Prevalence and determinants of blood pressure screening in Pakistan

We analysed data collected during a nationwide cross-sectional household survey to estimate the prevalence of, and to identify factors associated with, blood pressure screening in Pakistan.

A population-based cross-sectional survey (National Health Survey of Pakistan 1990-1994).

During 1990-1994, 18 135 people aged at least 6 months were surveyed across Pakistan. We restricted this analysis to individuals aged 18 years or older (n = 9442). Our primary outcome measure was self-reported blood pressure screening, which was assessed using the question: 'Have you ever had your blood pressure taken?' Individuals answering affirmatively or otherwise to this question were categorized as screened or unscreened for high blood pressure. Logistic regression analysis was performed to identify the factors independently associated with the primary outcome.

Overall, 35.6% [95% confidence interval (CI), 33.9-37.3%] of participants - 41.3% (95% CI, 39.9-42.7%) women versus 29.0% (95% CI, 27.6-30.4%) men - reported ever having had their blood pressure checked. The independent determinants of blood pressure screening identified in the multivariate logistic regression analysis [adjusted odds ratio (95% CI)] included age [26-35 years, 1.58 (1.37-1.81); 36-50 years, 2.18 (1.89-2.51); > 50 years, 2.29 (1.96-2.66)], female sex [2.25 (2.02-2.50)], socio-economic status [lower, 0.54 (0.47-0.63) and middle, 0.70 (0.61-0.80) versus high], province of residence [Punjab, 0.45 (0.39-0.51); Sindh, 0.80 (0.68-0.93); Balochistan, 0.47 (0.39-0.57) versus North West Frontier Province], rural dwelling [0.42 (0.38-0.47)] versus urban dwelling, and educational attainment [less than matriculation, 1.47 (1.27-1.69); matriculation, 1.69 (1.41-2.04); graduation and above, 2.50 (1.81-3.44) versus no education].

The rates of blood pressure screening in Pakistan are worryingly low, calling for the establishment of a nationwide programme to improve detection, awareness and treatment of hypertension.