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Concerns about the prevalence estimates of undiagnosed hypertension among women aged 15–49 years in India

Journal of Human Hypertension volume 37, pages 502–503 (2023)Cite this article

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We have read the paper titled “Prevalence and associated factors of undiagnosed hypertension among women aged 15–49 years in India: an analysis of National Family Health Survey-4 data” written by Debjyoti Talukdar et al. [1], published in your journal in August 2021 with great interest. The authors have estimated the prevalence of undiagnosed hypertension among Indian women aged 15–49 years and examined the factors associated with it. However, we have a few major concerns with regards to their reported results.

The prevalence of undiagnosed hypertension was reported to be 18.63% (n = 112,640) in the paper [1]. However, the official report of National Family Health Survey 4 (NFHS-4), the dataset of which was used by Talukdar et al. for their estimation process, reported the prevalence of hypertension in the same sample to be 11%, (estimated n = 76,965) [2], and the same was also reported in another paper from NFHS-4 [3]. Prenissl et al. have reported the prevalence of hypertension to be 17.2%, (n = 109,051) in the same survey sample by using a more liberal definition of hypertension. They also reported undiagnosed hypertension to be 55.3% (n = 60,305) of all hypertensives [4]. Therefore, the prevalence of undiagnosed hypertension (undiagnosed hypertensives are believed to be roughly 50% of all hypertensives) [5] reported by Talukdar et al. was found to be even greater than the prevalence of hypertension reported by others from the same sample. To clarify, we also analysed the NFHS-4 data with the same definition as used by Talukdar et al. (women who did not self-report having hypertension but whose mean BP readings taken during the survey indicated that they were hypertensive as per the JNC 7 guidelines in which systolic readings above 140 or diastolic readings above 90 or both were considered high BP) and found the prevalence of undiagnosed hypertension among Indian women aged 15–49 years to be 54,911 only, which is approximately half of that reported by Talukdar et al. Therefore, the prevalence of undiagnosed hypertension reported by Talukdar et al. is probably an overestimation possibly due to a misclassification error. The misclassification error could have been due to misapplication of the definition in the analytical software.

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References

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  1. Indian Institute of Public Health, Bhubaneswar, Public Health Foundation of India, Bhubaneswar, India

    Ambarish Dutta & Gayatri Nayak

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  1. Ambarish Dutta
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AD was responsible for designing the study, analysing data, interpreting results, writing, revising and reviewing the manuscript. GN was responsible for designing the study, analysing data, interpreting results, writing the manuscript and updating reference lists.

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Correspondence to Ambarish Dutta.

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Dutta, A., Nayak, G. Concerns about the prevalence estimates of undiagnosed hypertension among women aged 15–49 years in India. J Hum Hypertens 37, 502–503 (2023). https://doi.org/10.1038/s41371-021-00626-0

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