Association between hypertension awareness and preventive health behaviors among healthcare workers: evidence from the SHAHWAR study

Current evidence does not clearly support an association between hypertension awareness and improved cardiovascular outcomes. This study aimed to investigate the relationship between awareness of high blood pressure and adoption of healthy lifestyle behaviors among healthcare workers (HCWs) in Iran. We analyzed cross-sectional data from 1,178 HCWs enrolled in the SHAHWAR cohort study. Anthropometric measurements, blood pressure assessments, structured health interviews, and physical examinations were conducted by trained investigators. Multivariable logistic regression models were applied to evaluate the association between hypertension awareness and preventive behaviors, including salt intake, smoking status, physical activity, and body mass index (BMI). Among the 1,178 participants (58.7% women; mean age 39.4 ± 7.8 years), the prevalence of hypertension was 27% (age-standardized: 29.2%). Hypertension was significantly more prevalent in men than in women (38.8% vs. 19.0%, p < 0.001) and increased with age. Awareness (38.2% vs. 26.5%, p = 0.028) and control (85.1% vs. 58.1%, p = 0.004) of hypertension were significantly higher among women and younger individuals. Smoking and BMI ≥ 25 were more common among hypertensive individuals compared with non-hypertensive individuals (9.7% vs. 4.5%, p = 0.001; and 72.3% vs. 27.7%, p < 0.001, respectively). Smoking was not associated with hypertension awareness, treatment, or control. However, blood pressure control was significantly poorer among participants with BMI ≥ 25. Among women, hypertension awareness was associated with a higher proportion of individuals with BMI < 25 (36.0% vs. 18.8%; p = 0.028). Similarly, among participants younger than 38 years, awareness was linked to a higher prevalence of BMI < 25 (51.2% vs. 25.9%; p = 0.011) and lower salt intake (75.6% vs. 53.7%; p = 0.028). Despite their medical knowledge and professional status, hypertension awareness among HCWs does not appear to exceed that of the general population. The findings highlight suboptimal adherence to healthy lifestyle behaviors among HCWs with hypertension and emphasize the need for more effective lifestyle counseling and targeted educational interventions.