Barriers to hypertension prevention and control: insights from the «FOREST» art therapy trail project

Hypertension remains a prevalent health issue in Russia, characterized by insufficient public awareness and incomplete management. Identifying the barriers to the prevention and control of hypertension is crucial for enhancing public health strategies. Objective. To analyze the barriers to the prevention and control of hypertension by examining a specific cohort of the Russian population who participated in the Art and Therapy Trail «LES» research initiative. Materials and methods. Qualitative research was conducted as part of the Art and Therapy Trail «LES» project. A sample of 956 individuals (72.4% female; mean age of 40.2±11.6 years; with 91.2% holding higher education degrees) participated in the study. Blood pressure (BP) measurements were taken before and after the trail walk. Healthcare professionals gathered data on participants’ understanding of BP reference values, history data of hypertension, medications, and therapeutic compliance. The analysis involved descriptive statistics, with qualitative findings categorized according to the hypertension control cascade. Results. The study revealed a significant lack of knowledge and preventive measures among both individuals without hypertension and those previously unaware of their elevated blood pressure. Participants exhibited misunderstandings regarding BP reference values, misinterpretations of readings from different arms, and distrust towards electronic blood pressure monitors. Notable differences were observed by gender and age, with women and individuals aged 18—25 showing greater interest in health assessments. Among those diagnosed with hypertension, challenges included non-adherence to prescribed therapy, irregular self-monitoring of blood pressure, and a passive approach toward reaching target BP levels. Conclusions. The findings of this research systematically identified the barriers to the prevention and management of hypertension from three principal perspectives: a deficit in health literacy, inadequacies in preventive measures, and low therapeutic adherence. The study outlines strategic directions aimed at alleviating the burdens associated with hypertension, including: enhancing public awareness of the importance of blood pressure monitoring, facilitating access to blood pressure measurement outside of clinical settings, engaging healthy individuals in routine health assessments, improving treatment adherence, and leveraging digital health services to bolster the ongoing care of patients diagnosed with hypertension.