Understanding Knowledge and Perception of Hypertension in Rural Zambia: A Population-Based Study

Abstract Introduction Hypertension poses a significant challenge in sub-Saharan Africa, with Zambia reporting a 32% prevalence in 2019. However, there is a presumed lack of knowledge among residents due to inadequate preventive education. This study aims to describe the knowledge and perception of hypertension among rural residents in Zambia. Methods This cross-sectional study employed rigorous probability sampling. We recruited 690 residents aged 25-64 from the Mumbwa district using a multistage, clustered, household sampling method for surveys and measurements conducted from May to July 2016. Data analysis considered the complex sampling design. Results Males accounted for 48.6%, with a mean age of 41.9 (SE 0.6). The prevalence of hypertension was 36.5%, with only 37.1% of those aware of their condition. 98.0% perceived hypertension as common, 71.8% expressed concern, and 62.9% deemed it a more serious health risk than HIV. Stress (85.3%) and dietary habits (excessive oil 51.8%, salt 47.5%, sugar 42.4%, poor diet 31.5%) were recognized as the risks. Perception of smoking and physical inactivity as risk factors was low, at 14.9% and 22.7%, respectively. Regarding hypertension prevention, 73.9% believed it to be preventable, mainly through dietary improvements (69.0%), medication (51.1%), and exercise (36.0%). Perception of smoking cessation and alcohol abstinence was 18.0% and 1.4%, respectively. Only 20.4% had prior hypertension education. Conclusions This study reveals residents’ concerns about hypertension and their perception of dietary improvements as preventive measures. However, there was a notable gap in perceiving stress as a preventable risk factor, along with limited awareness of smoking and alcohol as risk factors. Comprehensive health education programs in rural Zambia are necessary to address these gaps, emphasizing lifestyle changes such as stress reduction, smoking cessation, and reducing alcohol consumption to enhance hypertension awareness and prevention. Key messages • Participants show a strong awareness of hypertension, perceiving it as a serious health risk and recognizing common factors such as stress and poor dietary habits. • There is a lack of awareness concerning smoking and physical inactivity as risk factors, emphasizing the necessity for comprehensive education to promote preventive measures.