Prevalence and Determinants of Undiagnosed Hypertension in Urban Slum Populations of Lahore Study Design: Community-based cross-sectional study

BACKGROUND: Hypertension is a leading contributor to cardiovascular morbidity and mortality, yet a significant proportion of affected individuals remain undiagnosed, particularly in socioeconomically disadvantaged urban settings. Urban slum populations are exposed to multiple risk factors while facing limited access to preventive healthcare, increasing the likelihood of prolonged undetected disease. OBJECTIVE: To determine the prevalence of undiagnosed hypertension and identify its associated determinants among adults residing in urban slum communities of Lahore, Pakistan. METHODOLOGY: A community-based cross-sectional study was conducted from March to September 2022 in selected urban slum localities of Lahore. A total of 400 adults aged ≥18 years without a prior diagnosis of hypertension were enrolled using multistage random sampling. Data on sociodemographic characteristics and lifestyle factors were collected through interviewer-administered questionnaires. Blood pressure was measured using standardized protocols with a calibrated digital sphygmomanometer. Undiagnosed hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg. Data were analyzed using descriptive statistics, bivariate analysis, and multivariable logistic regression. RESULTS: Undiagnosed hypertension was identified in 132 participants, yielding a prevalence of 33.0%. The prevalence increased with age, reaching 52.6% among individuals aged ≥60 years. Male gender (AOR=1.68), obesity (AOR=2.41), low physical activity (AOR=1.89), and lack of formal education (AOR=1.76) were independently associated with undiagnosed hypertension. The mean systolic and diastolic blood pressure among undiagnosed individuals were 148.9 ± 11.6 mmHg and 94.3 ± 8.7 mmHg, respectively. CONCLUSION: A substantial proportion of adults in Lahore’s urban slums had undiagnosed hypertension, underscoring missed opportunities for early detection. Community-based screening and targeted preventive interventions are essential to reduce cardiovascular risk in underserved urban populations. KEY TERMS: Community-based study, Determinants, Hypertension, Urban slums, Undiagnosed hypertension