Unawareness of having hypertension, dyslipidemia, and diabetes among medicated individuals

Published:September 09, 2020DOI:https://doi.org/10.1016/j.pcd.2020.08.020


      • Unawareness of chromic comorbidities among medicated individuals is common.
      • Caution is needed when using self-reported data to confirm a chronic disease.
      • People with healthy lifestyles or milder forms of diseases may be less aware.



      The objectives of this study were to assess the level of disease awareness in medicated patients with hypertension, dyslipidemia, or diabetes and to identify potential predictors of unawareness.


      A total of 17,323 participants who visited an institution for a medical checkup between 2009 and 2017 were investigated retrospectively. Disease unawareness was defined as taking medication for a disease but not being aware of having that disease.


      Among the medicated participants, 10% (169/1658), 30% (278/919), and 5% (21/389) were unaware of having hypertension, dyslipidemia, and diabetes, respectively. Multivariate analysis identified male sex as an independent predictive factor for unawareness of having hypertension. Participants who had an alcohol consumption habit, higher body mass index (BMI), or higher systolic blood pressure had a lower risk of hypertension unawareness. Male sex and BMI were identified as independent predictive factors for unawareness of having dyslipidemia. Participants with higher hemoglobin A1C levels were at decreased risk of diabetes unawareness.


      A relatively large number of medicated participants were unaware of the disease they were being treated for. Explanatory factors for disease unawareness included male sex, no alcohol consumption, lower BMI, and disease-related factors, such as lower blood pressure and hemoglobin A1C levels.


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        • Tanaka T.
        • Okamura T.
        • Yamagata Z.
        • et al.
        Awareness and treatment of hypertension and hypercholesterolemia in Japanese workers: the high-risk and population strategy for occupational health promotion (HIPOP-OHP) study.
        Hypertens. Res. 2007; 30: 921-928
        • Satish S.
        • Markides K.S.
        • Zhang D.
        • Goodwin J.S.
        Factors influencing unawareness of hypertension among older Mexican Americans.
        Prev. Med. 1997; 26: 645-650
        • Alkerwi A.
        • Pagny S.
        • Lair M.L.
        • et al.
        Level of unawareness and management of diabetes, hypertension, and dyslipidemia among adults in Luxembourg: findings from ORISCAV-LUX study.
        PLoS One. 2013; 8e57920
        • Owolabi E.O.
        • Goon D.T.
        • Adeniyi O.V.
        • Seekoe E.
        Social epidemiology of hypertension in Buffalo City Metropolitan Municipality (BCMM): cross-sectional study of determinants of prevalence, awareness, treatment and control among South African adults.
        BMJ Open. 2017; 7e014349
        • Satoh A.
        • Arima H.
        • Ohkubo T.
        • et al.
        Associations of socioeconomic status with prevalence, awareness, treatment, and control of hypertension in a general Japanese population: NIPPON DATA2010.
        J. Hypertens. 2017; 35: 401-408
        • McDonald M.
        • Hertz R.P.
        • Unger A.N.
        • Lustik M.B.
        Prevalence, awareness, and management of hypertension, dyslipidemia, and diabetes among United States adults aged 65 and older.
        J. Gerontol. A Biol. Sci. Med. Sci. 2009; 64: 256-263
        • Hajjar I.
        • Kotchen T.A.
        Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988–2000.
        JAMA. 2003; 290: 199-206
        • Ford E.S.
        • Mokdad A.H.
        • Giles W.H.
        • Mensah G.A.
        Serum total cholesterol concentrations and awareness, treatment, and control of hypercholesterolemia among US adults: findings from the National Health and Nutrition Examination Survey, 1999 to 2000.
        Circulation. 2003; 107: 2185-2189
        • Kearney P.M.
        • Whelton M.
        • Reynolds K.
        • et al.
        Worldwide prevalence of hypertension: a systematic review.
        J. Hypertens. 2004; 22: 11-19
        • Man R.E.K.
        • Gan A.H.W.
        • Fenwick E.K.
        • et al.
        Prevalence, determinants and association of unawareness of diabetes, hypertension and hypercholesterolemia with poor disease control in a multi-ethnic Asian population without cardiovascular disease.
        Popul. Health Metrics. 2019; 17: 17
        • Iseki K.
        • Asahi K.
        • Yamagata K.
        • et al.
        Mortality risk among screened subjects of the specific health check and guidance program in Japan 2008–2012.
        Clin. Exp. Nephrol. 2017; 21: 978-985
        • Ikeda N.
        • Saito E.
        • Kondo N.
        • et al.
        What has made the population of Japan healthy?.
        Lancet. 2011; 378: 1094-1105
        • Mirzaei M.
        • Truswell A.S.
        • Arnett K.
        • et al.
        Cerebrovascular disease in 48 countries: secular trends in mortality 1950–2005.
        J. Neurol. Neurosurg. Psychiatry. 2012; 83: 138-145
        • Finegold J.A.
        • Asaria P.
        • Francis D.P.
        Mortality from ischaemic heart disease by country, region, and age: statistics from World Health Organisation and United Nations.
        Int. J. Cardiol. 2013; 168: 934-945
        • Targher G.
        • Byrne C.D.
        • Lonardo A.
        • et al.
        Non-alcoholic fatty liver disease and risk of incident cardiovascular disease: a meta-analysis.
        J. Hepatol. 2016; 65: 589-600
        • Cai J.
        • Zhang X.J.
        • Ji Y.X.
        • et al.
        Nonalcoholic fatty liver disease pandemic fuels the upsurge in cardiovascular diseases.
        Circ. Res. 2020; 126: 679-704