Abstract
Hypertension is a major modifiable risk factor for cardiovascular disease and a leading cause of morbidity and mortality worldwide. This study aimed to identify factors associated with hypertension among Peruvian adults using nationally representative data from the 2023 Demographic and Family Health Survey (ENDES). We conducted an analytical cross-sectional study including adults aged ≥ 18 years with self-reported hypertension status available and the a priori covariates. Associations were evaluated using survey-weighted bivariate analyses and modified Poisson regression to estimate crude and adjusted prevalence ratios (aPRs), accounting for the complex design. Among 29 826 adults, the prevalence of self-reported hypertension was 9.2%. In survey-weighted, multivariable models, age showed a strong gradient (aPRs 1.01-1.25 vs. 18-29 years), diabetes was associated with higher prevalence (aPR 1.17), and body mass index (BMI) categories showed a dose-response pattern (overweight aPR 1.02; obesity aPR 1.05). Male sex had a slightly lower prevalence than females (aPR 0.98). Smoking and alcohol use showed minimal or null associations in the primary model; sensitivity analyses for missingness produced stable inferences for alcohol, but smoking estimates varied. Hypertension remains a public health challenge in Peru. Older age, diabetes, and excess body weight are key targets for prevention; BMI disaggregation clarifies a dose-response signal. Given high item nonresponse for smoking/alcohol, we emphasize cautious interpretation and the value of improved exposure ascertainment.