It is estimated that at least one in four adults in India has hypertension [1], but, only about 12% of them have their blood pressure under control [2]. Overall prevalence for hypertension in India was 29.8% (95% confidence interval: 26.7–33.0). Significant differences in hypertension prevalence were noted between rural and urban parts [1-3].

Hypertension confers the highest attributable risk to deaths from cardiovascular disease and epidemiological data provide convincing evidence that the risk of cardiovascular disease related to blood pressure is graded and continuous. This risk is evident even in childhood; with elevated blood pressure predicting hypertension in adulthood and adverse effects of elevated blood pressure in childhood on vascular structure and function, specifically left ventricular hypertrophy, are already apparent in youth [4].

Educating the public about risk factors for hypertension and preventative measures allows them to make their own decisions about whether to live a healthy lifestyle. Both policymakers and public health practitioners need accurate and reliable data on the prevalence and risk factors of hypertension-related health issues in the general population. These data are necessary to develop, implement and evaluate efficient intervention programmes [5].

Knowledge of the predisposing risk factors is vital in the modification of lifestyle behaviors conducive to optimal cardiovascular health. Measuring and appropriately disseminating knowledge of the modifiable risk factors at an early age is an essential preventive educational approach. Strategies to achieve even a modest lowering of the levels of blood pressure in the population are therefore important public health goals [4,5].

A number of studies conducted in different parts of India reveal widespread ignorance about the Hypertension among people. As this disease largely relies on prevention and the right information at the right time is essential to bring about a behavioral change when the population is most receptive. Hence, this study was undertaken with the objective to assess the knowledge of risk and preventive factors for Hypertension among OPD patients attending Primary Health Center, Dhanot of District Kangra. 

Objectives of the Study

To evaluate the knowledge of patients attending OPD towards risk and preventive factors for Hypertension among OPD patients attending Primary Health Center, Dhanot of District Kangra.

Research Methodology

• Research Approach-Descriptive

• Research Design-Descriptive survey design

• Setting of the study-OPD at Primary Health Center, Dhanot of District Kangra 

• Study duration- between Aug-December 2020

• Study population-OPD patients attending Primary Health Center, Dhanot of District Kangra 

• Sample size-400 OPD patients assuming 50% have adequate knowledge regarding Hypertension, 5% absolute error, 95% confidence level and 5% non-responses rate

• Sampling Technique-convenience Sampling Technique

• Sampling criteria-first five adult patients attending the OPD of Primary Health Center, Dhanot of District Kangra everyday were selected till the completion of sample size after explaining the purpose of the study. Informed consent was taken from them and confidentiality of the selected participants was also maintained

• Inclusive Criteria- Patients selected during the day of data collection in study setting and who were willing to participate in the study

• Exclusion Criteria: Patients who were not willing to participate in the study 

• Development of Tool-Knowledge related questionnaires

Description of Tool

Section A-Socio-demographic characteristics of the patients (Age, Gender etc.).

Sections B-Questions regarding knowledge of risk and preventive factors for Hypertension:

• Validity of tool - by the experts in this field

• Permission-obtained from the concerned head of the civil hospital

Data collection by myself and patients was given 5 minutes time to complete that questionnaire and collected at the end of the prescribed time.

Data analysis with appropriate statistical test in terms of frequencies and percentage.

The present study was Non-experimental descriptive study carried out to evaluate knowledge of risk and preventive factors for Hypertension at Primary Health Center, Dhanot of District Kangra. 

In the present study 38% (152) of the Patients fall were below 40 years of age while 62% (248) were above 40 years. 53% (212) of patients were male and 47% (188) were female.

In the Table 1, 239(59.75%) participants told the Alcohol was a risk factor for Hypertension followed by 278(69.5%) Unhealthy diet, 327(81.75%) Increase salt Intake, 167(41.75%0 Family History/Genetic, 223(55.75%) Poor Sleep, 232(58%) Ageing, 321(80.25%) Lack of physical activity/Exercise, 301(75.25%) Obesity, 202(50.5%) Smoking and 49 (12.25%) didn’t know about any risk factor for hypertension.

In the Table 2, 329(82.25%) participants told that Reduce salt Intake is the preventive measure for hypertension followed by, 265(66.25%) Increase fruit intake, 289(72.25%) Eat healthy food, 310(77.5%) Stop Alcohol Intake, 298(74.5%) Regular Exercise & yoga, 278(69.5%) Maintenance of ideal weight, 289(72.25%) Have sound sleep, 178                (44.5%) Stop Smoking, 212(53%) Avoid Stress and 41(10.25%) didn’t know about any preventive measure for hypertension.

Table 1: Knowledge about risk factors of Hypertension among participants

Table 2: Knowledge of participants towards Prevention of Hypertension

The adoption of healthy lifestyle adjustments and other preventative measures may be hampered by a lack of awareness of the risk factors for hypertension. Therefore, many preventative health actions seem to be influenced by a knowledge-based appraisal of one's own risk for hypertension.

Many participants in this study were unable to correctly identify more than two risk factors or preventive strategies for hypertension. Education level could be a factor in this ignorance. The public's profound ignorance about hypertension may also be reflected in their inability to identify risk factors and symptoms. It is likely to have detrimental effects on hypertension prevention or early diagnosis. The economies of emerging nations may likewise be severely harmed by it. This study highlights how vital it is to increase people's education and awareness of hypertension, especially in Himachal Pradesh. Studies from India had demonstrated that in order to achieve treatment recommendation compliance, multiple exposures to information on healthy lifestyles were required [6,7].

In nations like India, where the prevalence of hypertension is rising, there are no facilities for such integrated patient education modalities. The first stage in the fight against the disease is raising knowledge of the condition, its risk factors and preventive actions. A organised national campaign for raising knowledge of the disease should be viewed as a public health priority for nations like India, which suffer from a significant burden of hypertension [3,8].

Limitations

Due to the questionnaire's use of unrestricted open-ended questions rather than specific risk factor mentions, we may have underestimated the level of knowledge. However, we think that this particular question style made it possible to identify the most well-known hypertension risk factors and countermeasures.

Even still, many respondents were unaware about the causes of hypertension as well as its risk factors. The need for well-designed health education initiatives at the community level for the primary prevention of hypertension is supported by a number of study findings. The programme should take into account each person's distinctive circumstance, accommodate interpersonal variation and specifically take into account the demands of the local elderly and undereducated population.

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5. Carey, R. M., et al. "Prevention and control of hypertension: JACC health promotion series." Journal of the American College of Cardiology, vol. 72, no. 11, 2018, pp. 1278–1293.

6. Islam, S.M., et al. "Prevalence of risk factors for hypertension: A cross-sectional study in an urban area of Bangladesh." Global Cardiology Science & Practice, vol. 2015, no. 4, 2015, p. 43.

7. Chimberengwa, P.T. and M. Naidoo. "Knowledge, attitudes and practices related to hypertension among residents of a disadvantaged rural community in Southern Zimbabwe." PLoS ONE, vol. 14, no. 6, 2019, p. e0215500.

8. Mirzaei, M., et al. "Awareness, treatment and control of hypertension and related factors in adult Iranian population." BMC Public Health, 2020, pp. 667–676.