Non Adherence to Anti-Hypertensive Medications among Bangladeshi Adults with Raised Blood Pressure – A Public Health Concern

INTRODUCTION:  As an intermediate risk factor for cardio and cerebrovascular diseases; Hypertension and pre-hypertension creates serious burden on the already lumbered health system of Bangladesh. The best way of dealing with this situation is prevention backed by effective management system. Small scale evidence shows high rate of non adherence to anti hypertensive drugs in the country. Based on the available evidence on rising prevalence of hypertension and pre-hypertension in Bangladesh the recent Demographic and Health Survey published in 2012 included measuring blood pressure for the first time. The objective of this inclusion was to determine national status of this future development challenge.   

METHODS:  All women and men age 35 and older in 7543households were sampled for blood pressure testing. Three measurements of both systolic and diastolic blood pressure were taken at approximately 10-minute intervals between measurements. The American Heart Association (2003) guideline for cut-off points for blood pressure measurements was used. In addition a person who reports that they are currently taking antihypertensive medication to lower their blood pressure is also classified as having hypertension.

RESULTS:  The BDHS findings show that 45% of women and 57% of men who are hypertensive are unaware about their elevated blood pressure. 11% percent of women and 8% of men are aware of their hypertension, but aren’t treating. One in four women and one in five men are aware of their condition, are taking medication to lower the blood pressure, but are unsuccessful in controlling the elevated blood pressure. Only one in five women and one in six men are aware of their hypertension, are treating it, and have the hypertension under control.

CONCLUSIONS:  Evidence shows that uncontrolled hypertension leads to critical complications and can result into many chronic and morbid health situations creating burden to the already lumbered health system of the country.