Missed opportunities for hypertension screening: a cross-sectional study, India

Sanjay K. Mohanty*, Ashish Kumar Upadhyay, Prashant Shekhar, Fabrice Kämpfen, Owen O'Donnell, Jürgen Maurer

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)
23 Downloads (Pure)

Abstract

Objective To assess missed opportunities for hypertension screening at health facilities in India and describe systematic differences in these missed opportunities across states and sociodemographic groups. Methods We used nationally representative survey data from the 2017–2018 Longitudinal Ageing Study in India to estimate the proportion of adults aged 45 years or older identified with hypertension and who had not been diagnosed with hypertension despite having visited a health facility during the previous 12 months. We estimated age–sex adjusted proportions of missed opportunities to diagnose hypertension, as well as actual and potential proportions of diagnosis, by sociodemographic characteristics and for each state. Findings Among those identified as having hypertension, 22.6% (95% confidence interval, CI: 21.3 to 23.8) had not been diagnosed despite having recently visited a health facility. If these opportunities had been realized, the prevalence of diagnosed hypertension would have increased from 54.8% (95% CI: 53.5 to 56.1) to 77.3% (95% CI: 76.2 to 78.5). Missed opportunities for diagnosis were more common among individuals who were poorer (P = 0.001), less educated (P < 0.001), male (P < 0.001), rural (P < 0.001), Hindu (P = 0.001), living alone (P = 0.028) and working (P < 0.001). Missed opportunities for diagnosis were more common at private than at public health facilities (P < 0.001) and varied widely across states (P < 0.001). Conclusion Opportunistic screening for hypertension has the potential to significantly increase detection of the condition and reduce sociodemographic and geographic inequalities in its diagnosis. Such screening could be a first step towards more effective and equitable hypertension treatment and control.

Original languageEnglish
Pages (from-to)30-39B
JournalBulletin of the World Health Organization
Volume100
Issue number1
DOIs
Publication statusPublished - 1 Jan 2022

Bibliographical note

Funding:
This article was supported by
funding from the Swiss National Science
Foundation and the Swiss Agency for
Development and Cooperation through
the Swiss Programme for Research on
Global Issues for Development grant
400640_160374.
Publisher Copyright:
© 2022, World Health Organization. All rights reserved.

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