Exploring Knowledge of Hypertension and Treatment Adherence in Hypertensive Patients From Lahore, Pakistan

Objective This study aims to explore key factors influencing hypertension management, including demographic (e.g., age, gender, education level), clinical (e.g., presence of comorbid conditions), and behavioral influences (e.g., medication adherence, lifestyle choices such as diet and exercise). The study seeks to provide specific insights into the gaps in knowledge of hypertension and treatment adherence and identify potential barriers to effective treatment and lifestyle modifications. Methods This study was carried out in the Departments of Medicine and Cardiology at Chaudhary Muhammad Akram Teaching and Research Hospital, Azra Naheed Medical College, Superior University, Lahore, Pakistan, from November 2024 to February 2025. A total of 252 hypertensive patients, diagnosed for at least six months, aged ≥18 years, and of both genders, were enrolled using a nonprobability consecutive sampling technique after informed consent. Patients were excluded if they were unable to complete the questionnaire, had hypertensive emergencies, were critically ill or in the ICU, had an active myocardial infarction or stroke, were undergoing hemodialysis, or had a pre-existing psychiatric illness. A structured questionnaire was completed by the patients, collecting details including demographic and clinical information, the 12-item Hypertension Knowledge Test (HKT), and a 10-item domain regarding practices of hypertension control and treatment adherence. Both these questionnaires have been validated in previous studies. All data were entered into IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York) for statistical analysis. Results The mean age was 47.6±12.9 years, with 133 (52.8%) participants aged ≥45 years. The majority were female (154, 61.1%). Of the 252 patients, 201 (79.8%) were married, 136 (54.0%) had ≤5 years of education, and 152 (60.3%) were employed. The mean duration of hypertension was 7.7±6.0 years, with 146 (57.9%) having hypertension for ≥6 years. Diabetes mellitus was present in 134 (53.2%), ischemic heart disease in 94 (37.3%), and chronic kidney disease in 28 (11.1%). A positive family history of hypertension was reported in 179 (71.0%). The mean HKT score was 7.1±2.0, with the majority (203, 80.6%) having poor knowledge. A significant statistical association of good knowledge was seen with younger age (p <0.001), being unmarried (p = 0.001), being educated (p <0.001), being employed (p <0.001), duration of hypertension ≤5 years (p = 0.039), absence of ischemic heart disease (p = 0.002), absence of chronic kidney disease (p = 0.024), and having a positive family history (p <0.001). No association was seen with gender (p = 0.336) or diabetes mellitus (p = 0.053). Regarding medication adherence, 26 (10.3%) always forget to take their medication, while 65 (25.8%) do so most of the time. In terms of healthcare management, 68 (27.0%) always make their next doctor's appointment before leaving the office, while 99 (39.3%) do so most of the time. However, 21 (8.3%) have missed a scheduled appointment, and 54 (21.4%) do so most of the time. Conclusion This study underscores a significant gap in knowledge of hypertension and suboptimal adherence to treatment among hypertensive patients and highlights the need for educational programs and strategies to promote treatment adherence, especially among older patients and those with lower educational levels.