Control of High Blood Pressure in Gavar Region: Knowledge, Attitude and Practice (KAP) Survey of Hypertensive People

Abstract

Background: Hypertension is one of the preventable leading risk factors for cardio vascular disease (CVD) and mortality worldwide. The prevalence of hypertension continues to increase in low- and middleincome countries including Armenia, where it reached 3,684.4 per 100,000 people in 2011. Healthy lifestyle and treatment adherence can significantly reduce the burden of hypertension. Aim of the Study: The aim of this study was to assess the knowledge, attitude and practice of non-drug control of hypertension and the level of adherence to hypertension drug therapies among people who had self-reported hypertension in Gavar region of Gegharkunik marz. In addition, the study evaluated the perceived risk for cardiovascular disease among hypertensive people living in Gavar. Methodology: The study utilized a cross-sectional study design with telephone interviews. Stratified systematic random sampling was used to select potential respondents. Study population included hypertensive adults living in Gavar region. Sample size of the study was 236. The study team developed the study instrument based on questionnaires used in similar studies internationally. It included 5 domains: knowledge, attitude, and practice of non-drug control of hypertension, drug treatment adherence, and respondents’ demographic characteristics. Results: From 631 contacted households 307 (48.65%) had at least one hypertensive family member. The mean percent knowledge score was 50.23%, and the mean percent attitude score was 64.05%. The mean percent knowledge and attitude scores were significantly associated with education in adjusted analysis, with more educated respondents having higher knowledge and attitude scores. The lowest percent scores were recorded for practice domain (16.87%). Women and people in older ages had higher mean percent practice scores. Only 31.5% of participants adhered to drug treatment. The main reasons for not taking medication included feeling better and not continuing the treatment (51.3%), followed by not being able to buy medicines (28.7%), and forgetting to take them (25.2%). Forty-two percent of respondents were not able to assess their risk of developing CVD. About 30% of participants at second stage of hypertension perceived their risk of CVD as low. Conclusion: This was the first study which assessed KAP of non-drug control of hypertension, drug treatment adherence, and perceived CVD risk among hypertensive people in Gavar region. The study found inadequate levels of knowledge and practice of non-drug control of hypertension, along with poor adherence to drug treatment and inability to assess personal CVD risk or incorrect assessment of risk in the hypertensive respondents. The study revealed the need for educational programs to increase awareness of hypertensive people about the importance of both non-drug and drug control of hypertension. Broader interventions are necessary to bring positive behavioral changes not only among hypertensive people, but also in their families.