Undiagnosed Hypertension: A Silent Epidemic Among Middle-Aged and Older Adults With Elevated Blood Pressure in Malaysia

Undiagnosed hypertension is a major public health threat due to its association with premature death. This study examined the association between factors of health service utilization with undiagnosed hypertension among middle-aged (40-59 years) and older adults (≥60 years) with elevated blood pressure in Malaysia. A cross-sectional analysis of 2838 adults from the Malaysia Ageing and Retirement Survey Wave-1 revealed an undiagnosed hypertension proportion of 55.9%, higher in middle-aged (63.8%) than older adults (45.5%). Obesity, diabetes, hypercholesterolemia, and regular medical check-ups reduced the odds, while perceived good health increased the odds of undiagnosed hypertension in both age groups. Ethnicity, smoking status, and recent headaches also influenced undiagnosed hypertension in age-specific patterns. Overall, health service utilization emerged as a significant factor of undiagnosed hypertension in both age groups. Targeted health education and regular community hypertension screenings are crucial, particularly for low-risk or seemingly healthy adults, to mitigate the burden of undiagnosed hypertension.