Factors associated with Undiagnosed Hypertension in Thailand, Fiscal Year 2022 : A Cross-Sectional Study from Health Data Center (HDC) database

Abstract

Hypertension (HT) is a major cause of cardiovascular diseases in Thailand, where approximately 13.2 million adults have HT, and half of them are unaware of their condition. This study aimed to describe the characteristics of patients with elevated BP and undiagnosed HT and to identify factors associated with undiagnosed HT in Thailand. A cross-sectional study was conducted using data from the Health Data Center (HDC) database of the 2022 fiscal year. HT was defined as having two consecutive elevated BP visits (BP 140/90-179/109 mmHg) or a single BP reading of ≥180/110 mmHg. Data analysis was conducted using multiple Poisson regression. Results show out of 31 million valid last visits, 5.1 million (16%) had a BP of ≥140/90 mmHg. Among this group, one million (20%) were undiagnosed HT patients. The highest proportion of undiagnosed cases was among males, those aged 45-54, and patients accessing health services outside their registered area (type area 4). Factors strongly associated with undiagnosed HT included lower BP levels (140/90-159/99 mmHg), younger age (18-44 years), enrollment in "other" health insurance schemes, and having the last visit at a primary care hospital. The study concluded that undiagnosed HT remains a significant challenge in Thailand. To narrow the diagnostic gap, it is crucial to prioritize adherence to healthcare guidelines and establish a sustainable system to support physicians in diagnosing HT at primary care units. Further qualitative study is strongly suggested.