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International Conference on Global Public Health 2012

Incidence of childhood diarrhea and blood pressure in later life: Matlab, Bangladesh
Theme: Double burden of diseases
Preet K. Dhillon1, Khaled Hasan2, Shariful Islam2, Serajul Islam2, Dilip Jha1, George Davey-Smith3,
Dewan Alam2, Shah Ebrahim1
1- South Asia Network for Chronic Disease (SANCD), Public Health Foundation of India, India
2- Chronic Disease Unit, Health Systems and Infectious Diseases Division, International Centre for Diarrheal Disease,
Bangladesh (ICDDR,B), Bangladesh
3- Department of Social Medicine, University of Bristol, UK

Abstract
Severe dehydration from diarrhea in infancy may be associated with higher blood pressure (BP) in adulthood; a
survival mechanism to retain water may lead to salt-retention at a critical developmental period (1). Previous
studies in low-diarrhea incidence populations have yielded mixed, weak associations (1-4). We analyzed data
from a community-based cohort in Matlab, Bangladesh, a high-incidence setting, to evaluate the association
between childhood diarrhea (<5 years) and BP in later life. From June 1, 2011-May 31, 2012 in Dagorpur,
Matlab, we conducted an interviewer-administered questionnaire to 1404 persons aged > 2 years (mean=29.8 +
20.3 yrs) and measured BP, vision, lung function and anthropometrics. Of these participants, 49.8% (n=699) were
covered in annual ICDDR,B* surveys between 1986-2006, in which the cumulative prevalence of childhood
diarrhea was 66.0% (n=461). We used multivariate linear regression models to evaluate occurrence of childhood
diarrhea and later BP; age- and BMI adjusted models yielded a significant 2.62 mmHg increase in systolic BP
(95% CI: 0.67, 4.58) and no difference in diastolic BP (RR=-0.27, 95% CI: -1.90, 1.36). After adjusting for
gender, these differences attenuated. Our results do not suggest that diarrhea in early life is associated with
higher BP in later life.
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