Solid fuel use status in the household and the risk of elevated blood pressure: findings from the 2017/18 Bangladesh Demographic and Health Survey

IntroductionPrevalence of hypertension is now increasing rapidly in Bangladesh, particularly among the socio-economically disadvantaged population. This could be linked to their higher use of solid fuel; however, related evidence is scarce in Bangladesh. We aimed to determine the associations of household solid fuel use and its exposure level with systolic blood pressure, diastolic blood pressure and hypertension. MethodsTotal of 7,320 womens data extracted from the 2017/18 Bangladesh Demographic and Health Survey were analysed. We considered three outcome variables: (i) systolic blood pressure (continuous response), (ii) diastolic blood pressure (continuous response) and (iii) hypertension status (yes, no). Cooking fuel use (clean fuel vs solid fuel) and levels of exposure to household air pollution (HAP) through solid fuel use (unexposed, moderately exposed, highly exposed) were our primary exposure of interest. A multilevel mixed-effects Poisson regression model with robust variance was used to determine the association between exposure and outcome variable adjusting for confounders. ResultsAround 82% of the total respondents analysed used solid fuel for cooking. The overall age-standardised prevalence of hypertension was 28%. The likelihood of becoming hypertension was found 1.44 times (95% CI, 1.04-1.89) higher among respondents who used solid fuel as compared to the respondents who used clean fuel. The likelihood of hypertension was found to be increased with the increased exposure to HAP through the solid fuel used; 1.61 times (95% CI, 1.07-2.20) higher among the moderate exposure group and 1.80 times (95% CI, 1.27-2.32) higher among higher exposure group as compared to the women who used clean fuel. Similar associations were reported for systolic blood pressure and diastolic blood pressure. ConclusionSolid fuel use elevate systolic blood pressure, diastolic blood pressure and increases the likelihood of becoming hypertensive. Policies and programs are important to increase awareness about the adverse effects of solid fuel use on health, including hypertension. Focus should also be given to reducing solid fuel use and ensuring proper ventilation at the solid fuel use place.