Missed opportunities for initiation of treatment and control of hypertension among older adults in India

Abstract

Hypertension (HT) is a major public health problem globally. The unacceptably low treatment and control rates are a major concern for policy makers as they contribute to avoidable mortality and morbidity. This study quantifies the prevalence and the determinants of missed opportunities for the treatment and control of HT in older adults in India. The study utilized data from the Longitudinal Aging Study in India (LASI), a population-based national representative survey of 62,416 individuals aged over 45 years. Our findings suggest that the prevalence of missed opportunities for the treatment and control of HT was 29.9 % and 16.4 % respectively. Overall, more than 60 % of all missed opportunities were in the private sector, and 75 % were in outpatient consultations. Education, working status, diabetes, stroke, physical activities, smoking, monthly per capita consumption expenditure (MPCE) quintiles were positively associated with missed opportunities for both treatment and control of HT. Rural residents, individuals with no comorbidities, and those belonging to lower MPCE quintiles were positively associated with missed opportunities for treatment. This association was inverse in the case of missed opportunities for the control of HT. Significant missed opportunities exist with respect to the treatment and control of HT. We discuss the reasons behind low treatment and control rates, including failure to initiate treatment, suboptimal compliance, and lack of follow-up, in the context of significant financial barriers to access to health services and availability of free anti-hypertensive drugs in India.