Knowledge, attitudes, and practices (KAP) toward stroke prevention among hypertensive patients in Egypt: a multicenter cross-sectional study

Abstract Stroke is the second most common cause of death worldwide and represents a major health concern in Egypt. Hypertension is the most important modifiable risk factor for stroke; we aim to assess knowledge, attitudes, and practices (KAP) toward stroke prevention among hypertensive patients in Egypt. A cross-sectional, multicenter study recruited 700 hypertensive patients from June to November 2025 in university hospitals across urban governorates, Lower Egypt, and Upper Egypt using a stratified proportional allocation approach. Data were collected through face-to-face interviews with a validated questionnaire. KAP scores were classified as adequate (≥ 75%) or inadequate (< 75%). Descriptive statistics, Spearman correlations, and logistic regression analyses were performed. Most participants showed adequate knowledge (67.9%) and adequate attitudes (83%) toward stroke prevention; however, only 33.7% reported adequate preventive practices. Significant geographic disparities were observed. Participants from Lower Egypt (AOR = 3.3; 95% CI = 2.2 to 5.0; p < 0.001) and urban governorates (AOR = 2.9; 95% CI = 1.7 to 4.8; p < 0.001) were more likely to have adequate knowledge than those from Upper Egypt, while adequate preventive practices were more common among participants from urban governorates (AOR = 2.0; 95% CI = 1.2 to 3.2; p = 0.004). Higher educational level, controlled blood pressure, and prior awareness of stroke were significantly associated with KAP domains. Attitude showed a stronger correlation with practice (r = 0.424) than knowledge with practice (r = 0.334). Hypertensive patients in Egypt have adequate knowledge and attitudes toward stroke prevention; however, these do not consistently translate into adequate preventive practices. Public health interventions should prioritize behavioral change, address regional disparities, and implement targeted community-based programs to improve stroke prevention practices.