title: Untreated hypertension: prevalence and patient factors and beliefs associated with under-treatment in a population sample.
abstract: Identifying barriers to hypertension management may facilitate cardiovascular risk reduction. Therefore, our objective, was to determine the prevalence of hypertension not managed with medication ('untreated') in a representative adult sample and identify patient factors/beliefs, and aspects of the patient-general practitioner (GP) relationship associated with untreated hypertension. The North West Adelaide Health Study, a biomedical cohort study over three stages from 2000-2009, assesses hypertension (systolic > or =140 mm Hg and/or > or =90 mm Hg or current treatment with anti-hypertensive medication), chronic disease and associated risk factors and health-care experiences, including risk perception, decision-making preferences, GP/primary care provider affiliation and satisfaction with care (n=2425). The prevalence of hypertension was 32.1% (n=781) comprised of treated (19.0%, n=462) and untreated (13.1%, n=319) hypertension. Thus, 40.8% of hypertension was untreated. Among hypertensive subjects, non-treatment was significantly associated with male sex, age <45 years, workforce participation, infrequent GP visits, dissatisfaction with recent medical care, high total cholesterol, moderate-level physical activity and lower body weights. Compared with participants without hypertension (and no treatment), untreated subjects demonstrated significant (15%) 10-year Framingham general cardiovascular risk (odds ratio=6.44, 95% confidence interval=4.52-9.17). Novel screening strategies and public health messages to address beliefs and perceptions of both patients and the health system are required to identify untreated, at-risk hypertensive individuals.
authors.affiliation: The Health Observatory, Discipline of Medicine, University of Adelaide at The Queen Elizabeth Hospital Campus, Woodville, South Australia, Australia.
authors.forename: S L
authors.initials: SL
authors.lastname: Appleton
authors.forename: C
authors.initials: C
authors.lastname: Neo
authors.forename: C L
authors.initials: CL
authors.lastname: Hill
authors.forename: K A
authors.initials: KA
authors.lastname: Douglas
authors.forename: R J
authors.initials: RJ
authors.lastname: Adams
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D003142:Communication; D003466:Cultural Characteristics; D005260:Female; D058005:General Practitioners / Q000523:psychology; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology*; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D013021:South Australia / Q000453:epidemiology; D011795:Surveys and Questionnaires
chemical_list: D000959:Antihypertensive Agents