Burden of Undiagnosed Hypertension Among Adult Patients Undergoing Elective Surgery: A Cross-Sectional Study

Open Access

Abstract

Background: Hypertension is a major global public health problem and a leading risk factor for cardiovascular disease, stroke, and premature mortality. Despite being largely asymptomatic, undiagnosed hypertension remains common worldwide, making preoperative assessment an important opportunity for early detection and timely management. Objective: The aim of the study was to determine the burden of undiagnosed hypertension among adult patients undergoing elective surgery. Methods & Materials: This cross-sectional study was conducted in the Department of Anaesthesia, Analgesia and Intensive Care Medicine at Bangladesh Medical University (BMU), Dhaka, Bangladesh, from April 2024 to March 2025 among 2,084 adult patients attending the Preoperative Assessment Unit (PAU) for elective surgery using purposive sampling. The study assessed the burden of undiagnosed hypertension, including white coat and coincidental hypertension, using a structured data sheet with predefined variables. Data were analyzed using SPSS version 27.0. Results: Among 2,084 adult patients undergoing elective surgery, 445 (21.4%) were hypertensive, 1,561 (74.9%) were normotensive, and 78 (3.7%) had undiagnosed hypertension. Age and gender were significantly associated with hypertension status (p < 0.001 and p = 0.013). Among 1,639 patients without a previous diagnosis of hypertension, 78 (4.8%) had undiagnosed hypertension, including 26 (33.3%) with white coat hypertension and 52 (66.7%) with coincidental hypertension. Conclusion: Routine preoperative blood pressure screening is valuable for identifying undiagnosed hypertension and facilitating timely management to improve perioperative and long-term cardiovascular outcomes.