Prevalence of elevated blood pressure, elevated blood glucose, and cardiometabolic risk factors among rural adults in Chattogram Division, Bangladesh

Non-communicable diseases (NCDs), particularly hypertension and diabetes, represent a growing public health challenge in low- and middle-income countries (LMICs). Comprehensive community-based data on cardiometabolic risk factors among rural adults in Chattogram Division, Bangladesh remain limited. This study provides baseline evidence on cardiometabolic health during NCD policy implementation in Bangladesh. A cross-sectional analysis was conducted using de-identified data collected between November 2016 and November 2017 through the Portable Health Clinic (PHC) Project in four rural unions of Cumilla and Fatikchari subdistricts, Chattogram Division, Bangladesh. Data from 2,118 adult participants (1,018 males; 1,100 females) were included. Blood pressure was categorized using JNC 7 criteria (elevated: SBP ≥ 140 mmHg or DBP ≥ 90 mmHg) and blood glucose was categorized as elevated at ≥ 126 mg/dL. Independent-samples t-tests and Chi-square tests were used for group comparisons. Multiple linear and logistic regression analyses were used to identify factors associated with cardiometabolic indicators. The prevalence of elevated systolic blood pressure (≥ 140 mmHg) was 22.2% and elevated diastolic blood pressure (≥ 90 mmHg) was 26.3%. Nearly half of participants (48.4%) had elevated blood glucose (≥ 126 mg/dL). Overweight and obesity affected 28.8% and 8.4% respectively, while 17.3% were underweight. Age showed significant positive associations with systolic blood pressure (β = 0.48, p < 0.001), diastolic blood pressure (β = 0.17, p < 0.001), and blood glucose (β = 1.32, p < 0.001). Obesity was significantly associated with elevated blood glucose (OR = 1.45, 95% CI: 1.00–3.03, p = 0.049). Underweight individuals had lower odds of high cholesterol (OR = 0.21, 95% CI: 0.05–0.92, p = 0.039). Rural adults in Chattogram Division carried a substantial burden of elevated blood pressure and elevated blood glucose during 2016–2017. Older age and obesity were consistently associated with adverse cardiometabolic profiles, and sex differences were observed for selected outcomes. These findings highlight the urgent need for integrated public health interventions targeting prevention, early detection, and management of NCDs in rural Bangladesh.