DOI QR코드

DOI QR Code

The Determinants of Undiagnosed Hypertension Among Indonesian Adults: A Cross-sectional Study Based on the 2014-2015 Indonesia Family Life Survey

  • Mahwati, Yeni (Sekolah Tinggi Ilmu Kesehatan Dharma Husada) ;
  • Nurrika, Dieta (Ministry of Research, Technology and Higher Education, Higher Education Service Institutions (LL-DIKTI) Region IV) ;
  • Latief, Kamaluddin (Center for Family Welfare, Faculty of Public Health, University of Indonesia)
  • Received : 2021.09.16
  • Accepted : 2021.11.05
  • Published : 2022.02.03

Abstract

Objectives: This study investigated the determinants of undiagnosed hypertension among Indonesian adults. Methods: This study involved an analysis of secondary data from the 2014 Indonesia Family Life Survey (IFLS) on 5914 Indonesian adults (≥40 years). The determinant variables examined in this cross-sectional study were education level, monthly per capita expenditures (PCE), whether the participant experienced headaches in the morning, and other general health variables. The outcome variable was undiagnosed hypertension, which was defined as participants with hypertension who had not received a hypertension diagnosis from a health professional and had never been prescribed medication for treating hypertension. The data were analyzed using logistic regression. Results: A total of 3322 participants (56.2%) were found to have undiagnosed hypertension. The odds ratios (ORs) and 95% confidence intervals (CIs) of undiagnosed hypertension were significantly higher among those who completed primary school or lower (OR, 1.60; 95% CI, 1.29 to 1.98), had low monthly PCE (OR, 1.28; 95% CI, 1.13 to 1.43), did not report experiencing headaches in the morning (OR, 1.97; 95% CI, 1.76 to 2.21), and reported a general health status of healthy (OR, 2.05; 95% CI, 1.82 to 2.30) than those who had a higher education level, had high monthly PCE, experienced headaches in the morning, and were unhealthy. Conclusions: Education level, monthly PCE, the experience of headaches in the morning, and general health status were associated with undiagnosed hypertension. The monitoring system for detecting undiagnosed hypertension cases must be strengthened. Health promotion is also necessary to reduce the prevalence of undiagnosed hypertension.

Keywords

Acknowledgement

The authors would like to thank the RAND Corporation for making the data publicly available at http://www.rand.org/labor/FLS/IFLS.html.

References

  1. World Health Organization. Noncommunicable diseases; 2021 [cited 2021 Jul 23]. Available from: https://www.who.int/newsroom/fact-sheets/detail/noncommunicable-diseases.
  2. Ministry of Health of the Republic of Indonesia. National strategic action plan for the prevention and control of noncommunicable diseases; 2017 [cited 2020 Mar 20]. Available from: http://p2ptm.kemkes.go.id/uploads/VHcrbkVobjRzUDN3UCs4eUJ0dVBndz09/2018/10/Buku_Rencana_Aksi_Nasional_2015_2019.pdf (Indonesian).
  3. Ministry of Health of the Republic of Indonesia. Hypertension; 2014 [cited 2020 Mar 23]. Available from: https://pusdatin.kemkes.go.id/resources/download/pusdatin/infodatin/infodatin-hipertensi.pdf (Indonesian).
  4. Agency for Health Research and Development. Indonesia Basic Health Research (RISKESDAS) 2018; 2019 [cited 2021 Jul 23]. Available from: http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_FINAL.pdf (Indonesian).
  5. Peltzer K, Pengpid S. The prevalence and social determinants of hypertension among adults in Indonesia: a cross-sectional population-based national survey. Int J Hypertens 2018;2018:5610725. https://doi.org/10.1155/2018/5610725
  6. Souffront K, Gestal C, Melkus GD, Richardson L. Recognition of asymptomatic hypertension in an urban emergency department: where are we now? Adv Emerg Nurs J 2016;38(4):320-326. https://doi.org/10.1097/TME.0000000000000118
  7. Ministry of Health of the Republic of Indonesia. General guidelines of post non-communicable diseases integrated counseling; 2014 [cited 2021 Jan 29]. Available from: http://p2ptm.kemkes.go.id/uploads/2016/10/Pedoman-Umum-Pos-Pembinaan-Terpadu-Penyakit-Tidak-Menular.pdf (Indonesian).
  8. Zhou J, Fang S. Association between undiagnosed hypertension and health factors among middle-aged and elderly Chinese population. Int J Environ Res Public Health 2019;16(7):1214. https://doi.org/10.3390/ijerph16071214
  9. Strauss J, Witoelar F, Sikoki B. The fifth wave of the Indonesia Family Life Survey: overview and field report volume 1; 2016 [cited 2018 Nov 1]. Available from: https://www.rand.org/pubs/working_papers/WR1143z1.html.
  10. Strauss J, Witoelar Fi, Sikoki B. The fourth wave of the Indonesia Family Life Survey (IFLS 4): overview and field report; 2009 [cited 2018 Nov 1]. Available from: https://microdata.worldbank.org/index.php/catalog/1044/download/20909.
  11. Frankenberg E, Karoly LA, Gertler P, Achmad S, Agung IG, Hatmadji SH, et al. The 1993 Indonesian Family Life Survey: overview and field report; 1995 [cited 2021 Oct 27]. Available from: https://www.rand.org/pubs/drafts/DRU1195z1.html.
  12. Sri Anchana Diagnostics Distributors. Omron BP monitor upper arm (HEM-7203) [cited 2021 Oct 27]. Available from: http://www.srianchanadiagnosticgroup.com/images/instruments/PDF/16/16.BLOOD%20PRESSURE%20MONITOR%20-%20OMRON.pdf.
  13. Central Bureau of Statistics. Regulation of head statistical centre number 37 year 2010 about classification urban and rural in Indonesia; 2010 [cited 2021 Jul 23]. Available from: https://sirusa.bps.go.id/webadmin/doc/MFD_2010_Buku_1.pdf (Indonesian).
  14. Mulyana W. Rural-urban linkages: Indonesia case study. Working paper series No. 126; 2014 [cited 2021 Jul 23]. Available from: https://www.rimisp.org/wp-content/files_mf/files_mf/1421349176126_R_ULinkages_Indonesia_countrycase_Final_edited.pdf.
  15. Ozawa S, Grewal S, Bridges JF. Household size and the decision to purchase health insurance in Cambodia: results of a discrete-choice experiment with scale adjustment. Appl Health Econ Health Policy 2016;14(2):195-204. https://doi.org/10.1007/s40258-016-0222-9
  16. Witoelar F; World Bank. Note on the construction of the IFLS consumption expenditure aggregates; 2009 [cited 2021 Jul 26]. Available from: https://dokumen.tips/documents/ifls-consumption-expenditure-aggregatespdf.html.
  17. World Health Organization. Monitoring progress towards universal health coverage at country and global levels: framework, measures and targets; 2014 [cited 2021 Jul 26]. Available from: https://apps.who.int/iris/handle/10665/112824.
  18. Organization for Economic Cooperation and Development. Exchange rates; 2021 [cited 2021 Jul 23]. Available from: https://data.oecd.org/conversion/exchange-rates.htm.
  19. Nurrika D, Zhang S, Discacciati A, Tomata Y, Liu Y, Sugawara Y, et al. Education level, monthly per-capita expenditure, and healthy aging in the older Indonesian population: the Indonesia Family Life Survey 2007 and 2014. Tohoku J Exp Med 2020;250(2):95-108. https://doi.org/10.1620/tjem.250.95
  20. Cao J, Rammohan A. Social capital and healthy ageing in Indonesia. BMC Public Health 2016;16:631. https://doi.org/10.1186/s12889-016-3257-9
  21. Ahmed S, Tariqujjaman M, Rahman MA, Hasan MZ, Hasan MM. Inequalities in the prevalence of undiagnosed hypertension among Bangladeshi adults: evidence from a nationwide survey. Int J Equity Health 2019;18(1):33. https://doi.org/10.1186/s12939-019-0930-5
  22. Haider MR, Das Gupta R. Inequalities in undiagnosed hypertension among adult Nepalese population: evidence from a nationally representative survey. Int J Cardiol Hypertens 2020;5:100026. https://doi.org/10.1016/j.ijchy.2020.100026
  23. Lim OW, Yong CC. The risk factors for undiagnosed and known hypertension among Malaysians. Malays J Med Sci 2019;26(5):98-112.
  24. Johar M, Soewondo P, Pujisubekti R, Satrio HK, Adji A. Inequality in access to health care, health insurance and the role of supply factors. Soc Sci Med 2018;213:134-145. https://doi.org/10.1016/j.socscimed.2018.07.044
  25. Hasan MM, Tasnim F, Tariqujjaman M, Ahmed S, Cleary A, Mamun A. Examining the prevalence, correlates and inequalities of undiagnosed hypertension in Nepal: a population-based cross-sectional study. BMJ Open 2020;10(10):e037592. https://doi.org/10.1136/bmjopen-2020-037592
  26. Seyed Reza SR, Bayani M, Zabihi A, Shakerian M, Habibian T, Bijani A. Undiagnosed hypertension and diabetes among the elderly in Amirkola, North of Iran. Caspian J Intern Med 2019; 10(3):303-308.
  27. Talukdar JR, Mahmud I, Rashid SF. Primary health care seeking behaviour of people with physical disabilities in Bangladesh: a cross-sectional study. Arch Public Health 2018;76:43. https://doi.org/10.1186/s13690-018-0293-1
  28. Scheppers E, van Dongen E, Dekker J, Geertzen J, Dekker J. Potential barriers to the use of health services among ethnic minorities: a review. Fam Pract 2006;23(3):325-348. https://doi.org/10.1093/fampra/cmi113