Prevalence and risk factors associated with undiagnosed hypertension among adults aged 15 – 49 in India: insights from NFHS-5 national survey

Abstract

Abstract Undiagnosed Hypertension, especially among adults, is a significant public health concern, considering its long-term complications. We have estimated the prevalence and factors associated with undiagnosed hypertension in India. We used data from the fifth round of the National Family Health Survey (NFHS-5, 2019-21) to estimate the prevalence of undiagnosed hypertension among individuals aged between 15 to49) years. A log-binomial model with survey-adjusted Poisson regression was used to estimate the prevalence ratio between undiagnosed and diagnosed hypertension. Multinomial logistic regression analysis examined the factors associated with diagnosed hypertension (vs healthy) and undiagnosed hypertension (vs healthy). All the analyses were survey-weight adjusted and stratified by gender. Results are reported with 95% confidence intervals. The survey-adjusted prevalence of undiagnosed hypertension was 8.75% (8.62% to 8.87%) and was higher among males [13.56% (13.03% to 14.12%)] than in females [8.14% (8.03% to 8.25%)]. The proportion of individuals with undiagnosed hypertension among total hypertension was 44.99% (44.44% to 45.55%) and is higher in males [65.94% (64.25% to 67.60%)] than in females [42.18% (41.66% to 42.71%)]. Increasing age, higher body mass index, access to health care, and having comorbidities were risk factors for undiagnosed for hypertension. One in twelve people had undiagnosed hypertension, and of those with hypertension, one in two were undiagnosed, with males being disproportionately affected. Targeted public health interventions are crucial to improve hypertension screening, particularly among middle-aged and obese individuals without comorbidities. The findings also reveal disparities in hypertension burden among population subgroups in India, underscoring the need for targeted efforts.