Undiagnosed hypertension and its determinants among adults in Rwanda in the 2021–2022 WHO STEPS survey

Hypertension, or high blood pressure, poses a significant health challenge in Rwanda, yet many adults with the condition remain undiagnosed. A study conducted using data from Rwanda's 2021-2022 STEP (Screening for Trend, Evaluation, Prevention, and Treatment) Survey examined the prevalence and determinants of undiagnosed hypertension among adults aged 18-69 years. The survey included 1,223 participants who met clinical criteria for hypertension, with 42.9% (n=524) of them unaware of their condition.

The research found that younger adults were significantly more likely to be undiagnosed, with those aged 18-24 years having more than double the odds (AOR = 2.9, 95% CI: 1.30-6.30, p = 0.009) compared to older adults. Similarly, men had higher odds of undiagnosed hypertension than women (AOR = 2.7, 95% CI: 1.82-3.96, p < 0.001). Higher education levels were protective against undiagnosed hypertension, while residents of the Western Province showed elevated odds (AOR = 1.8, 95% CI: 1.07-3.05, p = 0.026).

A critical factor in undiagnosed hypertension was not visiting a health worker in the past year, with this behavior having the strongest predictor effect (AOR = 3.2, 95% CI: 2.33-4.51, p < 0.001). These findings emphasize the need for increased routine blood pressure screening among younger adults and men, as well as the strengthening of community-based detection efforts across Rwanda to address this public health concern.