Sociodemographic Determinants and Barriers to Treatment among Patients with Hypertension in Comprehensive Health Centre, Argungu, North-Western Nigeria

Objective: To investigate correlations between hypertensive patients' knowledge of hypertension, awareness of hypertension education, self-management behaviors, and hypertension control. Methods: Hypertensive patients from 5 community health centers in Xuhui District, Shanghai, China, were enrolled into this study. Data were collected via patient interviews and a questionnaire survey. Independent influence factors for hypertension control were identified by logistic regression analysis. Results: In total, 3,328 hypertensive patients, including 1,935 females and 1,390 males with a mean age 70.6 years, were studied. The mean systolic blood pressure was 133.1 mm Hg. The mean diastolic blood pressure was 80.5 mm Hg. Hypertension was controlled in 1,050 (36.1%) patients. Independent influence factors for failed hypertension control were comorbidities, including diabetes mellitus, coronary artery disease, and stroke. Patients who knew that ‘high blood pressure is related to salt intake' and were willing to receive regular health education were less likely to fail in hypertension control. Patients who visited clinics because of fear of complications and visited medical institutions other than community health centers for hypertension were more likely to fail in hypertension control. Conclusions: In Shanghai, failed hypertension control is significantly associated with chronic disease history. Limiting salt intake, receiving regular health education, and visiting community health centers for hypertension care may help control hypertension.

Background: Hypertension remains a major public health challenge and cause of morbidity and mortality globally. Patients’ knowledge of hypertension among other factors could influence their practice of hypertension control measures. Purpose: This study aimed to determine the knowledge and practice of hypertensive patients towards hypertension control as well as identify factors influencing the practice of hypertension control in the University of Port Harcourt Teaching Hospital (UPTH), a tertiary healthcare institution in Nigeria. Materials and Methods: This cross-sectional descriptive study was carried out at the University of Port Harcourt Teaching Hospital (UPTH). One hundred and twenty (120) consenting hypertensive patients attending a clinic at the outpatient department were recruited for this study. A pre-tested structured questionnaire incorporating sociodemographic characteristics and questions on knowledge, practice and factors affecting hypertension control was administered to the patients. Data obtained was presented using frequencies, percentages, mean and standard deviation. Spearman rank correlation was used for correlation analysis of data. Statistical significance was set at p<0.05. Results: Study participants demonstrated good knowledge with a mean knowledge score of 3.68±0.30. However, poor practice in the control of hypertension with a mean practice score of 2.59±0.48 was observed. Financial constraint was identified as the factor affecting the practice of hypertension control among hypertensive patients (mean score 3.09±0.66). There were statistically significant positive correlations between mean practice score with age (r=0.269, p=0.005) and educational status (r=0.232, p=0.017). Significant negative correlations between the mean practice score and financial constraint (r= -0.246, p=0.011), negative side effects of drugs (r= -0.318, p=0.001), herbal medicine use (r= -0.207, p=0.034), failure to remember (r= -0.225, p=0.020) as well as perceived absence of symptom (r= -0.261, p=0.007) were observed. Conclusion: Hypertensive patients attending clinics at the outpatient department of UPTH demonstrated good knowledge of hypertension though this did not translate to good practice in hypertension control. Poor practice in hypertension control was associated with age, educational status, financial constraint, a side effect of drugs, herbal medicine use, failure to remember and perceived absence of symptoms.

Hypertension is the number one cardiovascular risk factor and the leading cause of mortality worldwide. It's the driver of the cardiovascular disease epidemic in Africa where it is a major, independent risk factor for heart failure, stroke and renal failure. There is no study to assess the level of knowledge of hypertension among hypertensive patients in our setup. The objective of this study was to assess knowledge, attitude and selfcare practice towards control of hypertension among hypertensive patients on follow up at our hospital. A total of 385 hypertensive patients who were on follow up at our hospital were randomly selected for interview. The Sociodemographic and relevant clinical data were extracted using a structured questionnaire. Operational definitions and Likert scale was used to compare the variables. Only 48.6% of hypertensive patients participated in this study have good basic knowledge of hypertension, 47.8% of them have good attitude and only 39.5% of the study participants have good practice towards control of hypertension. Male sex, formal education and being urban resident are associated with better knowledge, attitude and self-care practice of hypertensive patients at our hospital. The result states that there is an inadequate knowledge about hypertension; as well attitude and self-care practice towards control of hypertension among our hypertensive patients is generally poor. Responsible bodies should focus on addressing such limitations of hypertensive patients. Attention should be given to hypertensive patients who are females, low educational level and those coming from rural.

Context: Hypertension is highly prevalent in Vietnam, yet the rate of controlled hypertension remains low. Knowledge about hypertension is linked to patient beliefs and medication adherence. However, there's limited data on hypertension knowledge among primary care patients in Vietnam. Aims: To evaluate the knowledge of hypertension among hypertensive patients in primary care settings in Central Vietnam and identify factors affecting their knowledge. Methods: A cross-sectional study was conducted, and a thorough examination was performed to assess hypertension knowledge and its related factors. Utilizing the Hypertension Knowledge Level Scale and Medication Adherence Report Scale, hypertension knowledge and medication adherence were evaluated. Additionally, demographic, clinical, lifestyle, and patient belief data were gathered. Statistical analyses and logistic regression models were applied to pinpoint key factors associated with hypertension knowledge. Results: In the study involving 761 participants (55.7% male), the average hypertension knowledge score was 15.0 (SD = 4.6), with only 45.3% demonstrating a high level of knowledge. Significant correlations were observed between hypertension knowledge and variables such as education level, ethnicity, home blood pressure monitoring, patient beliefs, and medication adherence. Logistic regression analysis indicated that higher education levels and belonging to the majority ethnicity were linked to enhanced hypertension knowledge. Notably, individuals with better hypertension knowledge tended to recognize the necessity of their prescribed medications. Conclusions: Hypertension knowledge among primary care patients in Central Vietnam is suboptimal, with approximately half having a high knowledge level. These findings emphasize the importance of hypertension knowledge in shaping patient beliefs, perceptions, and medication adherence. Tailored educational interventions are crucial, especially for those with lower education and minority backgrounds, to enhance hypertension management.

Estudio Conocimiento: grado de conocimiento sobre hipertensión arterial de nuestros pacientes. Relación con el nivel de control de la misma

Hypertension is a major public health concern globally, including in Pakistan, contributing significantly to cardiovascular morbidity and mortality. Despite its prevalence, knowledge and attitudes toward hypertension management remain inadequately explored in Pakistan. Objectives: To assess the knowledge, attitudes, and practices of hypertensive patients toward hypertension control at Hayatabad Medical Complex (HMC), Peshawar. Methods: A descriptive cross-sectional study was conducted from July 2023 to July 2024, involving 584 hypertensive patients aged 40-75 years. Data were collected using a structured, physician-administered questionnaire, which assessed patients' knowledge of hypertension, attitudes toward lifestyle modifications, and medication adherence. Descriptive statistics summarized the demographic characteristics, while chi-square tests were used to explore associations between knowledge and adherence behaviours. Results: Of the participants, 34.8% demonstrated good knowledge of hypertension, and 69.8% recognized it as a cardiovascular risk. Medication adherence was high, with 72.5% of patients consistently following their prescribed regimen. Regular blood pressure monitoring was performed by 59.7% of participants, though 31.5% had not monitored their BP for over a month. A significant association was found between knowledge levels and adherence to medication (p<0.05). Conclusions: It was concluded that the study reveals substantial gaps in knowledge about hypertension among patients, despite good medication adherence rates. Targeted educational interventions are needed to improve understanding of hypertension and its management, especially in resource-limited settings.

Aims: Prevention and control of hypertension can be achieved by improving patient adherence to long-term treatment regimens. Non-adherence is an obstacle to chronic disease management. We studied the impact of value reference point and risk preference on patient adherence and influencing factors from the perspective of behavioral economics so as to offer targeted recommendations to improving patient adherence in low-income areas. Methods: A representative impoverished area, Qianjiang District in Chongqing was selected as the sample district. A cross-sectional survey using questionnaire augmented with an interview was conducted to collect information with 321 patients previously diagnosed with hypertension stage 3. Preference experiments conducted through scenario simulation were used to elicit and measure patients’ value and risk preferences. We constructed a structural equation model to verify the impact of value reference points and risk preference on adherence behavior decision-making. Logistic regression models were constructed to analyze other factors that may influence adherence. Results: Adherence was determined by patients’ value reference points (path coefficient = 0.876, p < 0.01) and risk preference (path coefficient = 0.715, p < 0.01). The factor loadings of all indicators on the latent variables were significant (p < 0.01). Hypertensive patients in our cohort adhered poorly to health management and were heavily influenced by knowledge of hypertension, expectation, health literacy and opportunity costs. Certainty effect, overconfidence and optimism significantly affected patients’ risk preference in decision-making progress. In the face of the uncertain benefits of adherence, patients preferred to delay treatment until condition affected their quality of life, resulting in poor adherence. Satisfaction with current services and relationship with physicians, as well as type of drugs also influenced adherence. Conclusions: Adherence may be improved by changing patients’ value reference points and perceptions through health education and better health service resources. One of the key to increasing adherence is through identifying and eliminating bias.

Education, literacy, and health: Mediating effects on hypertension knowledge and control

Background : Hypertension is a global public health concern. Awareness and knowledge about the disease in a community collectively would allow adequate prevention, promote self-care practices, adherence to medication and ultimately effective management of hypertension. Aims: To ascertain the level of education associated with the knowledge of hypertension and control of blood pressure. Methods: A cross-sectional questionnaire survey consisting of item questions about awareness and knowledge of hypertension. Hypertensive patients (n = 424) of both genders and more than 20 years of age were included in the study. Hypertensive patients were divided into two groups (school group and school pass-out group) to assess the level of knowledge. Chi-square test was performed to determine the assessment, and p-value &lt; 0.05 was considered significant. Results: Out of 424 participants, 71.2% were school group and 28.7% school pass-out group. School pass-out group had significant knowledge about dangerous natural course of hypertension (p = 0.00069), hypertension can lead to death if untreated (p = 0.015), benefits of cessation of smoking (p = 0.03), advantage of limiting alcohol (p = 0.019) and performing regular exercise (p = 0.013) reduces blood pressure. School pass-out group had significant (p = 0.04) hypertension control compared to the school group. Conclusion: Educational status plays a vital role in increasing knowledge and improving the management of hypertension through better self-care practices and strict adherence to medication. Community- based health education interventional programs targeting the lower socioeconomic group of a population would help to reduce the gap in awareness and effective control of hypertension.

Objective:Uncontrolled hypertension negatively impacts on mortality. This study aimed to evaluate the impact of a pharmacist-led patient counseling and education model to empower hypertensive patients on chronic medication.Methods:This was an operational research project with a quasi-experimental design including an intervention group (55 patients) and a control group (31 patients) of chronic hypertensive patients. The data were collected with interview-administered questionnaires, and were analyzed using SAS® version 9.4. Pharmacist interventions included an educational diary on hypertension management and patient counseling.Findings:A 34.7% improvement was observed in patients’ understanding of what normal blood pressure (BP) is in the intervention group compared to the control group (P < 0.001), whereas a 9.1% improvement was also observed in the intervention group in their knowledge about the fact that systolic BP and diastolic BP are both important in controlling hypertension, with no change in the control group. After the intervention, 40.0% of patients in the intervention group versus 17.9% in the control group had adequate knowledge (≥75% correct answers) about hypertension and its management. Pharmacist interventions were well received by the majority of patients (>90%).Conclusion:A pharmacist-led patient counseling and education model can help improve patients’ hypertension knowledge and BP control. These should increasingly become routine, aiming to improve chronic disease management.

Hypertension in Moderate-to-Severe Nondiabetic CKD Patients

Knowledge, awareness, behavior (KAB) and control of hypertension among urban elderly in Western China

Objective To analyze the factors which influence the treatment compliance of hypertensive patients in health management. Methods Data of 6 325 hypertensive patients who received physical examination in our department were collected; 4 132 male cases and 2 193 female were included, their ages ranged from 28 to 84 years old; the average age was 61.2 ± 5.8 years. The patients of the health intervention group were randomly divided into 3 groups(group 1, group 2 and group 3). They were provided with regular health management(including weight management, catering management, sports management, medication management and monitoring of blood pressure), respectively, given different frequency of telephone follow-up(1 time per 2 months, 1 time per month, and 1 time per month), evaluating treatment compliance. All the results were analyzed and compared respectively according to the level of education, age and mental status. Data of 1 892 hypertensive patients who received outpatient services were enrolled as the control group. Among them, 4 132 were male and 2 193 were female, aged 28-84 years old, average(61.2 ± 5.8)years old. They received the traditional outpatient follow-up(outpatient service review and health education), their treatment compliance, timely correcting unhealthy lifestyle and medication method and self-testing blood pressure were evaluated. ANOVA and chi square test were used to analyze the treatment compliances and blood pressure control rates of the two groups. Result Compared with the control group, health intervention for hypertension patients could significantly improve the treatment compliance and blood pressure control rate(64.8% vs. 41.3%, 56.7% vs. 29.6%; χ2=2.827, 1.382; P=0.032, 0.007). Comparing the results of telephone follow-up frequency, the treatment compliance and blood pressure control rate of the 3 intervention groups were higher than those of the two other groups(77.3% vs. 65.4%, 51.7%, χ2=3.414, P= 0.041; 69.6% vs. 57.3%, 43.2%, χ2=2.763, P=0.028). The treatment compliance of patients with high education level was significantly higher than that of patients with low education level(68.7% vs. 59.1%, 46.4%, χ2=3.257 , P=0.037; 60.1% vs. 47.2%, 32.8%, χ2=1.234 , P=0.009). And the treatment compliance of patients with good mental state was significantly higher than that of patients with anxiety(Intervention group1 :64.3% vs. 55.1%,41.9%,31.0%, χ2=2.257, P=0.016; 59.4%vs.46.1% ,20.9% ,21.8% , χ2=3.34 5 P= 0.021; Intervention group2 :75.5% vs. 64.3%, 51.8% ,41.2%, χ2=2.932, P=0.030; 68.3% vs.57.1%, 39.2%, 32.1% , χ2=2.382, P=0.032; Intervention group3: 86.5% vs.73.2% , 62.6% , 52.4% , χ2=2.435, P=0.026; 75.2%vs. 68.0% , 51.7% , 43.3% , χ2=3.251, P=0.036). Conclusion More frequently follow-up can improve the treatment compliance and control rate of blood pressure in hypertensive patients; education, age and psychological condition are factors influencing treatment compliance in hypertensive patients. Key words: Primary hypertension; Health management; Treatment compliance; Affecting factor

Background: Globally, cervical cancer affects approximately 528,000 women each year, with about 80% of them occurring in developing countries. Developed countries have successfully reduced the incidence of cervical cancer by 70% through organized cervical screening programs. Objective: The aim of the study is to assess the level of Pap smear awareness and utilization among adult females attending the general outpatient clinic of Aminu Kano Teaching Hospital, Northwestern Nigeria, in order to encourage early detection of premalignant cervical cancer. Methods: This was a descriptive cross-sectional study that assessed Pap smear awareness, utilization, and pattern of cervical intraepithelial neoplasia among 422 adult females in Kano, Northwestern Nigeria, using an interviewer-administered questionnaire. SPSS version 20 was used to analyze the data. The sociodemographic characteristics of participants, risk factors of cervical cancer, and awareness and utilization of Pap smears by participants were expressed in means and proportions. The Chi-square test was used to explore associations between categorical variables. Logistic regression was performed to identify the predictors of Pap smear awareness and its utilization among the study participants. P < 0.05 was considered statistically significant. Results: Of the 422 women who participated in the study, the majority (292, 69.2%) had never heard of Pap smear screening while 130 (30.8%) were aware of Pap smear. Similarly, 342 (81.0%) women who participated in the study had never undergone a Pap smear. Three hundred and eight (74%) had normal cytology results, 107 (25%) had inflammatory changes, 4 (0.8%) had low-grade squamous intraepithelial lesion, and 1 (0.2%) had high-grade squamous intraepithelial lesion. Having higher education and being employed were associated with Pap smear awareness while increasing age and educational level were associated with Pap smear utilization. Conclusion: This study revealed a low awareness and utilization of Pap smear screening in Northwestern Nigeria.

Aging has the fastest growth rate in age groups. With age, the prevalence of a variety of chronic diseases also increases. Among chronic diseases, hypertension is one of the most important diseases among older adults and self-care is one of the effective approaches to control it. The aim of the present study was to apply the health belief model (HBM) in promoting self-care in hypertensive older adults to help improve self-care behaviors in this age group. This was a quasi-experimental study. This study was conducted at comprehensive health centers in the east of Guilan province, Iran. This intervention study was conducted on 106 elderly people with hypertension who were selected with a multi-stage random sampling method from those referred to east health centers of Gilan, Iran, in 2019. The data gathering tool was a questionnaire including demographic characteristics, HBM structure, hypertension knowledge, and hypertension self-care questionnaires. The intervention group received an educational program based on the HBM model. The questionnaire was completed by the elderly before and 2 months after the intervention. The data were analyzed by descriptive statistics, Mann-Whitney, Chi-square, Wilcoxon, Fisher, and ANCOVA tests usingSPSS ver.16. There was a significant difference in knowledge and all HBM constructs before and after the intervention in the intervention group (P < 0.001). In the control group, knowledge (P-value = 0.023), self-efficacy (P-value = 0.001), perceived severity (P-value = 0.005), and cues to action (P-value = 0.008) were significantly different (P < 0.05) after the intervention. The present study showed that HBM-based education can be considered an effective educational framework for improving self-care of the hypertensive older adults.