open access

Vol 27, No 3 (2023)
Original paper
Published online: 2023-06-27
Get Citation

Why some treated patients with arterial hypertension do not report of having it: Findings from epidemiological studies

Piotr S. Szczęsny1, Kacper Jagiełło1, Krzysztof Flis1, Tomasz Zdrojewski1
·
Arterial Hypertension 2023;27(3):152-156.
Affiliations
  1. Department of Preventive Medicine and Education, Medical University of Gdańsk, Gdańsk, Poland

open access

Vol 27, No 3 (2023)
ORIGINAL PAPERS
Published online: 2023-06-27

Abstract

Background: Diagnosis of hypertension (HT) in epidemiological studies sometimes requires careful clinical evaluation. This may be particularly challenging in the subgroup of patients taking antihypertensive drugs for indications other than HT.

Material and methods: The PolSenior2 study was conducted on a representative sample of Polish residents aged 60 or older. Blood pressure measurements were taken three times during two separate visits in a total of 5,981 people (2,920 men and 3,044 women). The diagnosis of HT was made according to the European Society of Cardiology and  European Society of Hypertension (ESC/ESH) criteria. On this basis, 4607 people were classified as having HT. Among them, 424 respondents were taking antihypertensive drugs, but were not aware of having the disease. Additional analysis was performed, consisting of a detailed telephone questionnaire and additional clinical assessment of potential comorbidities. The researchers managed to contact 269 people, of whom 265 agreed to participate in the study.

Results: Based on the answers obtained, the respondents were divided into four subgroups: A. 54 (20.4%) respondents confirmed they had been diagnosed with HT and admitted that they considered the fact of taking medications as the absence of the disease; B. 79 (29.8%) respondents were not aware of HT, but the available clinical data indicated taking antihypertensive drugs due to HT; C. 79 (29.8%) of the respondents declared having HT, which may indicate that during the study they gave the wrong answer or their answer was incorrectly recorded by the research team member; D. 53 (20.0%) respondents answered “I don’t know/I don’t remember”. There were no differences in the distribution of responses between those with elevated and normal blood pressure, or between the age groups of 60–79 and over 80.

Conclusions:

  1. A small percentage of patients with HT (approx. 1.5%) may confuse good control of the disease with being cured of it. This indicates the need for better patient education.
  2. On the other hand, some patients take antihypertensive drugs for reasons other than HT. Therefore, accurate determination of the diagnosis of HT in epidemiological studies requires obtaining complete medical documentation with detailed data on the reasons for prescribing drugs and comorbidities.

Abstract

Background: Diagnosis of hypertension (HT) in epidemiological studies sometimes requires careful clinical evaluation. This may be particularly challenging in the subgroup of patients taking antihypertensive drugs for indications other than HT.

Material and methods: The PolSenior2 study was conducted on a representative sample of Polish residents aged 60 or older. Blood pressure measurements were taken three times during two separate visits in a total of 5,981 people (2,920 men and 3,044 women). The diagnosis of HT was made according to the European Society of Cardiology and  European Society of Hypertension (ESC/ESH) criteria. On this basis, 4607 people were classified as having HT. Among them, 424 respondents were taking antihypertensive drugs, but were not aware of having the disease. Additional analysis was performed, consisting of a detailed telephone questionnaire and additional clinical assessment of potential comorbidities. The researchers managed to contact 269 people, of whom 265 agreed to participate in the study.

Results: Based on the answers obtained, the respondents were divided into four subgroups: A. 54 (20.4%) respondents confirmed they had been diagnosed with HT and admitted that they considered the fact of taking medications as the absence of the disease; B. 79 (29.8%) respondents were not aware of HT, but the available clinical data indicated taking antihypertensive drugs due to HT; C. 79 (29.8%) of the respondents declared having HT, which may indicate that during the study they gave the wrong answer or their answer was incorrectly recorded by the research team member; D. 53 (20.0%) respondents answered “I don’t know/I don’t remember”. There were no differences in the distribution of responses between those with elevated and normal blood pressure, or between the age groups of 60–79 and over 80.

Conclusions:

  1. A small percentage of patients with HT (approx. 1.5%) may confuse good control of the disease with being cured of it. This indicates the need for better patient education.
  2. On the other hand, some patients take antihypertensive drugs for reasons other than HT. Therefore, accurate determination of the diagnosis of HT in epidemiological studies requires obtaining complete medical documentation with detailed data on the reasons for prescribing drugs and comorbidities.
Get Citation

Keywords

arterial hypertension; unawareness; epidemiological survey; diagnosis

About this article
Title

Why some treated patients with arterial hypertension do not report of having it: Findings from epidemiological studies

Journal

Arterial Hypertension

Issue

Vol 27, No 3 (2023)

Article type

Original paper

Pages

152-156

Published online

2023-06-27

Page views

340

Article views/downloads

244

DOI

10.5603/AH.a2023.0013

Bibliographic record

Arterial Hypertension 2023;27(3):152-156.

Keywords

arterial hypertension
unawareness
epidemiological survey
diagnosis

Authors

Piotr S. Szczęsny
Kacper Jagiełło
Krzysztof Flis
Tomasz Zdrojewski

References (11)
  1. Wierucki Ł, Kujawska-Danecka H, Mossakowska M, et al. Health status and its socio-economic covariates in the older population in Poland - the assumptions and methods of the nationwide, cross-sectional PolSenior2 survey. Arch Med Sci. 2022; 18(1): 92–102.
  2. Bogaert P, Van Oyen H. for BRIDGE Health. An integrated and sustainable EU health information system: national public health institutes' needs and possible benefits. Arch Public Health. 2017; 75: 3.
  3. Kislaya I, Leite A, Perelman J, et al. Combining self-reported and objectively measured survey data to improve hypertension prevalence estimates: Portuguese experience. Arch Public Health. 2021; 79(1): 45.
  4. Peterson KL, Jacobs JP, Allender S, et al. Characterising the extent of misreporting of high blood pressure, high cholesterol, and diabetes using the Australian Health Survey. BMC Public Health. 2016; 16: 695.
  5. Guo H, Yu Yi, Ye Y, et al. Accuracy of Self-Reported Hypertension, Diabetes, and Hyperlipidemia among Adults of Liwan, Guangzhou, China. Iran J Public Health. 2020; 49(9): 1622–1630.
  6. Tolonen H, Koponen P, Mindell JS, et al. European Health Examination Survey Pilot Project. Under-estimation of obesity, hypertension and high cholesterol by self-reported data: comparison of self-reported information and objective measures from health examination surveys. Eur J Public Health. 2014; 24(6): 941–948.
  7. Zdrojewski T, Szpakowski P, Bandosz P, et al. Arterial hypertension in Poland in 2002. J Hum Hypertens. 2004; 18(8): 557–562.
  8. Mosca I, Bhuachalla BNí, Kenny RA. Explaining significant differences in subjective and objective measures of cardiovascular health: evidence for the socioeconomic gradient in a population-based study. BMC Cardiovasc Disord. 2013; 13: 64.
  9. Spirk D, Noll S, Burnier M, et al. Effect of Home Blood Pressure Monitoring on Patient's Awareness and Goal Attainment Under Antihypertensive Therapy: The Factors Influencing Results in Anti-HypertenSive Treatment (FIRST) Study. Kidney Blood Press Res. 2018; 43(3): 979–986.
  10. Rodrigues AP, Gaio V, Kislaya I, et al. INSEF Research group. Sociodemographic disparities in hypertension prevalence: Results from the first Portuguese National Health Examination Survey. Rev Port Cardiol (Engl Ed). 2019; 38(8): 547–555.
  11. Zdrojewski T, Wizner B, Więcek A, et al. Prevalence, awareness, and control of hypertension in elderly and very elderly in Poland: results of a cross-sectional representative survey. J Hypertens. 2016; 34(3): 532–8; discussion 538.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., Grupa Via Medica, ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl