Page 117 - IJPS-3-1

Tareque MI and Saito Y

of all ages and adults aged 60 years and older as well as information on healthy
life expectancy for people aged 15 years and above. For example, in Bangladesh
as a whole, despite having longer LE, elderly women have a greater prevalence
of disability and shorter disability-free life expectancy than elderly men (Tareque,
Begum, and Saito, 2013). Clear inequalities in LE, disability-free life expectancy
and LE with disability between rural and urban areas are reported. Urban males and
females, respectively, have a longer disability-free life expectancy and shorter LE with
disability both in number and proportion when compared to rural males and females
(Islam, Tareque, Mondal et al., 2017). Healthy life expectancy declines significantly
as age increases in the Rajshahi district of Bangladesh (Tareque, Islam, Kawahara
et al., 2015). Men expected fewer life years spent in good health but a much larger
proportion of expected life in good health than did women in Bangladesh in 1996
and 2002 (Tareque, Saito, and Kawahara, 2015). However, life expectancies with and
without hypertension (HTN) have never been computed in Bangladesh.
Raised or high blood pressure acts as one of the contributing and intermediate risk
factors for developing coronary heart disease, stroke, and kidney disease. High blood
pressure in adulthood is reported to be associated with reduced LE and more years
of expected life with cardiovascular disease, and in the United States, it affects both
men and women similarly (Franco, Peeters, Bonneux et al., 2005). The LE benefits
of antihypertensive treatment were examined in a study for the United States (Sesso,
Chen, L’Italien et al., 2003). Successful blood pressure lowering in hypertensive
patients and those with additional cardiovascular disease risk factors such as diabetes
or current smoking was reported to have the potential to provide substantial gains in
LE. The study revealed that gains in LE occurred with even modest reductions in blood
pressure (Sesso, Chen, L’Italien et al., 2003).
A number of studies have been devoted to gender differences in health, mortality,
and health expectancy (Doblhammer and Hoffmann, 2010; Knodel and Ofstedal, 2003;
Mishra, Roy, and Retherford, 2004; Oksuzyan, Juel, Vaupel et al., 2008; Tareque,
Begum, and Saito, 2013), which have been of longstanding interest to researchers.
Gender differences in HTN as well as Hypertension-Free Life Expectancy (HFLE)
are also areas of interest, particularly in Bangladesh where women are highly
disadvantaged compared with men. In Bangladesh, HTN is reported to be higher
among women and the older population than among their counterparts (National
Institute of Population Research and Training (NIPORT), Mitra and Associates, and
ICF International, 2013; Saquib, Saquib, Ahmed et al., 2012; Tareque, Koshio, Tiedt
et al., 2015). Though there were fluctuations in male and female LE at age 35 and
over until 2005, since 2006 female LE at every age has been consistently longer than
that of males in Bangladesh (Bangladesh Bureau of Statistics (BBS), 2011). In 2011,
female and male LE at age 35 were, respectively, 40.08 and 38.92 years (World Health
Organization, 2014). Whether greater LE implies better health and longer HFLE for
women is a critical question in Bangladesh. The current study thus examines gender
differences in HTN prevalence and in HFLE in Bangladesh.

2 Materials and Methods

2.1 Data

This study utilized data from a nationally representative sample survey, the 2011
Bangladesh Demographic and Health Survey (BDHS). The 2011 BDHS is the sixth
Demographic and Health Survey undertaken in Bangladesh. The sampling design,
questionnaires, and data collection procedures of the 2011 BDHS are described
elsewhere in detail (National Institute of Population Research and Training (NIPORT),
Mitra and Associates, and ICF International, 2013). The 2011 BDHS is the first
survey that collected blood pressure measurements for people aged 35 years and
over. It collected data from individuals residing in non-institutional dwelling units in
Bangladesh and is based on a two-stage stratified sample of households. Based on the
sampling design, a total of 17,964 households were selected, 17,511 of which were

International Journal of Population Studies 2017, Volume 3, Issue 1 111