Underreporting of Hypertension among Older Chinese Adults

Background. Hypertension severely affects older Chinese adults, with more than half of those aged 60 years or older estimated to have hypertensive symptomology. The purpose of this study is to examine the extent to which older Chinese adults underreport their hypertension, and factors associated with this underreporting.

Methods. We included 2,503 adults aged 60 years or older clinically identified as hypertensive from the panel data surveyed in 1997, 2000, 2004, and 2006 as part of the China Health and Nutrition Survey (CHNS). This was compared to respondents' self-reports to estimate hypertension underreporting. Covariates included sociodemographic, health status, functional disability, and behavioral factors. Generalized estimating equations (GEE) were used to identify risk factors for underreporting hypertension.

Results. More than 60% of study participants underreported hypertension. Those who underreported in a previous survey wave, lived in rural area, or had more severe categories of hypertension were more likely to underreport hypertension. Inversely, those who had higher incomes or had acute conditions were less likely to underreport hypertension.

Significance of the work. The current study is one of few to explore factors associated with hypertension underreporting among an older Chinese adult sample who significantly underreported their hypertensive status. Studying dynamics of hypertension underreporting can be meaningful for clinician their doctor-patient discussions as well as policymakers who design services around population need.