Key result
Self-reported hypertension demonstrated moderate sensitivity (72.0%) and high specificity (94.5%) compared to reference criteria, with an overall agreement of 89.8%.
Why the study?
The study was designed to investigate the validity of self-reported hypertension and its related factors in the adult population of the Dehgolan Prospective Cohort Study.
Is self-reported hypertension a valid measure compared to reference criteria in an adult population?
Cohort (n=3,996)
Is self-reported hypertension a valid measure compared to reference criteria in an adult population?
Effect estimate: Sensitivity 72.0%, Specificity 94.5%
Absolute Event Rate: 19.49% vs 21.6%
Self-reported hypertension has acceptable validity for epidemiological screening, though its accuracy is influenced by age, gender, BMI, and family history.
Self-reported hypertension should not guide individual diagnosis due to moderate sensitivity; leaves open its value in epidemiological cohorts prioritizing specificity.
This study aimed to investigate the validity of self-reported hypertension and related factors in the Dehgolan Prospective Cohort Study (DehPCS). Data were obtained from 3996 participants aged 35-70 years in the enrolment phase of DehPCS. Self-reported hypertension and sociodemographic factors were collected by well-trained interviewers before hypertension diagnosis based on the reference criteria. The history of anti-hypertensive medication use and/or systolic blood pressure ≥140 (mmHg), or diastolic blood pressure ≥90 (mmHg) were considered as hypertension. Disagreement between self-reported and reference measures was assessed using sensitivity, specificity, positive, and negative predictive values (PPV and NPV), and kappa values. Binary and multinomial logistic regressions were used to investigate the correlates of validity of self-reported hypertension. The hypertension prevalence based on self-reports and the reference criteria was 19.49% and 21.60%, respectively. An acceptable percentage of kappa agreement value of 68.7% and relatively good overall agreement of 89.8% were found. Self-reported hypertension was guaranteed moderate sensitivity of 72.0% and high specificity of 94.5%, as well as the NPV and PPV of 92/7% and 77/9%, respectively. The chances of false-positive and false-negative reporting increased with older age, higher BMI, and a family history of hypertension. Being female, older age, higher BMI, concurrent diabetes, and stronger family ties to hypertension patients significantly increased the chance of reporting true positives relative to true negatives. Although, self-reported hypertension has an acceptable validity and can be used as a valid tool for screening epidemiological studies, it needs to be investigated because its validity is affected by age, gender, family history of hypertension, and other socio-demographic characteristics.
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Piri et al. (2023) conducted a cohort in Hypertension (n=3,996). Self-reported hypertension vs. Reference criteria (anti-hypertensive medication use or BP ≥140/90 mmHg) was evaluated on Validity of self-reported hypertension (sensitivity, specificity, PPV, NPV, and kappa agreement) (Sensitivity 72.0%, Specificity 94.5%). Self-reported hypertension demonstrated moderate sensitivity (72.0%) and high specificity (94.5%) compared to reference criteria, with an overall agreement of 89.8%.
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