Barriers and Determinants to the Underutilized Hypertension Screening in Primary Care Patients in Hong Kong: A...

Area of Science:

• Public Health
• Cardiovascular Disease Prevention
• Primary Care Medicine

Background:

• Hypertension (HT) affects over 1.13 billion globally, representing a significant public health challenge.
• Despite accessible blood pressure (BP) devices in primary care (PC) settings, many patients forgo regular HT screening and remain untreated.

Purpose of the Study:

• To determine the proportion of primary care patients in Hong Kong who do not undergo hypertension screening.
• To identify the underlying individual, social, and healthcare-related barriers contributing to low HT screening rates.
• To highlight the urgent need for enhanced HT screening protocols within primary care.

Main Methods:

• An explanatory mixed-method cross-sectional study conducted in a Hong Kong primary care clinic in 2020.
• Involved a questionnaire survey, office BP measurements, and semi-structured interviews with adult patients without a prior HT diagnosis.
• Logistic regression analyzed associations between non-screening and sociodemographic factors; 24 patients were interviewed for qualitative insights.

Main Results:

• Out of 428 participants, 44.4% had not been screened for HT in two years, yet 46.0% had elevated BP.
• Lack of screening was linked to male gender, single status, younger age, no family history of HT, infrequent clinic visits, employment, and self-perceived health.
• A significant majority (77.8%) misinterpreted their BP readings, indicating a critical knowledge gap.

Conclusions:

• Barriers to hypertension screening are complex and multifactorial, encompassing individual, social, and healthcare system issues.
• A substantial proportion of primary care patients are not regularly screened for hypertension, despite high rates of undiagnosed elevated BP.
• There is an urgent necessity to implement and improve hypertension screening strategies within primary care settings.