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.
Word Count = 239 (Maximum limit=200) now 197

References
1.
Davey Smith G, Leary S, Ness S. Could dehydration in infancy lead to high blood pressure? J Epidemiol
Community Health. 2006 Feb;60(2):142-3.
2.
Miranda JJ, Davies AR, Davey Smith G, Smeeth L, Cabrera L, Gilman RH, et al. Frequency of diarrhoea
as a predictor of elevated blood pressure in children. J Hypertens. 2009 Feb;27(2):259-65.
3.
Batty GD, Davey Smith G, Fall CH, Sayer AA, Dennison E, Cooper C, et al. Association of diarrhoea in
childhood with blood pressure and coronary heart disease in older age: analyses of two UK cohort studies. Int J
Epidemiol. 2007 Dec;36(6):1349-55.
4.
Batty GD, Horta BL, Davey Smith G, Barros FC, Victora C. Early life diarrhoea and later blood pressure
in a developing country: the 1982 Pelotas (Brazil) birth cohort study. J Epidemiol Community Health. 2009
Feb;63(2):163-5.
5.
Kauhanen L, Lynch JW, Lakka HM, Kauhanen J, Davey Smith G. Association of diarrhoea, poor hygiene
and poor social conditions in childhood with blood pressure in adulthood. J Epidemiol Community Health.
May;64(5):394-9.