Abstract
Hypertension is the leading risk factor for global disease burden. Self-management of high blood pressure (BP) through self-monitoring and self-titration of medications, has proved to be one successful and cost-effective tool to achieve better BP control in many high-income countries but not much is known about its potential in low- and middle-income countries (LMICs). We used semi-structured questionnaires and focus groups in three LMICs; Peru, Cameroon and Malawi to examine perceptions and attitudes of patients diagnosed with essential hypertension towards living with hypertension, BP measurement and treatment, patient-physician relationship and opinions about self-management of high blood pressure. Results in all three countries were comparable. Patients showed varied levels of health literacy related to hypertension. BP measurement habits were mostly affected by resources available and caregiver support. Treatment and adherence to it were primarily affected by cost. Most patients were welcoming of the idea of self-management but skeptical about the ability to do self-monitoring accurately and the safety involving self-titration of medications.
Highlights
High blood pressure remains the leading preventable cause of premature death and disability worldwide, killing almost eight million people every year and is projected to increase by 60% to affect 1.6 billion adults worldwide by 2025[1,2]
With regard to experiences and attitudes related to the diagnosis of hypertension, we found that in all three countries, there is a clear role for health literacy and the source of information that the patients primarily rely on in shaping their perceptions of illness, treatment and future Home blood pressure monitoring (HBPM) interventions
This study presents foundational research that explores patient attitudes and perceptions of hypertension diagnosis, measurement, treatment, patient–physician relationship and self-management of blood pressure in three different low- and middle-income countries (LMICs)
Summary
High blood pressure remains the leading preventable cause of premature death and disability worldwide, killing almost eight million people every year and is projected to increase by 60% to affect 1.6 billion adults worldwide by 2025[1,2]. Prevalence rates vary widely in these countries, from 11% to 37%[6] These trends create a need for more foundational research to understand the global disparities of hypertension to inform health policies and interventions[7,8,9]. Home blood pressure monitoring (HBPM) and self-titration of medications have proven to be cost-effective self-management strategies to control BP in higher-income countries[10,11,12]. While there is growing evidence on the premise of community-wide interventions in reducing the incidence of hypertension in LMICs[13], HBMP and self-titration of medications as a BP self-management strategy have been associated with health behavior and lifestyle modifications to achieve optimal BP control[14,15,16,17]
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