Undiagnosed Hypertension and Diabetes Mellitus in the Tabari Cohort: a Population-based Study

Overview

Journal BMC Public Health

Publisher Biomed Central

Specialty Public Health

Date 2024 Nov 18

PMID 39558296

Authors

Mahmood Moosazadeh

Pedram Ebrahimnejad

Mehrnoush Sohrab

Alireza Rafiei

Mahdi Abastabar

Maryam Khazaee-Pool

Shamim Mahboubi

Motahareh Kheradmand

Affiliations

Soon will be listed here.

Abstract

Background: Undiagnosed hypertension (HTN) and diabetes mellitus (DM) are major public health challenges worldwide. We aimed to investigate the prevalence of undiagnosed HTN and DM, and their correlates, in a large-scale population-based cohort study.

Methods: In this cross-sectional study, data collected during the enrollment phase of the Tabari Cohort study (TCS) were utilized. Data were collected in the TCS using a standard questionnaire, blood collection, and measurement of anthropometric indices and blood pressure. Data were analyzed using the chi-squared test and univariate and multivariate logistic regression analyses. Undiagnosed HTN included those who were not aware of HTN at the time of enrollment but had systolic and diastolic blood pressures ≥ 140 mm or ≥ 90 mmHg, respectively. Undiagnosed DM included participants who were unaware of their DM at the time of enrollment and had FBS levels ≥ 126 mg/dL.

Results: The total prevalence of undiagnosed HTN and DM were 5% (508) and 4.7% (485), respectively. The findings of multivariable logistic regression analysis showed that young age (OR: 0.40, P < 0.001), residents of urban regions (OR: 0.70, P = 0.03), lower Body Mass Index kg/m2 (BMI) (OR: 0.51, P = 0.002), waist-to-hip ratio (WHR)(OR: 0.70, P = 0.023), total cholesterol (TC) ≥ 200 mg/dL (OR: 0.1.83, P < 0.001), lack of history of DM (OR: 0.38,P < 0.001), cardiovascular diseases (CVD)(OR: 0.12, P < 0.001), and lack of a positive family history of HTN in first-(OR: 0.39, P < 0.001) and second-degree(OR: 0.56, P = 0.009) relatives were the main predictors of undiagnosed HTN. Accordingly, male sex(OR: 0.52, P = 0.004), young age(OR: 0.28, P < 0.001), residence in urban regions(OR: 0.30, P < 0.001), BMI ≥ 30 (OR: 1.51, P = 0.044), low-density lipoprotein (LDL) ≥ 130 mg/dL (OR:1.93, P < 0.001), TC ≥ 200 mg/dL (95% CI, 1.47-2.51, P < 0.001), positive history of chronic kidney disease (OR:1.39, P = 0.010 ), and lack of family history of first-(OR: 0.38, P < 0.001) and second-degree (OR: 0.62, P < 0.015) DM were the main predictors of undiagnosed DM.

Conclusion: Overall, younger participants, those residing in urban areas, those with TC ≥ 200 mg/dL, and those without a positive family history of HTN or DM were at a greater risk of undiagnosed HTN/DM.

References

Seyed Reza S, 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. PMC: 6729154. DOI: 10.22088/cjim.10.3.303. View

Kheradmand M, Moosazadeh M, Saeedi M, Poustchi H, Eghtesad S, Esmaeili R . Tabari Cohort Profile and Preliminary Results in Urban Areas and Mountainous Regions of Mazandaran, Iran. Arch Iran Med. 2019; 22(6):279-285. View

Ogurtsova K, Guariguata L, Barengo N, Ruiz P, Sacre J, Karuranga S . IDF diabetes Atlas: Global estimates of undiagnosed diabetes in adults for 2021. Diabetes Res Clin Pract. 2021; 183:109118. DOI: 10.1016/j.diabres.2021.109118. View

Chockalingam A, Campbell N, Fodor J . Worldwide epidemic of hypertension. Can J Cardiol. 2006; 22(7):553-5. PMC: 2560860. DOI: 10.1016/s0828-282x(06)70275-6. View

Ayalew T, Wale B, Zewudie B . Burden of undiagnosed hypertension and associated factors among adult populations in Wolaita Sodo Town, Wolaita Zone, Southern Ethiopia. BMC Cardiovasc Disord. 2022; 22(1):293. PMC: 9238150. DOI: 10.1186/s12872-022-02733-3. View

Eikenberg J, Davy B . Prediabetes: a prevalent and treatable, but often unrecognized, clinical condition. J Acad Nutr Diet. 2013; 113(2):213-8. PMC: 3565426. DOI: 10.1016/j.jand.2012.10.018. View

Mumena W, Hammouda S, Aljohani R, Alzahrani A, Bamagos M, Alharbi W . Prevalence and determinants of undiagnosed hypertension in the Western region of Saudi Arabia. PLoS One. 2023; 18(3):e0280844. PMC: 9990946. DOI: 10.1371/journal.pone.0280844. View

Mirzaei M, Rahmaninan M, Mirzaei M, Nadjarzadeh A, Dehghani Tafti A . Epidemiology of diabetes mellitus, pre-diabetes, undiagnosed and uncontrolled diabetes in Central Iran: results from Yazd health study. BMC Public Health. 2020; 20(1):166. PMC: 6998152. DOI: 10.1186/s12889-020-8267-y. View

Bianco A, Pomara F, Thomas E, Paoli A, Battaglia G, Petrucci M . Type 2 diabetes family histories, body composition and fasting glucose levels: a cross-section analysis in healthy sedentary male and female. Iran J Public Health. 2014; 42(7):681-90. PMC: 3881614. View

10.

Bjarko V, Haug E, Sorgjerd E, Stene L, Ruiz P, Birkeland K . Undiagnosed diabetes: Prevalence and cardiovascular risk profile in a population-based study of 52,856 individuals. The HUNT Study, Norway. Diabet Med. 2022; 39(6):e14829. PMC: 9310609. DOI: 10.1111/dme.14829. View

11.

Damtie S, Workineh L, Berhan A, Tiruneh T, Legese B, Getie B . The magnitude of undiagnosed diabetes mellitus, prediabetes, and associated factors among adults living in Debre Tabor town, northcentral Ethiopia: A community-based cross-sectional study. Heliyon. 2023; 9(7):e17729. PMC: 10372355. DOI: 10.1016/j.heliyon.2023.e17729. View

12.

Alharithy M, Alobaylan M, Alsugair Z, Alswat K . Impact of Family History of Diabetes on Diabetes Control and Complications. Endocr Pract. 2018; 24(9):773-779. DOI: 10.4158/EP-2018-0071. View

13.

Lauria M, Moreira L, Machado-Coelho G, do Nascimento Neto R, Soares M, Ramos A . Ability of body mass index to predict abnormal waist circumference: receiving operating characteristics analysis. Diabetol Metab Syndr. 2013; 5(1):74. PMC: 3918104. DOI: 10.1186/1758-5996-5-74. View

14.

Punthakee Z, Goldenberg R, Katz P . Definition, Classification and Diagnosis of Diabetes, Prediabetes and Metabolic Syndrome. Can J Diabetes. 2018; 42 Suppl 1:S10-S15. DOI: 10.1016/j.jcjd.2017.10.003. View

15.

Esteghamati A, Etemad K, Koohpayehzadeh J, Abbasi M, Meysamie A, Noshad S . Trends in the prevalence of diabetes and impaired fasting glucose in association with obesity in Iran: 2005-2011. Diabetes Res Clin Pract. 2014; 103(2):319-27. DOI: 10.1016/j.diabres.2013.12.034. View

16.

Norhammar A, Kjellstrom B, Habib N, Gustafsson A, Klinge B, Nygren A . Undetected Dysglycemia Is an Important Risk Factor for Two Common Diseases, Myocardial Infarction and Periodontitis: A Report From the PAROKRANK Study. Diabetes Care. 2019; 42(8):1504-1511. DOI: 10.2337/dc19-0018. View

17.

Lim O, Yong C . The Risk Factors for Undiagnosed and Known Hypertension among Malaysians. Malays J Med Sci. 2019; 26(5):98-112. PMC: 6839659. DOI: 10.21315/mjms2019.26.5.9. View

18.

Ivicevic Uhernik A, Kralj V, cukelj P, Brkic-Bilos I, Erceg M, Benjak T . Undiagnosed hypertension in Croatia. Croat Med J. 2023; 64(1):4-12. PMC: 10028561. View

19.

Najafipour H, Nasri H, Rostamzadeh F, Amirzadeh R, Shadkam M, Mirzazadeh A . Prevalence and incidence of pre-hypertension and hypertension (awareness/control) in Iran: findings from Kerman coronary artery diseases risk factors study 2 (KERCADRS). J Hum Hypertens. 2020; 36(5):461-472. DOI: 10.1038/s41371-020-00392-5. View

20.

Eghtesad S, Mohammadi Z, Shayanrad A, Faramarzi E, Joukar F, Hamzeh B . The PERSIAN Cohort: Providing the Evidence Needed for Healthcare Reform. Arch Iran Med. 2018; 20(11):691-695. View