Biological and Social Pathways

Hypertension risk reflects interactions among social position, healthcare access, behavioural exposures, and biological changes. Ageing within reproductive years increases vulnerability through cumulative metabolic and vascular changes. Higher BMI contributes to hypertension through insulin resistance, inflammation, sympathetic activation, and sodium retention. Smoking adds vascular stress through vasoconstriction, oxidative damage, arterial stiffness, and atherosclerosis. Lower education can reduce health literacy and awareness, limiting prevention and timely care. Sociocultural norms in Bangladesh restrict women's physical activity through limited mobility and exclusion from labour-intensive occupations. Sex differences in fat distribution and gestational weight retention increase women's susceptibility to excess body weight over the life course. Gender role expectations around body image and household responsibilities may further reinforce sedentary behaviour in women. Socioeconomic and urban transitions may be elevating men's obesity risk toward that of women rather than protecting women. The narrowing sex gap at higher socioeconomic levels may primarily reflect a rise in male…