Silent but not harmless: asymptomatic hypertension, medication non-adherence and complications in a Rural Punjab outreach population

Abstract

Background: Hypertension is often symptomless and consequently can go diagnosed until it accelerates and causes medical emergencies. This study determined the prevalence of hypertension, presence of symptomless cases, adherence to antihypertensive medications, complications and awareness among adults residing in outreach camps in two rural villages in Sangrur, Punjab.

Methods: This was a descriptive cross-sectional study undertaken between 2024 to 2026, to evaluate adults 18 years and above, residing in outreach camps in Mehlan and Kheri. Descriptive statistics and chi-square/Fisher’s exact test were done. In a univariate analysis, lack of adherence was assessed against other variables. Logistic regression was done to evaluate the effect of independent variables. A p value of less than 0.05 was taken as significant.

Results: Of the 300 participants, 182 (60.7%) had hypertension. Of these, 90 (49.5%) were previously undiagnosed. Of the 92 hypertensive patients, 27 (29.3%) were non-adherent to their medication. Of the 92 hypertensive patients, 106 (58.2%) had at least one medical complication. In the univariate analysis, lack of adherence was not significant (OR=2.29, 95% CI=0.92, 5.74). After controlling for other variables (AOR=3.16, 95% CI=1.04, 9.59), lack of adherence and old age (≥60 years) were significantly associated with medical complications.

Conclusions: The study participants were largely hypertension diagnosis and medication adherence. As such, there is justification for large scale hypertension diagnosis and medication adherence interventions in similar rural setups. The findings are applicable to other rural areas of Punjab. The study revealed inadequate diagnosis and treatment of hypertension among outreach camp participants.