Undiagnosed Hypertension and Associated Factors Among Adults in Hawela Tula Sub-City, Hawassa, Southern Ethiopia: A Community-Based Cross-Sectional Study

Abstract

Background

Hypertension (HTN) is a major public health problem and often it is unnoticed. Undiagnosed HTN may lead to a high burden of cardiovascular diseases and complications such as stroke and heart attack. In this study, we aimed to assess the prevalence and associated factors of undiagnosed HTN.

Methods

From February to June 2019, a community-based cross-sectional study was conducted on 383 randomly selected adults in Hawela Tulla Sub-city, Hawassa, southern Ethiopia. Data were collected by pretested questionnaires, and physical measurements of weight, height and blood pressure were collected through standardized procedures adapted from WHO STEPS survey tools. Data entry and analysis were carried out using SPSS version 23 statistical software. Descriptive analysis and logistic regression models were used to describe the results. Logistic regression analysis results were declared statistically significant if the P-value was below 0.05 and the 95% CI did not cross the null value.

Results

The prevalence of undiagnosed HTN among the respondents was 12.3%. Only 152 (39.7%) of the study population knew the symptoms of HTN. Males (adjusted odds ratio [AOR] =2.5, 95% CI: 1.2, 5.2; P=0.016), people with a family history of HTN (AOR=2.7, 95% CI: 1.0, 7.0; P= 0.044), people who chewed khat (AOR=4.6, 95% CI: 2.0, 10.2; P<0.001), overweight or obese individuals (AOR=3.5, 95% CI: 1.7, 7.3; P=0.001) and people with diabetes mellitus (AOR=3.2, 95% CI: 1.1, 9.3; P=0.036) had a higher risk of undiagnosed HTN than their counterparts.

Conclusion

Identification of people with the risk factors of undiagnosed HTN and delivering health education to reduce the risky behaviors could reduce the burden and consequences of HTN. Integrating interventions at the community level may be important.

Keywords:

• undiagnosed HTN
• health-seeking behavior
• Hawassa city
• Ethiopia

Acknowledgments

The authors would like to thank Hawassa University for providing funding for the study. The authors are grateful to all data collectors and study participants for their valuable contributions

Abbreviations

AOR, adjusted odds ratio; COR, crude odds ratio; DBP, diastolic blood pressure; ETB, Ethiopian Birr; mmHg, millimeters of mercury; NCD, non-communicable disease; SBP, systolic blood pressure; WHO, World Health Organization.

Data Sharing Statement

The datasets used in this study are available from the corresponding author on reasonable request.

Ethics Approval and Consent to Participate

Ethical clearance was obtained from the Institutional Review Board (IRB) of Hawassa University College of Medicine and Health Sciences and the study was conducted in accordance with the Declaration of Helsinki. A letter of support was obtained from Hawassa City Administration and Hawela Tulla Sub-city Health Offices. All participants were informed about the purpose, risks, benefit and confidentiality issues related to the study. Participation was on a voluntary basis and written informed consent was obtained from each participant, while verbal informed consent was obtained for participants who could not read and write.

Author Contributions

DW wrote the research proposal, study design, execution, acquisition of data, analysis and interpretation. EMW and DG reviewed and approved the proposal and participated in data analysis. EMW reviewed the manuscript. All authors made a significant contribution to the work reported, data analysis, drafting or revising the article, have agreed on the journal to which the article will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no conflict of interests for this work.

Additional information

Funding

Hawassa University provided funding for the study. The funder had no role in designing the study and conducting the analysis.