A retrospective study of the prevalence and socio-demographic and clinical factors associated with hypertension awareness, treatment, and control in geographically isolated and disadvantaged areas (GIDA) in the Philippines

Abstract Introduction Hypertension remains a major yet under-documented health concern in geographically isolated and disadvantaged areas (GIDAs) of the Philippines, where healthcare access is limited and routine screening is uncommon. This study examined the burden of hypertension and its key factors among adults receiving care through Remote Area Medical (RAM) missions across Luzon, Visayas, and Mindanao. Methods A retrospective cross-sectional analysis was conducted using 2,358 deidentified patient records collected from RAM medical missions between 2022 and 2024. Hypertension was defined as documented systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. Variables included age, sex, BMI, tobacco and alcohol use, geographic location, municipality class, and comorbidities classified using ICD-11. Missing data were documented and handled on a per-variable basis, with records excluded only from analyses requiring the missing variable. Poisson regression with robust variance estimation was used to estimate crude and adjusted prevalence ratios. Results Hypertension prevalence was 36.5%, with variation across island groups, highest in Mindanao at 44.6%, followed by the Visayas at 37.6% and Luzon at 28.7%. In crude analysis, adults aged 40 to 59 years had higher hypertension prevalence than those aged 18 to 39 years (PR = 1.95; 95% CI: 1.65 to 2.31; p < 0.001), as did adults aged 60 years and older (PR = 2.41; 95% CI: 2.04 to 2.85; p < 0.001). After adjustment, female sex was associated with lower hypertension prevalence (aPR = 0.24; 95% CI: 0.08 to 0.74; p = 0.013). The estimate for height was statistically significant but was based on limited anthropometric data and was therefore interpreted only as exploratory. Most sociodemographic, geographic, behavioral, and clinical factors were not statistically significant in adjusted analyses. Among clinical comorbidity categories, only diseases of the ear or mastoid process remained statistically significant after adjustment (aPR = 1.72; 95% CI: 1.11 to 2.66; p = 0.016), although this should be interpreted with caution given the small number of cases. Conclusion Hypertension was common among adults served through RAM medical missions in GIDA communities in the Philippines. The findings suggest possible differences in hypertension prevalence by selected sociodemographic and clinical characteristics, but results should be interpreted considering the retrospective cross-sectional design, missing data, and limited ability to infer causal relationships. These findings may inform future prospective studies and context-specific hypertension screening strategies in underserved communities.