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Untreated hypertension: prevalence and patient factors and beliefs associated with under-treatment in a population sample

Journal of Human Hypertension volume 27, pages 453–462 (2013)Cite this article

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Abstract

Identifying barriers to hypertension management may facilitate cardiovascular risk reduction. Therefore, our objective, was to determine the prevalence of hypertension not managed with medication (‘untreated’) in a representative adult sample and identify patient factors/beliefs, and aspects of the patient–general practitioner (GP) relationship associated with untreated hypertension. The North West Adelaide Health Study, a biomedical cohort study over three stages from 2000–2009, assesses hypertension (systolic⩾140 mm Hg and/or⩾90 mm Hg or current treatment with anti-hypertensive medication), chronic disease and associated risk factors and health-care experiences, including risk perception, decision-making preferences, GP/primary care provider affiliation and satisfaction with care (n=2425). The prevalence of hypertension was 32.1% (n=781) comprised of treated (19.0%, n=462) and untreated (13.1%, n=319) hypertension. Thus, 40.8% of hypertension was untreated. Among hypertensive subjects, non-treatment was significantly associated with male sex, age <45 years, workforce participation, infrequent GP visits, dissatisfaction with recent medical care, high total cholesterol, moderate-level physical activity and lower body weights. Compared with participants without hypertension (and no treatment), untreated subjects demonstrated significant (15%) 10-year Framingham general cardiovascular risk (odds ratio=6.44, 95% confidence interval=4.52–9.17). Novel screening strategies and public health messages to address beliefs and perceptions of both patients and the health system are required to identify untreated, at-risk hypertensive individuals.

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Acknowledgements

The Study was funded by the University of Adelaide and a Health Services Research Improvement Projects Grant from the South Australian Department of Health.

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  1. The Health Observatory, Discipline of Medicine, University of Adelaide at The Queen Elizabeth Hospital Campus, Woodville, South Australia, Australia

    S L Appleton, C Neo, C L Hill & R J Adams

  2. Australian National University Medical School, Australian National University, Canberra, Australian Capital Territory, Australia

    K A Douglas

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  1. S L Appleton
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Correspondence to S L Appleton.

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Appleton, S., Neo, C., Hill, C. et al. Untreated hypertension: prevalence and patient factors and beliefs associated with under-treatment in a population sample. J Hum Hypertens 27, 453–462 (2013). https://doi.org/10.1038/jhh.2012.62

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