Undiagnosed hypertension in Peru: analysis of associated factors and socioeconomic inequalities, 2019

Delia Vanessa Guerrero-Díaz,Akram Hernández-Vásquez,Wency Cecilia Montoya-Rivera,Carlos Rojas-Roque,Manuel Alberto Chacón Díaz,Guido Bendezu-Quispe

doi:10.1016/j.heliyon.2021.e07516

Delia Vanessa Guerrero-Díaz, Akram Hernández-Vásquez + Show 4 more

Open Access

https://doi.org/10.1016/j.heliyon.2021.e07516

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Abstract

ObjectiveTo determine the factors associated and measure the socioeconomic inequalities in people with undiagnosed hypertension in Peru. Materials and methodsAn observational, cross-sectional, analytical study was performed using data from the 2019 Demographic and Family Health Survey (ENDES, acronym in Spanish) database. The dependent variable was the presence of undiagnosed hypertension (mean systolic blood pressure ≥140 mmHg and/or mean diastolic blood pressure ≥90 mmHg in the two blood pressure measurements and with no prior diagnosis of hypertension by a health care professional). Adjusted prevalence ratios were estimated to determine the factors associated with undiagnosed hypertension. The socioeconomic inequality in undiagnosed hypertension was estimated using concentration curves and the Erreygers concentration index. Results67.2% of 3697 persons with hypertension had not been diagnosed. Non-diagnosis of hypertension was more prevalent in men who were residents of the Coast and in inhabitants residing at more than 3000 m above sea level. Being 50 years of age or older, having health insurance, being obese and having diabetes mellitus were associated with a lower prevalence of undiagnosed hypertension. Inequality of the non-diagnosis of hypertension was found to be concentrated in the poorest population. ConclusionsAt least one out of every two adult Peruvians with hypertension have not been diagnosed with this condition. Socioeconomic inequality was found, as well as socio-demographic and health-related factors associated with undiagnosed hypertension. Our findings identify some population subgroups in which interventions for screening and treatment of hypertension should be prioritized in order to reduce both inequalities and complications of hypertension among the most vulnerable.

Highlights

Hypertension is the most important risk factor for cardiovascular mortality worldwide [1] and is responsible for 45% and 51% of deaths by ischemic cardiopathy and cerebrovascular accident, respectively [2]
According to the Cardiovascular Risk Factor Multiple Evaluation in Latin America (CARMELA) study, the prevalence of undiagnosed hypertension varies between 24% and 47% in 7 cities of Latin America [11]
This study sought to determine the prevalence and factors associated with undiagnosed hypertension in the Peruvian population

Summary

Introduction

Hypertension is the most important risk factor for cardiovascular mortality worldwide [1] and is responsible for 45% and 51% of deaths by ischemic cardiopathy and cerebrovascular accident, respectively [2]. It is estimated that in one out of every five people with hypertension, the condition is controlled [4], and among patients not diagnosed with hypertension, 3 out of every four are considered to be at high cardiovascular risk [5]. According to the Cardiovascular Risk Factor Multiple Evaluation in Latin America (CARMELA) study, the prevalence of undiagnosed hypertension varies between 24% and 47% in 7 cities of Latin America [11]. Undiagnosed hypertension is a challenge in Latin American countries (which are the most affected by this condition)

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