Comparative Study of Hypertension Prevalence, Health-Related Quality of Life, and Healthcare Barriers Among Diabetic and Non- Diabetic Populations in Urban Slums of Bangladesh

Background The rising burden of non-communicable diseases (NCDs), particularly diabetes and hypertension, disproportionately affects urban slum residents in Bangladesh, where approximately 40% of urban populations face socioeconomic challenges such as poverty, overcrowding, and limited healthcare access. These conditions contribute to health inequities and diminished health-related quality of life (HRQoL). However, comprehensive data on prevalence, associated factors, barriers to healthcare, and HRQoL in this marginalized group remain limited. Methods A community-based cross-sectional study was conducted from June to August 2025 across five slums in Dhaka (Mirpur, Khilgaon, Korail, Bhashantek, and Kamalapur). Using simple random sampling, 400 adults aged ≥ 45 years (200 with self-reported diabetes and 200 without) were enrolled. Data were collected via a validated Bengali version of the World Health Organization (WHO) STEPwise Approach to Surveillance (STEPS) questionnaire for sociodemographics, lifestyle factors, and healthcare barriers, plus the EQ-5D-5L instrument for HRQoL assessment. Analyses included descriptive statistics, chi-square tests, independent t-tests, and multivariable logistic regression in R software (p < 0.05 for significance). Results Prevalence of diabetes ranged from 10.0% to 14.1%, hypertension from 28.3% to 34.4%, and their comorbidity from 4.5% to 15.4% across slums. Independent risk factors for hypertension/diabetes included older age (adjusted odds ratio [OR] = 6.67, 95% confidence interval [CI]: 3.57–12.5, p = 0.003), higher body mass index (OR = 2.86, 95% CI: 1.64–5.00, p < 0.001), smoking (OR = 10.0, 95% CI: 5.00–20.0, p = 0.048), and sedentary occupations (OR = 12.5, 95% CI: 6.25–25.0, p = 0.048). Major barriers to care were financial constraints (83.5%), limited healthcare access (9.5%), and low awareness (4.5%). HRQoL was significantly lower in participants with diabetes (EQ-5D index score: 0.72 ± 0.18 vs. 0.85 ± 0.12 in non-diabetics, p < 0.001), with greater impairments in mobility (p = 0.012), pain/discomfort (p = 0.021), and anxiety/depression (p = 0.004), linked to disease burden and slum-related stressors (e.g., pollution, poverty). Conclusions Urban slums in Dhaka bear a substantial burden of diabetes and hypertension, exacerbated by socioeconomic barriers and poorer HRQoL. Urgent targeted interventions—community screening, subsidized care, health literacy programs, and lifestyle modifications—are needed to mitigate disparities, aligning with national NCD strategies and Sustainable Development Goal 3.4.