Abstract

Background: Poorly controlled hypertension has serious health and economic consequences. Patient’s proactive engagement with improved knowledge, perceived seriousness and behavior regarding drug compliance and lifestyle modification remains the most effective strategy to control high blood pressure. This study tried to produce evidence on knowledge and perceived seriousness of hypertension, as well as lifestyle modification measures among patients with high blood pressure. Evidence of this study informs the ministry of health to design appropriate strategy on modifiable risk factors against hypertension.
Methodology: A facility based cross-sectional study was conducted in February 2017 among sample of 423 adult patients with high blood pressure who visited hypertension follow up clinics of six purposely selected health centers with high caseload in Addis Ababa. Data on socio-demographic, general health status, knowledge, perceived seriousness and lifestyle modification were collected using structured interviewer-administered questionnaire, and analyzed using SPSS version 20 software for windows to describe findings and examine possible associations through logistic regression.
Result: 242 (57%) hypertensive patients had good knowledge of hypertension, with mean score of 14 (SD ± 3) out of nineteen questions; 189 (44.7%) had favorable perceived seriousness towards hypertension with mean score of 8.2 (SD ± 1.5) out of ten questions; and 192 (45%) had favorable lifestyle related to hypertension risk factors with mean score of 2.5 (SD ± 0.9) out of six questions. Educated patients were two times more likely to have good knowledge about hypertension than those with no formal education. Housewives were 79% more likely to have good knowledge than farmers, daily laborers and the unemployed. Moreover, those who received counseling from health care providers were two times more likely to have good knowledge about life style risk factors than those who didn’t receive counseling. When looking at the relationship between perceived seriousness and patients’ knowledge of hypertension, those who perceived that high blood pressure could disable or kill were three times more likely to have good knowledge about lifestyle risk factors compared to those who did not perceive the seriousness of high blood pressure. Patients less than forty years of age were 39% and 24% more likely to have good lifestyle modification compared to age group between 41-60 and over 60 years, respectively. Those who were married and living together were 60% more likely to have good lifestyle modification than those who were divorced or widowed. Patients who accessed information from other sources were 1.5 times more likely to have good lifestyle modification than those who didn’t access information. Family history of hypertension was positive predictor for good knowledge at bivariate level but lost its significance at multivariate analysis.
Conclusion: The overall perceived seriousness towards hypertension and practice related to modifying lifestyle risk factors was inadequate, though knowledge on hypertension was relatively better. Level of knowledge did not significantly associate with level of perceived seriousness. Even when patients perceived the seriousness of their disease, appropriate lifestyle modification was not evidenced. Health care providers’ counseling was found to predict level of knowledge, perceived seriousness and lifestyle modification.

Keywords: Ethiopia; Knowledge; Perceived seriousness; Lifestyle risk factors; Hypertension