Inequalities in Undiagnosed Hypertension Among Adult Population in Bangladesh: Evidence from a Nationally Representative Survey

Bangladesh has experienced a rising trend in hypertension in recent years and women are suffering from this non-communicable disease more than men. About one-fifth of the adult population is suffering from hypertension and almost three-fifth of them are undiagnosed. This study aims to assess the prevalence and determinants of undiagnosed hypertension and to examine the extent of socioeconomic inequalities in undiagnosed hypertension among adult Bangladeshi population (≥ 18 years). This study used nationally representative Bangladesh Demographic and Health Survey 2017–18 data. Undiagnosed hypertension was defined as having systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg and was never told by the health professionals to lower/control blood pressure. Multiple logistic regression analysis was performed to assess factors associated with undiagnosed hypertension. Further, socioeconomic inequalities in the prevalence of undiagnosed hypertension were estimated using Concentration Index. Out of total 3196 hypertensive adults, half (50.1%) were undiagnosed. In the adjusted model, older age, overweight/obesity, female gender, richest wealth quintiles had lower odds of being undiagnosed. Overall concentration index showed that poor patients were disproportionately affected by undiagnosed hypertension (Concentration Index: − 0.103, Standard Error (SE) of Concentration Index: 0.024; P value < 0.001). The poor(Q1)-to-rich(Q5) ratio of 1.3 also demonstrates that poorest hypertensive Bangladeshi adults have higher prevalence of undiagnosed hypertension than their richest counterparts. Awareness building program should be targeted towards adults belong to poor wealth quintiles for checking blood pressure regularly. Hypertension should be diagnosed and treated to prevent further complications.