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Prevalence and determinants of hypertension unawareness among Egyptian adults: the 2015 EHIS

Abstract

Hypertension (HTN) is a major cardiovascular risk factor that affects 1.3 billion people and accounts for 17.9 million deaths annually worldwide. Seventy-five percent of global deaths due to HTN occur in low- and middle-income countries where HTN prevalence is higher, and HTN control and population awareness are lower, than in high-income countries. Approximately 26% of Egyptian adults meet criteria for HTN, but the prevalence of HTN unawareness is unknown in this population. The purpose of this study was to assess prevalence and predictors of HTN unawareness among Egyptian adults. Using data from the 2015 Egyptian Health Issues Survey (EHIS), we identified 2869 participants 18–59 years of age whose blood pressure met criteria for HTN at the time of data collection. Our outcome of interest, hypertension unawareness, was indicated when a participant reported that they had not been diagnosed with HTN (despite meeting criteria). Descriptive statistics and multivariable logistic regression were performed to determine prevalence of, and risk factors for, HTN unawareness. Fifty-six percent of the sample were unaware of their HTN status. The odds of HTN unawareness were highest among participants 18–39 years old compared to those 40–59 years old (OR 1.91; 95% CI 1.48–2.47); males compared to females (OR 2.59; 95% CI 1.85–3.62); and never married compared to currently married participants (OR 1.96; 95% CI 1.19–3.24). Compared to those who had a college level education, the odds of HTN unawareness were highest among participants who had no education (OR 2.21; 95% CI 1.45–3.38). In addition, the odds of HTN unawareness were higher for participants who had a normal body mass index compared to those who were obese (OR 1.82; 95% CI 1.26–2.65); and those considered healthy compared to those who had at least one chronic illness (OR 4.53; 95% CI 3.29–6.24). Our findings indicate that more than half of Egyptian adults who meet criteria for HTN are unaware of their blood pressure status. Younger, healthier, and normal weight people—who are typically at lowest risk for HTN—appear mostly likely to be unaware of their HTN status. Less educated people are least likely to know their hypertensive status. This suggests the need for a targeted health education campaign and regular blood pressure screening in Egypt.

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Author information

Affiliations

  1. Department of Family Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt

    Saeed S. A. Soliman

  2. Department of Primary Care and Diabetes Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, USA

    Emily Hill Guseman

  3. Department of Social Medicine, Heritage College of Osteopathic Medicine, Ohio University, Dublin, OH, USA

    Zelalem T. Haile

  4. Department of Social Medicine, Heritage College of Osteopathic Medicine and College of Health Science and Professions, Ohio University, Athens, OH, USA

    Gillian Ice

Corresponding author

Correspondence to
Saeed S. A. Soliman.

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Soliman, S.S.A., Guseman, E.H., Haile, Z.T. et al. Prevalence and determinants of hypertension unawareness among Egyptian adults: the 2015 EHIS.
J Hum Hypertens (2020). https://doi.org/10.1038/s41371-020-00431-1

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