Behavioral risk factors profile of people living with hypertension and diabetes comorbidity: a cross-sectional study in Chirirbandar sub-district, Bangladesh

Abstract

Introduction: Non-Communicable Disease (NCDs) and their behavioral risk factors are rising worldwide. Moreover, co-occurrence of hypertension and diabetes is also rising among adults in low- and middle-income countries (LMICs) like Bangladesh. The study aims to assess the behavioral risk factors and to identify the factors associated with the clustering of behavioral risk factors (≥3 risk factors) among people living with hypertension and diabetes comorbidity in Chirirbandar sub-district of Bangladesh. Methods: A cross-sectional study was conducted to assess behavioral risk factors among 387 participants from rural households of Chirirbandar sub-district. The data was conducted using WHO STEPs approach to chronic disease risk factor surveillance (STEPs) tools. Presence of three or more risk factors of NCDs was defined as the presence of clustering of NCDs risk factors. Multivariable logistic regression was conducted to identify the factors associated with clustering of behavioral risk factors. Findings: This community-based study covered twelve community clinics of Chirirbandar sub-district of Bangladesh. In total, 387 (148 men and 239 women) were included in the study. The mean age of the respondent was 56.99 years, more than half of them were unemployed, currently married, and less than one third of them had secondary and higher level of education. The prevalence of tobacco use, insufficient fruits and vegetable intake and inadequate physical activity was higher among men, however exposure to indoor air pollution was higher among women. The prevalence of clustering of NCDs risk factors for zero risk factors, one risk factor, two risk factors, three risk factors, and four risk factors were 0.78%, 9.04%, 51.94%, 32.3%, and 5.94% respectively. Majority (61.76%) of the study participants had at most two risk factors and 38.24% of them had three or four risk factors of NCDs. Risk of three or more risk factors was higher among the respondents aged 60 and above (48.47%), and male participants (43.92%). Moreover, the clustering of risk factors was found significantly associated with increased age, and self-care management for hypertension, particularly those who frequently forget to take their medications. Conclusion: The high prevalence of clustering of risk factors demands an integrated NCDs preventive strategies to reduce the burden of risk factors and relevant complications in the rural setting of the country.