Cardiovascular risk assessment among undiagnosed hypertensive older adults in India: Evidence from LASI, wave-1

Elevated blood pressure is one of the commonly modifiable risk factors of cardiovascular diseases (CVDs). Inadequate prevention, diagnosis, and treatment of hypertension lead to increased cardiovascular complications in low- and middle-income countries such as India. We aimed to estimate the prevalence of undiagnosed hypertension and assess the associated cardiovascular risk among older adults in India.

Data from Longitudinal Ageing Study in India (LASI), 2017-18 were utilized. We included 45991 participants aged ≥40 years who were not aware about their hypertension status. A multivariable regression model assessed the correlates of undiagnosed hypertension presented as adjusted odds ratio (AOR) with 95% CI. Cardiovascular risk assessment was done using World Health Organization/International Society of Hypertension (WHO/ISH) chart for South-East Asian Region D (SEAR-D).

The prevalence of undiagnosed hypertension was 12%. Undiagnosed hypertension was significantly associated with alcohol consumption [AOR: 1.58 (95% CI: 1.32-1.88)] and obesity [AOR: 1.77 (95% CI: 1.41-2.24)]. 36% of the undiagnosed individuals with hypertension had visited healthcare facility at least once in the past 12 months. We observed 43% of the undiagnosed Individuals with hypertension had the CVD risk of <10% as per WHO/ISH risk chart.

A significant proportion of undiagnosed individuals with hypertension are at a risk of having CVD which cannot be overlooked. Primary care should be strengthened to increase the early diagnosis and treatment where the recent initiatives of upgraded Ayushman Arogya Mandir may play a major role. Additionally, primary care providers should not miss the opportunistic screening of patients visiting healthcare facilities.