Abstract
Background/Objectives: National estimates of undiagnosed hypertension that separate health-care contact from demographic characteristics are scarce for the last pre-pandemic period. We estimated its prevalence and correlates among US adults in 2017–2018. Methods: Cross-sectional analysis of 5,186 examined, non-pregnant adults in the National Health and Nutrition Examination Survey 2017–2018. Undiagnosed hypertension was a mean measured blood pressure of at least 140 mmHg systolic or 90 mmHg diastolic without a reported diagnosis. Survey-weighted prevalence and logistic regression were used. Results: Undiagnosed hypertension affected 7.6% (95% CI 6.3–9.2) of adults (17.8 million people) and 19.1% (95% CI 16.2–22.4) of adults with hypertension. Compared with four or more health-care visits in the past year, no visit (adjusted odds ratio 5.20 (95% CI 2.80–9.68)) and one visit (3.42 (95% CI 2.06–5.69)) were associated with being undiagnosed; insurance and a routine place for care were not. Obesity (0.43 (95% CI 0.26–0.71)) and diabetes (0.37 (95% CI 0.20–0.68)) were associated with lower odds. Under the lower 130 mmHg systolic or 80 mmHg diastolic threshold the prevalence was 19.4% (95% CI 17.8–21.1). Conclusions: About one in thirteen US adults and one in five adults with hypertension were undiagnosed in 2017–2018; infrequent contact with health care, not insurance or demographic group, was the strongest correlate.
Keywords
- hypertension
- undiagnosed diseases
- awareness
- NHANES
- cross-sectional studies
- health services accessibility
- complex survey analysis
Declarations
- Ethics approval
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- Consent to participate
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- Consent for publication
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- Funding
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- Competing interests
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- Author contributions
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- Data availability
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- Registration
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- Acknowledgements
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