Purpose Knowledge of hypertension risks and consequences can equip patients with the motivation and skills necessary to reduce their blood pressure. However, this knowledge is thought to be limited in indigent, minority populations.
Methods Between January and August 2005, a trained interviewer administered a telephone questionnaire to 296 patients identified from an urban public hospital primary care clinic. Blood pressure knowledge was assessed through a validated 10-item/10-point questionnaire and included items measuring patient understanding of the prognosis, treatment, and adverse outcomes of hypertension.
Results Overall, 12% (n = 34) of patients answered all 10 questions correctly. Only 8% (n = 23) answered less than half of the questions correctly. Among participants, 98% (n = 290) and 95% (n = 281) of patients knew that high blood pressure was associated with heart attacks and stroke, but only 76% (n = 226) knew it caused kidney disease. Only 42% (n = 124) of respondents knew that high blood pressure did not cause cancer; 8% (n = 24) responded they thought hypertension did cause cancer and 50% (n = 148) were uncertain. A logistic regression model was performed adjusting for age, race, gender, and including time since hypertension diagnosis, comfort asking their doctor questions, having dependents, income level, cigarette smoking, cohabitation status, and education. The odds ratios (95% confidence interval (CI)) of having limited blood pressure knowledge (score # 7 versus $ 9) were 2.4 (1.1-5.0) for patients > 60 compared to # 50 years, 5.2 (1.7-15.7) and 3.0 (1.4-6.3) for patients who were first diagnosed with hypertension < 1 year and 1-5 years ago, respectively, compared to > 10 years ago, and 2.3 (1.2-4.3) for patients with less than a high school education compared to completion of high school.
Conclusions Knowledge of high blood pressure in these patients receiving care in an urban public health system is good, except in specific areas, such as its relationship to chronic kidney disease. Older patients and those with less formal education are most at risk for insufficient hypertension knowledge. Targeting hypertension education content to select areas and audiences may improve efficiency and effectiveness of hypertension education in urban, minority populations.
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