Hypertension-related Knowledge and Its Relationship with Blood Pressure Control in Hypertensive Patients Visiting a Semi-private Tertiary-care Charity Hospital in Karachi, Pakistan

Abstract

IntroductionHypertension is one of the leading causes of mortality worldwide. Fifty-four percent of strokes and forty-seven percent of cardiovascular deaths are caused by suboptimal control of blood pressure. Economically developing countries like Pakistan are heavily burdened with an ever-rising epidemic of cardiovascular disease and stroke morbidity and mortality. Therefore, urgent steps are required to treat, as well as modify, risk factors for cardiovascular disease, including hypertension.PurposeThe objective of this study was to ascertain the knowledge of hypertension and other sociodemographic variables and their impact on controlling blood pressures in the hypertensive population belonging to the low socioeconomic strata.MethodsThis cross-sectional study was conducted in the general medicine and cardiology outpatient clinics of a tertiary care charity hospital. Three-hundred thirty-five hypertensive patients of age >24 years were selected and informed consent was obtained. Hypertension-related knowledge was assessed using the Modified "Hypertensive Knowledge-Level Scale (HK-LS)" via a 15-20 min interview. Secondary variables in the questionnaire included social demographics, medical history, and assessment of body mass index (BMI) and blood pressure average values, which were measured during the interview. Knowledge was recorded based on the 33-point modified HK-LS scale, whereas secondary variables were not counted toward the assessment of knowledge.ResultsThe frequencies of low, moderate, and high levels of hypertension-related knowledge were recorded as 2.1%, 79.4%, and 62%, respectively. Among 335 patients, (57.3%) were male, the mean age was 52.5 ± 11.5 years, and 63.6% were professionally active. Median systolic blood pressure (SBP) and diastolic blood pressure (DBP) in hypertensive patients were 140 and 86 mmHg, respectively. Sixty-nine percent of patients reported existing comorbidities, 54% had diabetes, 20.7% had cardiovascular disease, and 24% reported renal disease. No significant association was observed between the levels of knowledge of hypertension and gender, blood pressure (BP) status, professional activity, and age groups (p=0.877, p=0.863, p=0.125, and p=0.400, respectively).ConclusionThe majority had adequate knowledge of hypertension but only 64.8% had controlled BP status. This depicts not a lack of knowledge and awareness but rather a lack of prevention of risk factors related to hypertension. Thus, further studies are advised to look into the preventive strategies employed by patients to control their BP and assess their effectiveness.

Adherence to Treatment and Level of Satisfaction Among Saudi Hypertensive Patients: A Multi-City Study

“…This result is consistent with two studies from the US, which reported that stress, obesity, and diabetes were the major risk factors for HTN [23,24]. Public awareness of HTN and its risk factors is necessary to facilitate the job of health professionals to prevent and treat high blood pressure [21,23].…”

“…The discrepancy between our findings and the findings of the US study can be explained by the difference in the nature of the sample population: their study sampled the general public, whereas our sample only included patients attending primary healthcare centers. Patients' awareness of the importance of adherence to treatment is essential to achieve good control of blood pressure [21]. Most of the participants in this study (73.4%) were satisfied with the information and explanation of the treatment plan provided by the health workers.…”

Construct Validity and Reliability of the Arabic Version of Hypertension Knowledge-Level Scale Among Saudi Population

“…In 2021, the same authors, Arthur et al, published the Brazilian version, testing the validity and reliability of (HK-LS) [11]. In 2019, in Pakistan, the researchers used the scale to ascertain the knowledge of hypertensive patients [12]. The HK-LS was originally developed in Turkish and English but has been translated and cross-culturally adapted into Greek, Polish, Indonesian, Brazilian, and Arabic [5,[7][8][9][10][11].…”

Knowledge, Attitudes and Practices towards Hypertension among Hypertensive Patients in Rural Area, Tanvè (Benin)

“…On the other hand, lower frequency (14.0%) was reported in Cameroon, among 221 hypertensive patients in the Bamenda health district in 2015 [22]. Similar studies in other regions showed various results from 25.2% in Iran, 41.2% in India, 62.0% in Pakistan, 69.9% in Sri-Lanka, to 82.3% in Brazil [23][24][25][26][27]. In USA, Oliveira et al had reported in 2004 among 826 patients that most of them had good knowledge: 81.8% knew the meaning of the term of hypertension, 70.2% how dangerous hypertension is for health and 90.2% knew lowering high blood pressure would improve the health [28].…”