J Prev Med Public Health.  2019 Mar;52(2):131-139. 10.3961/jpmph.18.257.

Validity of Self-reported Hypertension and Factors Related to Discordance Between Self-reported and Objectively Measured Hypertension: Evidence From a Cohort Study in Iran

Affiliations
  • 1Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran. m.moradinazar@kums.ac.ir
  • 2Kermanshah Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
  • 3Nutritional Sciences Department, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
  • 4School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
  • 5Department of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
  • 6Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran.
  • 7Department of Psychiatry, Charles Drew University of Medicine and Science (CDU), Los Angeles, CA, USA.

Abstract


OBJECTIVES
Self-reporting can be used to determine the incidence and prevalence of hypertension (HTN). The present study was conducted to determine the validity of self-reported HTN and to identify factors affecting discordance between self-reported and objectively measured HTN in participants in the Ravansar Non-Communicable Diseases (RaNCD) cohort.
METHODS
The RaNCD cohort included permanent residents of Ravansar, Iran aged 35-65 years. Self-reported data were collected before clinical examinations were conducted by well-trained staff members. The gold standard for HTN was anti-hypertensive medication use and blood pressure measurements. The sensitivity, specificity, positive and negative predictive values, and overall accuracy of self-reporting were calculated. Univariate and multivariate logistic regression were used to examine the discordance between self-reported HTN and the gold standard.
RESULTS
Of the 10 065 participants in the RaNCD, 4755 (47.4%) were male. The prevalence of HTN was 16.8% based on self-reporting and 15.7% based on medical history and HTN measurements. Of the participants with HTN, 297 (18.8%) had no knowledge of their disease, and 313 (19.9%) had not properly controlled their HTN despite receiving treatment. The sensitivity, specificity, and kappa for self-reported HTN were 75.5%, 96.4%, and 73.4%, respectively. False positives became more likely with age, body mass index (BMI), low socioeconomic status, and female sex, whereas false negatives became more likely with age, BMI, high socioeconomic status, smoking, and urban residency.
CONCLUSIONS
The sensitivity and specificity of self-reported HTN were acceptable, suggesting that this method can be used for public health initiatives in the absence of countrywide HTN control and detection programs.

Keyword

Hypertension; Self report; Prevalence; Accuracy; Iran

MeSH Terms

Blood Pressure
Body Mass Index
Cohort Studies*
Female
Humans
Hypertension*
Incidence
Internship and Residency
Iran*
Logistic Models
Male
Methods
Prevalence
Public Health
Self Report
Sensitivity and Specificity
Smoke
Smoking
Social Class
Smoke
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