Characterising the extent of misreporting of high blood pressure, high cholesterol, and diabetes using the Australian Health Survey. (December 2016)

• Record Type: Journal Article
• Authors: Peterson, Karen; Jacobs, Jane; Allender, Steven; Alston, Laura; Nichols, Melanie
• Is Part Of: BMC public health. Volume 16:Number 1(2016)
• Page Start: 1
• Page End: 11
• Publication Date: 2016-12
• Subjects: Cardiovascular disease/epidemiology -- Diabetes mellitus/epidemiology -- Health surveys -- Hypertension/epidemiology -- Hypercholesterolemia/epidemiology -- Logistic models -- Multivariate analysis -- Odds ratio -- Self disclosure; Public health -- Periodicals; 362.105
• DOI: 10.1186/s12889-016-3389-y
• Languages: English
• ISSNs: 1471-2458

Abstract

Abstract Background Measuring and monitoring the true prevalence of risk factors for chronic conditions is essential for evidence-based policy and health service planning. Understanding the prevalence of risk factors for cardiovascular disease (CVD) in Australia relies heavily on self-report measures from surveys, such as the triennial National Health Survey. However, international evidence suggests that self-reported data may substantially underestimate actual risk factor prevalence. This study sought to characterise the extent of misreporting in a large, nationally-representative health survey that included objective measures of clinical risk factors for CVD. Methods This study employed a cross-sectional analysis of 7269 adults aged 18 years and over who provided fasting blood samples as part of the 2011–12 Australian Health Survey. Self-reported prevalence of high blood pressure, high cholesterol and diabetes was compared to measured prevalence, and univariate and multivariate logistic regression analyses identified socio-demographic characteristics associated with underreporting for each risk factor. Results Approximately 16 % of the total sample underreported high blood pressure (measured to be at high risk but didn't report a diagnosis), 33 % underreported high cholesterol, and 1.3 % underreported diabetes. Among those measured to be at high risk, 68 % did not report a diagnosis for high blood pressure, nor did 89 % of people with high cholesterol and 29 % of people with high fasting plasma glucose. Younger age was associated with underreporting high blood pressure and high cholesterol, while lower area-level disadvantage and higher income were associated with underreporting diabetes. Conclusions Underreporting has important implications for CVD risk factor surveillance, policy planning and decisions, and clinical best-practice guidelines. This analysis highlights concerns about the reach of primary prevention efforts in certain groups and implications for patients who may be unaware of their disease risk status.