Knowledge of hypertension and understanding of home blood pressure monitoring among hypertensive patients in India: results from the GRAND Study

Home blood pressure monitoring (HBPM) is recommended for the management of hypertension; however, patients' understanding of hypertension and HBPM remains insufficient. This multicenter cross-sectional study assessed knowledge of hypertension and HBPM among 1920 patients receiving pharmacological treatment across 12 states in India and identified factors associated with relatively higher knowledge. Knowledge was evaluated across four domains: understanding of clinic and home blood pressure (BP) thresholds, awareness of causes of hypertension, recognition of risks associated with uncontrolled BP, and awareness of the benefits of HBPM. The median knowledge score was 1 (range 0-7), indicating generally low knowledge. Knowledge varied across domains, with particularly poor understanding of BP thresholds and limited awareness of HBPM benefits, while awareness of causes and complications was relatively higher but still insufficient. Relatively higher knowledge (≥75th percentile) was observed in 38.0% of participants and was more common among participants with prior HBPM experience than among those without prior HBPM experience (46.9% vs. 29.9%, p < 0.001). Higher education, type of healthcare facility, and prior HBPM experience were associated with relatively higher knowledge. These findings suggest that knowledge of hypertension among patients in India is limited and domain-specific, with critical gaps in areas essential for interpreting and utilizing BP measurements. Improving hypertension management may require not only promoting HBPM but also strengthening patient education. Clinical trial registration status: Registered at Clinical Trials Registry-India (CTRI) under CTRI/2023/02/049486 on 06 February 2023.