Validity of Self‐Report Data in Hypertension Research: Findings From The Study on Global Ageing and Adult Health

Abstract

2Several studies indicate little congruence between selfreport and biometric data, yet very few have examined the reasons for such differences. This paper contributes to the limited but growing body of literature that tracks inconsistent reports of hypertension using data from the Study on Global Ageing and Adult Health (SAGE). Focusing on five countries with different levels of development (Ghana, China, India, South Africa, and Russia), this study offers a comparative perspective that is missing in the literature. Data were obtained from wave 1 of SAGE collected in 2007/2008. A multinomial logit model was used to examine the effects of demographic and socioeconomic variables on the likelihood of respondents self-reporting that they are not hypertensive when their biometric data show otherwise. The authors also model the likelihood of respondents self-reporting that they are hypertensive when in fact their biometric data show they are not. Socioeconomic and demographic variables were shown to be significantly associated with inconsistent reporting of hypertension. For instance, it was observed that wealth was associated with a lower likelihood of selfreporting that one is not hypertensive when their biometric data indicate otherwise. Tracking such inconsistent reports is crucial to minimizing measurement errors and generating unbiased and more precise parameter estimates in hypertension research. J Clin Hypertens (Greenwich). 2015;17: 977-984. ª 2015 Wiley Periodicals, Inc.Hypertension or high blood pressure (BP) has been described as a public health crisis and a global health emergency. Related to other cardiovascular diseases, such as stroke and diabetes, hypertension has been associated with a mortality rate of approximately 7.1 million people globally.1 Measured as the ratio of systolic BP (SBP) to diastolic BP (DBP), hypertension is defined as having an SBP ≥140 mm Hg and/or a DPB value ≥90 mm Hg. Monitoring SBP (arterial BP during cardiac contraction) and DBP (arterial BP during cardiac relaxation) has become effective in the diagnosis, management, and prevention of cardiovascular diseases including hypertensive-related conditions.2 Recognized as a noncommunicable disease, BP-related conditions are endemic worldwide. 3,4 It is well-documented that the hypertension epidemic is a rapidly emerging burden of disease in low-and middle-income countries, and this is attributable to the changing demographic characteristics as well as subsequent shift in epidemiologic transitions. 5 The prevalence of hypertension in developing countries is about twice of that observed in developed countries. 6 Most alarming is that levels of awareness, treatment, and control of hypertension in low-and middle income countries are low. 7,8 Such issues of unawareness and poor control of high BP are attributed to high illiteracy levels, poor access to health facilities, and poverty. Faced with existing issues of morbidity and mortality from communicable and infectious diseases, 10 most parts of the developing world pay less attention ...

Accuracy of self‐reported hypertension: Effect of age, gender, and history of alcohol dependence

“…The low sensitivity reported here for the entire sample is consistent with the report of Tenkorang et al 22 who studied a cohort over the age of 18 and found low sensitivity in data from 4 out of the 5 countries studied (China, India, Russia, South Africa, and Ghana). That report suggested the importance of considering sociodemographic factors (access to health care, sex, education, and wealth) when interpreting self‐report data on hypertension.…”

Inequalities in Hypertension and Diabetes in Canada: Intersections between Racial Identity, Gender, and Income

“…Second, although selfreported hypertension and diabetes are often treated as valid surrogates of biometric measures, people with lower income and education more frequently underreport them, which can lead to an underestimate of the true strength of associations. 38,39 This is especially problematic for our study if the underreporting of hypertension and diabetes among people of low socioeconomic standing is itself fur-ther patterned by racial identity and gender. This potential source of error might perhaps explain the lack of significant associations found among Black men in our study.…”

Accuracy of self‐reported hypertension in Brazilian adolescents: Analysis of the Study of Cardiovascular Risk in Adolescents

“…A study of the validity of self-reported hypertension status in adults aged 50 years or more from 5 countries in different stages of development (Ghana, China, India, South Africa, and Russia) found sensitivities and specificities ranging from 13% to 73% and 72% to 97%, respectively. 22 Studies of adults aged 20 years or more in Brazil and Spain, and 25 years or more in the United States, also found varying results but the sensitivities were generally higher. 11,[23][24][25] Despite the wide sensitivity range found in adults, their sensitivities were always higher than those of Brazilian adolescents.…”

“…Other similar studies in adolescents were not found, but in adults, the subject has been widely researched. A study of the validity of self‐reported hypertension status in adults aged 50 years or more from 5 countries in different stages of development (Ghana, China, India, South Africa, and Russia) found sensitivities and specificities ranging from 13% to 73% and 72% to 97%, respectively . Studies of adults aged 20 years or more in Brazil and Spain, and 25 years or more in the United States, also found varying results but the sensitivities were generally higher …”