The Determinants of Undiagnosed Hypertension Among Indonesian Adults: A Cross-sectional Study Based on the 2014-2015 Indonesia Family Life Survey

Abstract

Objectives: This study investigated the determinants of undiagnosed hypertension among Indonesian adults.Methods: This study involved an analysis of secondary data from the 2014 Indonesia Family Life Survey (IFLS) on 5914 Indonesian adults (≥40 years). The determinant variables examined in this cross-sectional study were education level, monthly per capita expenditures (PCE), whether the participant experienced headaches in the morning, and other general health variables. The outcome variable was undiagnosed hypertension, which was defined as participants with hypertension who had not received a hypertension diagnosis from a health professional and had never been prescribed medication for treating hypertension. The data were analyzed using logistic regression.Results: A total of 3322 participants (56.2%) were found to have undiagnosed hypertension. The odds ratios (ORs) and 95% confidence intervals (CIs) of undiagnosed hypertension were significantly higher among those who completed primary school or lower (OR, 1.60; 95% CI, 1.29 to 1.98), had low monthly PCE (OR, 1.28; 95% CI, 1.13 to 1.43), did not report experiencing headaches in the morning (OR, 1.97; 95% CI, 1.76 to 2.21), and reported a general health status of healthy (OR, 2.05; 95% CI, 1.82 to 2.30) than those who had a higher education level, had high monthly PCE, experienced headaches in the morning, and were unhealthy.Conclusions: Education level, monthly PCE, the experience of headaches in the morning, and general health status were associated with undiagnosed hypertension. The monitoring system for detecting undiagnosed hypertension cases must be strengthened. Health promotion is also necessary to reduce the prevalence of undiagnosed hypertension.

Prevalence and associated factors of undiagnosed hypertension among adults in the Central African Republic

“…It is possible that individuals with high physical activity are less health conscious and feel less susceptible to getting chronic diseases 11 . Contrary to several previous studies 8 , 11 , 13 , 15 , we did not find a significant association between education, household income, and undiagnosed HTN. Possible reasons for this nonsignificant effect of socioeconomic status on undiagnosed HTN may be related to the very low Human Development Index (HDI) measured by 'a long and healthy life, access to knowledge and a decent standard of living' of 0.397 in 2019 in CAR (the second lowest of 189 countries and territories) 30 .…”

“…Some of these country differences can be attributed to less developed health care systems in low-income countries, such as CAR and Sudan, as opposed to more developed health care systems in upper middle-income countries, such as China, Malaysia and South Africa 11 , 28 . Poor awareness of blood pressure screening can be attributed to the high proportion of undiagnosed HTN in CAR 15 .…”

“…Factors associated with undiagnosed HTN in terms of predisposing health service use can include male sex 8 , 11 – 14 , and younger age 8 , 12 – 14 . Enabling/disabling factors include lower economic status 8 , 11 , 13 , lower education 13 , 15 , no health care utilization 12 , 16 , and health risk behaviours, such as low physical activity 17 , and tobacco use 11 , 18 . Factors inversely associated with undiagnosed HTN in terms of health service need can include obesity 8 , 11 , 14 , underweight 13 , 16 , other chronic diseases 16 , and diabetes 14 .…”

Undiagnosed hypertension in Sudan: results of the cross-sectional national STEPS survey in 2016

“…Rural residents in Sudan may have poorer access to health care services than urban residents, hindering them from screening of blood pressure [ 30 ]. Contrary to several previous studies [ 5 , 7 , 13 - 15 ], we did not find an association between socioeconomic status (education) with undiagnosed HTN.…”

“…Enabling/disabling factors associated with undiagnosed HTN include socioeconomic status (lower economic status [ 5 , 13 ], higher economic status [ 14 ], lower education [ 7 , 13 , 14 ], higher education [ 15 ]), rural residence [ 13 ], geographical region [ 14 ], no health care visit in the past month [ 16 ], and no health insurance [ 17 ]. Furthermore, health risk behaviours associated with undiagnosed HTN include physical inactivity [ 18 ], not physically inactive [ 13 ], high sedentary behaviour [ 19 ], dietary habit [ 19 ], and tobacco use [ 20 ].…”