposure variable, and multivariable linear regression examined factors associated with the EQ-5D-5L index score.
RESULTS: Hypertension was more prevalent among participants with diabetes (121/200, 60.5%) than without (46/200, 23.0%; χ 2 = 57.8, p < 0.001). After adjustment, diabetes remained the strongest independent correlate of hypertension (adjusted odds ratio [aOR] 3.82, 95% CI 2.46-5.93, p < 0.001), alongside older age, higher body mass index, smoking, and non-manual occupation. Diabetic participants had significantly lower EQ-5D-5L index scores (0.72 ± 0.18 vs. 0.85 ± 0.12, p < 0.001); this association persisted after adjustment (β = -0.081, 95% CI - 0.104 to -0.058, p < 0.001). Among participants with diabetes, financial constraints were the leading healthcare barrier (167/200, 83.5%).
CONCLUSION: Diabetes is strongly and independently associated with hypertension and impaired HRQoL among older adults in Dhaka's urban slums. Financial constraints dominate healthcare access barriers. Equity-focused, integrated NCD interventions targeting this vulnerable population are urgently needed.