Abstract

Undiagnosed hypertension has resulted in significant health and economic burdens. This study sought to investigate the association between health factors and undiagnosed hypertension among hypertensive Chinese and to assess the urban-rural disparity. A total of 6455 diagnosed and undiagnosed hypertensive adults were included. Multivariable logistic regression was conducted to examine the association between health factors and undiagnosed hypertension. The urban–rural disparity was investigated through stratified analysis. Undiagnosed hypertension was prevalent (28.8%), and rural residents were more likely to have undiagnosed hypertension compared to their urban counterparts (30.1% versus 24.7%). Physical examination, healthcare service utilization, body mass index, chronic diseases, headache, and self-rated health status were found to be significantly associated with undiagnosed hypertension. In addition, healthcare service utilization, underweight in body mass index, headache, and self-rating health status were associated with undiagnosed hypertension among the rural sample but not in the urban sample. Undiagnosed hypertension was significantly related to health factors among hypertensive Chinese. The findings provided implications for future hypertension prevention programs. The use of physical examination (e.g., blood pressure measurements) is recommended; special attention may be given to those who are underweight and self-rate their health as good and fair, as they are more likely to be neglected.

Highlights

  • Hypertension or high blood pressure remains a daunting global health challenge

  • Healthcare service utilization, body mass index, chronic diseases, headache, and self-rated health status were found to be significantly associated with undiagnosed hypertension

  • The findings provided implications for future hypertension prevention programs

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Summary

Introduction

Hypertension or high blood pressure remains a daunting global health challenge. The financial cost of hypertension is substantially high across different countries. It is estimated that 31.1% of the global population had hypertension in 2010 [1]. In China, the hypertension prevalence could be as high as 44.7% in 2015–2017 [2]. The increasing hypertension burden is a national public health priority. This leads to a high rate of undiagnosed or undetected hypertension [3]. A previous study indicated that only 44.7% of hypertensive Chinese participants were aware of their diagnosis [2]. The high prevalence of undiagnosed hypertension has resulted in heavy health and economic burdens [2]

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