Knowledge Of Hypertension Research Articles

Assessment of Hypertension Care in a Nigerian Hospital

Purpose: To describe and compare the treatment pattern of patients with hypertension using the JNC 7 guideline, and to assess patients’ body mass index (BMI) and their knowledge of hypertension in a Nigerian secondary health care facility.Methods: A cross-sectional, prospective, and observational study of 200 consecutive patients was conducted. Data were gathered on the patients’ demographics and clinical characteristics, including body mass index. Patients’ knowledge of hypertension was assessed using a 9-item instrument. Descriptive statistics was used to compute percentage frequency distributions of the variables. Inferential statistics employed Students’ t-test and one-way ANOVA at 95 % confidence interval.     Results: Females were 131 (65.5 %), 138 (69.0 %) were either overweight or obese, 107 (53.5 %) had blood pressure ≥ 160/100 mmHg (Stage 2); 150 (75 %) did not know that hypertension is chronic and 132 (66 %) were not aware of risk of non-adherence. Poor knowledge of risk factors was associated with gender, marital status, income, and level of education (p < 0.05). Patients, 167 (83.5 %) received a combination of two antihypertensive medications with 88 (44 %) having thiazide diuretic as first line, and lifestyle modification was not an integral component of care.Conclusion: Most patients received thiazide diuretic medication but not lifestyle education. Obesity was a common risk factor among the study group. Patients’ knowledge of hypertension was below average and they may need to be educated on hypertension and its effective management using drugs and lifestyle changes.Keywords: Antihypertensive medication, Hypertension, Lifestyle, Nigeria, Patient knowledge

Efectividad de una intervención educativa sobre hipertensión arterial dirigida a pacientes hipertensos de edad avanzada

IntroductionHypertension is the most prevalent cardiovascular risk factor among people over the age 60. The aim of this study is to assess the effectiveness of an educational intervention tool, and its reliability. Material and methodsExperimental study, prospective, randomised, parallel-group in a sample of 120 patients, 62 in the intervention group and 58 in the control group. The intervention group received a written and oral educational program on hypertension and cardiovascular risk; the control group did not receive any intervention. ResultsAt the end of the intervention there was an increase in the percentage of correct responses, with statistically significant differences compared to the control group, as regards knowledge of hypertension, risk factors associated with the risks of having high blood pressure and control medication. ConclusionThe implementation of an educational intervention on hypertension and cardiovascular risk associated with the same care activity is capable of increasing the level of knowledge by elderly hypertensive patients admitted to hospital.

The Changing Role of Hypertension Societies

In 2012, hypertension still stands as the most diffuse and principal risk factor for cardiovascular disease worldwide. Hypertension is partially preventable, as healthy lifestyle measures, especially in Western or ‘westernized’ societies, play a key role in holding blood pressure levels within normal limits, although pharmacological support sooner or later becomes unavoidable in most patients developing hypertension. This may have relevant consequences, from both the clinical and the socioeconomic points of view. The prevention of hypertension, in fact, translates into a major healthcare benefit for both individuals and societies, in view of the reduced burden of hypertension-related cardiovascular disease and healthcare costs. Thus, in any cardiovascular preventive strategies at the individual level or at the population level, the central role of hypertension cannot be minimized or ignored, and should be, indeed, fully recognized. Once hypertension is established in an individual patient, the achievement of blood pressure targets within the normal limits (i.e. blood pressure below 140/90mmHg, or below 130/80 in hypertensive patients with diabetes mellitus or nephropathy) bringsmajor clinical advantages in terms of preventing or delaying the development of cardiovascular damage and disease, reducing incidence or recurrence of stroke, myocardial infarction and acute coronary syndromes, reducing progression towards congestive heart failure and end-stage renal disease, reducing or delaying progression of atherosclerotic damage at vascular kidney, eye and peripheral level, and reducing death. Therefore, the effective management and prevention of hypertension is definitely one of the most important healthcare targets of our time. However, the results achieved so far in terms of blood pressure control are largely unsatisfactory around the world, including Italy. Despite the doubtless progress in the pathophysiological role of hypertension and its complex syndromic nature, as well as of themajor achievements in the effectiveness, tolerability and safety of the new drugs used for the clinical management of hypertension, the general outcomes remain disappointing. Control of blood pressure in different countries ranges at best between 20% and 35%, according to the latest reports. This means that, for a number of reasons that are difficult to synthesize here, about three-quarters of hypertensive patients are not treated properly, i.e. they remain exposed at a considerably higher risk than what could be accomplished just treating them at goal. This implies complex and integrated actions, including appropriate population information, general and specific interventions on lifestyle, patient knowledge, physician commitment, physician-patient communication, choice of appropriate therapies, wider use of combination therapies (which is in the end needed in about 60% of treated hypertensive patients), and so on. The role of scientific societies is, indeed, to promote progress, knowledge and science. In the general landscape of scientific societies, hypertension societies around the world have played a growing role in this specific field, generating through committees and scientific journals authoritative, exhaustive and even pragmatic guidelines, as well as a significant progress in the knowledge and care of hypertension from the 1960s to the eve of the third millennium. Also, the clinical studies prompted in the field of hypertension represent keystones and landmark examples in modern medicine. The Italian Society of Hypertension has occupied a leading role, not only in Europe, but even worldwide, being extensively recognized by the international community, also through its founders and leaders, as one of the driving forces in the whole progressive process, that has characterized the field of hypertension over the last 50 years. As with other hypertension scientific groups or societies around the world, the Italian Society of Hypertension has EDITORIAL High Blood Press Cardiovasc Prev 2012; 19 (1): 1-2 1120-9879/12/0001-0001/$49.95/0

Resistant Hypertension

Since the publication of the American Heart Association (AHA) Scientific Statement on the Evaluation and Treatment of Resistant Hypertension in 2008, there has been growing clinical and research interest in the epidemiology, pathophysiology, and therapeutic management of resistant hypertension.1 Highlighted, however, by the authors of that AHA Scientific Statement were important deficiencies in our knowledge and understanding of resistant hypertension. Specifically commented on was the lack or even absence of data on the incidence, prevalence, and prognosis of resistant hypertension.

Validation of the diabetes, hypertension and hyperlipidemia (DHL) knowledge instrument in Malaysia.

BackgroundPatient's knowledge on diabetes, hypertension and hyperlipidaemia and its medications can be used as one of the outcome measures to assess the effectiveness of educational intervention. To date, no such instrument has been validated in Malaysia. Therefore, the aim of this study was to evaluate the validity and reliability of the Diabetes, Hypertension and Hyperlipidemia (DHL) knowledge instrument for assessing the knowledge of patients with type 2 diabetes in Malaysia.MethodsA 28-item instrument which comprised of 5 domains: diabetes, hypertension, hyperlipidemia, medications and general issues was designed and tested. One point was given for every correct answer, whilst zero was given for incorrect answers. Scores ranged from 0 to 28, which were then converted into percentage. This was administered to 77 patients with type 2 diabetes in a tertiary hospital, who were on medication(s) for diabetes and who could understand English (patient group), and to 40 pharmacists (professional group). The DHL knowledge instrument was administered again to the patient group after one month. Excluded were patients less than 18 years old.ResultsFlesch reading ease was 60, which is satisfactory, while the mean difficulty factor(SD) was 0.74(0.21), indicating that DHL knowledge instrument was moderately easy. Internal consistency of the instrument was good, with Cronbach's α = 0.791. The test-retest scores showed no significant difference for 26 out of the 28 items, indicating that the questionnaire has achieved stable reliability. The overall mean(SD) knowledge scores was significantly different between the patient and professional groups [74.35(14.88) versus 93.84(6.47), p < 0.001]. This means that the DHL knowledge instrument could differentiate the knowledge levels of participants. The DHL knowledge instrument shows similar psychometric properties as other validated questionnaires.ConclusionsThe DHL knowledge instrument shows good promise to be adopted as an instrument for assessing diabetic patients' knowledge concerning their disease conditions and medications in Malaysia.

Effects of a hypertension management program by Seongcheon primary health care post in South Korea: an analysis of changes in the level of knowledge of hypertension in the period from 2004 to 2009

The objective of this study was to examine the effects of a hypertension management program provided by a primary health care post located in a distant rural area in South Korea on the level of knowledge of hypertension. The panel data consisted of a total of 319 people or the entire population aged above 40 years of five villages located in Goseong-gun, Gangwon province, South Korea. Preliminary interviews were conducted with all the residents prior to their enrollment in the health care post's hypertension management program. After 5 years of program operation, follow-up interviews were carried out with the same population. A total of 207 participants who completed both interviews were used in the final analysis. First, only the hypertensive group who participated in the program exhibited a significant difference in the level of knowledge. Second, educational level was associated with the level of knowledge in the entire group. Third, the effects of the program differed by gender, with men demonstrating more significant variations in knowledge upon participating in the program. For effective use of resources, considering that the effects of a hypertension education programs worked differently for groups, more customized hypertension management programs need to be targeted at each group to improve the effectiveness of hypertension education programs.

Veterans service organization engagement in ‘POWER,’ a peer-led hypertension intervention

The purpose of this study was to determine the influence of program factors on participant engagement in POWER, a peer-led intervention designed to reduce hypertension, increase hypertension knowledge, and improve other relevant health behaviors, such as diet and exercise, among US veterans involved in veterans service organizations throughout Southeastern Wisconsin. Two hundred and nineteen hypertensive members from 58 VSOs participated in a year-long peer-led intervention designed to improve hypertension knowledge, disease self-management behaviors, and health outcomes. This study represents a qualitative evaluation of post and participant engagement in this intervention. We triangulated data collected via three qualitative approaches (observations, focus groups, and in-depth interviews) from intervention posts to derive a model of engagement. Our findings indicate that discrete characteristics of the peer leaders, post members, posts, and the intervention itself contributed to intervention engagement. We make suggestions for future research studies, particularly as related to understanding how peer leader identities and cultural norms within VSOs might contribute to peer-led health intervention success.

Epidemiology of hypertension in Serbia: results of a National Survey.

BackgroundWe evaluated the prevalence of high blood pressure and the level of awareness, treatment, and control of hypertension in a Serbian population.MethodsA cross-sectional study of an adult population was carried out across Serbia in 2006. The study involved 14 204 adults aged 20 years or older. Interviews and measurements of blood pressure were performed at participants’ homes.ResultsOverall, 47% of the Serbian adult population had hypertension: 25.3% had stage 1 hypertension and 18.1% had stage 2 hypertension. Only 58.0% of the hypertensive population were aware that they had the disease, and 60.4% were receiving medical treatment. Among those receiving medical treatment, only 20.9% had a blood pressure within the normal range. One in 10 participants with hypertension were not treated because, among other reasons, they thought treatment was unnecessary (55.3%) or they lacked money for medication (19.3%).ConclusionsThe prevalence of undiagnosed and untreated hypertension is high in the adult population of Serbia. Further action is required to hasten detection and treatment of high blood pressure. Attention should be directed toward educational programs that improve knowledge, attitudes, and awareness of hypertension among adults.

Adolescents’ Knowledge of Diet-Related Chronic Diseases and Dietary Practices in Ghana

Diet-related chronic diseases constitute public health and developmental challenges in Ghana. The Ghana Health Service in 2007 reported a national prevalence of diabetes of 11.6%, 27.8% for hypertension and 25% of women were reported to be overweight. Adolescents usually adopt lifestyles that negatively affect their nutritional and health status and increase their risk for development of diet-related chronic diseases later in life. The study was therefore carried out to investigate adolescents’ knowledge of diet-related chronic diseases and its influence on their dietary practices. The study design was a cross-sectional survey involving 313 adolescents aged 14 18 years from public and private senior high schools. Structured interviews and diet assessment methods were used to collect information on respondents’ knowledge of diet-related chronic diseases and dietary practices. The data collected were analyzed using the SPSS program version 16. The Chi-square test and ANOVA were used to determine the relationships between respondents’ knowledge of diet-related chronic diseases and dietary practices. The results revealed that knowledge of diabetes, hypertension and obesity were low among the respondents with most of them (89.2%) having fair to poor knowledge of the diseases. Eighty-eight percent of the adolescents ate three or more times in a day. Meals mostly skipped were breakfast and lunch. Dietary diversity of the respondents was generally poor. There was a significant relationship between knowledge of diet-related chronic diseases and the dietary practices of the adolescents. As knowledge of the diseases increased, dietary diversity also improved.

Factors Associated With Knowledge and Control of Arterial Hypertension in the Canary Islands

Introduction and objectivesTo analyze the factors associated with knowledge and control of hypertension in the adult population of the Canary Islands (18-75 years). MethodsWe recruited a random sample of the general population aged ≥18 years. Hypertension was defined as systolic/diastolic blood pressure ≥140/90mmHg or known hypertension (self-declared, or controlled hypertension <140/90mmHg). The bivariate association of known and controlled hypertension with age, sex, anthropometry, serum lipids, medication, and lifestyle was corroborated by adjusting a multivariate logistic model. ResultsWe included 6675 participants. The prevalence of hypertension was higher in men (40% vs 31%, P<.001), who also had a lower frequency of treated and controlled hypertension. Female sex (P<.001), age ≥55 years (P<.001), obesity (P<.001), and diabetes (P<.001) were associated with known hypertension. The modifiable factors that, in spite of treatment, increased the risk of poor control of hypertension were alcohol consumption (>30g/day, odds ratio [OR]=2.4, P<.001; >15-≤30g/day, OR=2, P=.009; >5-≤15, g/day, OR=1.83, P=.004), obesity (body mass index ≥30, OR=2, P=.003; >24.9-<30, OR=1.7, P=.024), serum cholesterol >250mg/dL (OR=1.6, P=.006) and elevated heart rate (>80 bpm, OR=1.45, P=.045; >70-≤80 bpm, OR=1.36, P=.038). ConclusionsThe awareness of hypertension increases with frequent use of the health system and with factors associated with known hypertension: female sex, age, underlying health problems. The modifiable factors associated with poor control of known hypertension are alcohol consumption, obesity, elevated heart rate, and hypercholesterolemia.

Factores asociados al conocimiento y el control de la hipertensión arterial en Canarias

Introduction and objectivesTo analyze the factors associated with knowledge and control of hypertension in the adult population of the Canary Islands (18-75 years). MethodsWe recruited a random sample of the general population aged ≥18 years. Hypertension was defined as systolic/diastolic blood pressure ≥140/90 mmHg or known hypertension (self-declared, or controlled hypertension <140/90 mmHg). The bivariate association of known and controlled hypertension with age, sex, anthropometry, serum lipids, medication, and lifestyle was corroborated by adjusting a multivariate logistic model. ResultsWe included 6675 participants. The prevalence of hypertension was higher in men (40% vs 31%, P<.001), who also had a lower frequency of treated and controlled hypertension. Female sex (P<.001), age ≥55 years (P<.001), obesity (P<.001), and diabetes (P<.001) were associated with known hypertension. The modifiable factors that, in spite of treatment, increased the risk of poor control of hypertension were alcohol consumption (>30 g/day, odds ratio [OR]=2.4, P<.001; >15-≤30 g/day, OR=2, P=.009; >5-≤15, g/day, OR=1.83, P=.004), obesity (body mass index ≥30, OR=2, P=.003; >24.9-<30, OR=1.7, P=.024), serum cholesterol >250 mg/dL (OR=1.6, P=.006) and elevated heart rate (>80 bpm, OR=1.45, P=.045; >70-≤80 bpm, OR=1.36, P=.038). ConclusionsThe awareness of hypertension increases with frequent use of the health system and with factors associated with known hypertension: female sex, age, underlying health problems. The modifiable factors associated with poor control of known hypertension are alcohol consumption, obesity, elevated heart rate, and hypercholesterolemia.Full English text available from:www.revespcardiol.org

Knowledge of Hypertensive Patients With or Without HIV on Hypertension and Their Experience in Using Their Medicines in Dar es Salaam, Tanzania: The Role of the Pharmacist

Purpose: The study assessed the knowledge of both HIV and non-HIV hypertensive patients on hypertension and the role of pharmacists in their pharmaceutical care.Methods: The study was conducted at the hypertension and HIV clinics in government hospitals in Dar es Salaam, Tanzania. Patients were interviewed using a structured questionnaire and pharmacists were assessed using a self-administered questionnaire and by observation.Results: Few patients in both groups knew the names of antihypertensive medicines they were taking. Information on the use of antihypertensive and antiretroviral (ARV) medicines was mostly provided by doctors. Adverse drug reactions were significantly more when patient used both ARVs and antihypertensive medicines than when they used only antihypentsives. Only 20 % of hypertensive-HIV patients informed the pharmacist dispensing antihypertensive medicines that they were using ARVs, and only 19 % of the pharmacists knew the drug interactions between ARVs and antihypertensive medicines. During dispensing, about 2 % of the patients were asked about other medicines being used. Conclusion: There is a need to improve patients&rsquo; knowledge of hypertension. The pharmacists should also have up-to-date knowledge of hypertension-HIV co-morbidity. Proper coordination between HIV and hypertension clinics and the full integration of a pharmacist in the health care team can help to improve patient care.Keywords: Hypertension, HIV/AIDS, Antiretroviral medicines,&nbsp; Antihypertensive medicines, Adverse drug reaction, Dispensing, Knowledge

Using an Established Telehealth Model to Train Urban Primary Care Providers on Hypertension Management

The objective of this study was to determine whether a videoconference-based telehealth network can increase hypertension management knowledge and self-assessed competency among primary care providers (PCPs) working in urban Federally Qualified Health Centers (FQHCs). We created a telehealth network among 6 urban FQHCs and our institution to support a 12-session educational program designed to teach state-of-the-art hypertension management. Each 1-hour session included a brief lecture by a university-based hypertension specialist, case presentations by PCPs, and interactive discussions among the specialist and PCPs. Twelve PCPs (9 intervention and 3 controls) were surveyed at baseline and immediately following the curriculum. The mean number of correct answers on the 26-item hypertension knowledge questionnaire increased in the intervention group (13.11 [standard deviation (SD)]=3.06) to 17.44 [SD=1.59], P<.01) but not among controls (14.33 [SD=3.21] to 13.00 [SD=3.46], P=.06). Similarly, the mean score on a 7-item hypertension management self-assessed competency scale increased in the intervention group (4.68 [SD=0.94] to 5.41 [SD=0.89], P<.01) but not among controls (5.28 [SD=0.43] to 5.62 [SD=0.67], P=.64). This model holds promise for enhancing hypertension care provided by urban FQHC providers.

The relation between health literacy, hypertension knowledge, and blood pressure among middle-aged Japanese adults

With the growth in the popularity of the Internet, individuals' skills in finding and applying information about health issues [health literacy (HL)] are affecting their health behaviors. This study aimed to examine functional HL (FHL), critical HL (CHL), and hypertension knowledge (HK) among middle-aged Japanese adults. In addition, to measure health outcomes, we examined the relationship between HL, HK, and blood pressure (BP) level. The study included middle-aged participants who received an annual health check-up at an urban clinic in Japan. FHL, CHL, and HK were assessed using structured questionnaires. In addition, BP was obtained from the electronic medical record. Participants included 139 women and 181 men with a mean age of 54.4 years (standard deviation = 0.69). Individuals with lower reading comprehension scores in FHL were more likely to have a history of hypertension (P = 0.003) and diabetes mellitus (P = 0.02). Individuals with lower CHL had significantly higher rates of current smoking (P = 0.03) and men with lower CHL had a significantly higher waist circumference (P = 0.03). There was a significant relationship between sex and HK (P = 0.03). Systolic BP in women with higher HL and HK was significantly lower than in men with higher FHL (P < 0.001), CHL (P = 0.01), and HK (P = 0.001). Lower HL and HK were associated with a poor health status and BP level in middle-aged participants. Further research is needed to examine the role of health management in improving outcomes and to address disparities between individuals with higher and lower HL.

A pilot study to evaluate learning style-tailored information prescriptions for hypertensive emergency department patients.

This pilot study explored whether learning style-tailored education materials, "information prescriptions," are effective in increasing hypertension knowledge in emergency room patients. In a randomized trial, hypertensive emergency medicine patients received either standard care discharge instructions or discharge instructions in combination with an information prescription individualized to each patient's learning-style preference. Two weeks post-visit, the study team assessed changes in hypertension knowledge via a survey. No significant difference was observed for changes in quiz scores on the hypertension knowledge assessment, though patients receiving the tailored information prescriptions reported higher levels of satisfaction with intervention materials. The study demonstrated the workflow feasibility of implementing a learning-style approach to patient education in the emergency department setting. Further research is needed to develop more robust measures of high blood pressure knowledge among the emergency department patient population. This work will contribute to establishing a framework for developing customized information prescriptions that can be broadly adapted for use in varied settings and with varied health care conditions.

Blood Pressure Success Zone: You Auto Know A Worksite-Based Program to Improve Blood Pressure Control Among Auto Workers

Worksite-based wellness programs can be a means to improve employee health awareness and potentially reduce health care costs. The "BP Success Zone: You Auto Know" program was a worksite-based intervention to reduce the incidence of hypertension among auto workers at Chrysler LLC. This 6-month program comprised an intervention consisting of education, awareness, and support intended to intensify the engagement of Chrysler employees at moderate-to-high cardiovascular risk who were not adequately controlling their blood pressure. The 539 participants had systolic blood pressure of ≥ 120 mmHg, diastolic blood pressure of ≥ 80 mmHg, or were told by a health care provider that they had hypertension. Questionnaires compared awareness and knowledge of hypertension and lifestyle choices before and at the end of the intervention. After the 6-month intervention, mean systolic blood pressure had decreased from a baseline value of 133 mmHg to 129 mmHg (P < 0.0001) and mean blood diastolic pressure had decreased from 85 mmHg to 82 mmHg (P < 0.0001). The proportion of participants with controlled blood pressure increased from 52% to 62% (P < 0.0001) over the course of the intervention. Eighty-six percent of the participants reported that the program helped them to better understand and control their blood pressure and 84% reported that they had a better understanding of their treatment options. In conclusion, a program of hypertension awareness, education, and lifestyle modification helped to improve blood pressure control among a group of Chrysler LLC employees.

Improving adherence in African American women with uncontrolled hypertension.

African American women are disproportionately affected with hypertension (HTN). The aim of this randomized controlled trial was to evaluate the effectiveness of a 6-week culturally tailored educational intervention for 60 African American women with HTN. Sixty African American women, 29 to 86 years old (mean ± SD, 57.98 ± 12.37 years), with primary HTN were recruited from 4 rural locations and randomized to intervention (n = 30) and control (n = 30) groups to determine the effectiveness of the intervention on knowledge, attitudes, beliefs, social support, adherence to an HTN regimen, and blood pressure control. Culturally tailored educational classes were provided for 90 minutes once a week for 6 weeks. The control group received usual care. A significant favorable overall main effect (time) was found for systolic blood pressure (F3,174 = 11.104, P = .000) and diastolic blood pressure (F3,174 = 4.781, P = .003) for both groups. Also for diastolic blood pressure, older age was a significant covariate (F1,56 = 6.798, P = .012). Older participants tended to have increased diastolic blood pressures. There were no significant differences between groups on knowledge, adherence, or attitudes. The culturally tailored program used the African American church as a basis for recruitment and implementation of the program that retained all participants over a 6-month period. African American women living in rural Texas who participated in a 6-week intervention program demonstrated a significant decrease in blood pressure over a 6-month period regardless of whether they were in the intervention or control group. In general, they had a relatively good knowledge of HTN and reported an average level of adherence. Future studies using a culturally tailored program with a larger sample size are warranted to decrease the high level of HTN-related complications in African American women.

Development and Evaluation of a Hypertension Knowledge Test for Korean Hypertensive Patients

Patients' knowledge concerning high blood pressure (HBP) is a useful outcome measure in HBP education programs. However, valid and easy-to-use HBP knowledge assessment tools are scarce. The purpose of the study was to validate the HBP Knowledge Test (HKT) in two independent samples of Korean Americans with HBP (N=885). A total of 61% of the sample were women with a mean age of about 61 years (standard deviation=11.0) and 44% reported some college education or greater. Psychometric and item response theory analyses identified 21 items that fit a unidimensional model to form the HKT. Internal consistency was acceptable, with Cronbach's α=0.70. Construct validity testing revealed that patients with controlled BP had significantly higher HKT scores than those with uncontrolled BP (P=.012). The HKT is a simple questionnaire for assessing and monitoring HBP knowledge. It is sensitive to differences in blood pressure control status and should provide a valid, reliable, and standardized measure of HBP knowledge with wide relevance.

Integrated Connection to Neighborhood Storytelling Network, Education, and Chronic Disease Knowledge Among African Americans and Latinos in Los Angeles

Combining key ideas from the knowledge-gap hypothesis and communication infrastructure theory, the present study aimed to explain the relations among individuals' education, access to community-based communication resources, and knowledge of chronic diseases (diabetes, hypertension, breast cancer, and prostate cancer) among African Americans and Latinos in Los Angeles. Rather than explore the effect of isolated communication resources, this study explored the effect of an integrated connection to community-based storytellers on chronic disease knowledge. The authors hypothesized that individuals' access to a community-based communication infrastructure for obtaining and sharing information functions as an intervening step in the process where social inequality factors such as education lead to chronic disease knowledge gaps in a local community context. With random samples of African Americans and Latinos in Los Angeles, the authors found that access to community-based communication resources plays a mediating role in the case of breast cancer and diabetes knowledge, but not in hypertension and prostate cancer knowledge. The authors discussed these findings on the basis of communication infrastructure theory and knowledge-gap hypothesis.

Assessment of hypertension control in a district of Mombasa, Kenya

As populations move to urban centres across East Africa, lifestyle habits that affect cardiovascular disease have changed, affecting non-communicable disease risk. In particular, the prevalence of hypertension, and associated awareness of this life-threatening condition, has not been studied in Mombasa, Kenya. This paper assesses the rates of prevalence, awareness, treatment and control of hypertension in Old Town, an urban district of the coastal city. We surveyed 469 subjects, gathered via a clustered sampling technique. Age-adjusted prevalence of hypertension was measured at 32.6% (±2.2) for adults over 18 and was linearly related to age. Results indicate that hypertension awareness was associated with age and sex, as women were substantially more likely to be aware of and to control their hypertension. Only 23.2% (±2.0) of subjects had knowledge of both the causes of and practical solutions to hypertension, and practical hypertension knowledge was associated with hypertension awareness and gender (women had higher rates of knowledge than men). These results indicate that hypertension is a real public health concern in Old Town, and that younger individuals, particularly males, are least likely to be aware of the dangers of hypertension. Public health measures should focus on this population.