Knowledge and lifestyle practices of hypertensive patients attending a primary health care clinic in Botswana

Abstract

Background: Hypertension is a significant public health problem in many developing countries experiencing epidemiological transition from communicable to non-communicable chronic diseases. The World Health Organization reports that the number of people with hypertension worldwide is estimated at 600 million, of whom 3 million will die annually as a result of hypertension. According to the world health report, hypertension has been identified as the third ranked condition that reduces life expectancy. In the year 2000, there were 972 million people living with hypertension worldwide, and it is estimated that this number will escalate to more than 1.56 billion by the year 2025. The aim of this quantitative cross-sectional descriptive survey was to assess the lifestyle practices of patients with hypertension who were attending a primary health clinic in Botswana.

Methods: A quantitative cross-sectional descriptive survey was conducted among patients with hypertension attending Extension II clinic for follow-up care in Gaborone. A self-administered questionnaire translated from English to Setswana (local language) consisting of both closed and open-ended questions was used to collect data.

Results: A total of 446 participants were recruited, of which 293(65.9%) were females and 285 (63.9%) were aged greater than 40 years. 219(49.1%) of the participant reported a family history of hypertension. Among those, 171(78%) stated that their biological parents had hypertension, 31(14.1%) stated that it was their grandparents and only 8(3.7) indicated others (like their uncles/aunts). Such findings indicate a possible contribution of the family disposition to the prevalence of hypertension. The results showed that non-smokers were however more likely to know more about HPT than smokers (OR = 1.995; CI: 0.639 – 6.225).

Participants’ level of knowledge varied from average to high as almost all of them 96% and 97% gave a correct response for practices related to prohibiting/preventing smoking and reducing the levels of stress respectively. Only 37% of the participants scored greater than75% for assessment of their knowledge regarding the acceptable lifestyle practices for persons with hypertension and cumulatively 59% can be rated as having acceptable knowledge of lifestyle practices in relation to their chronic disease.

A significant relationship between alcohol intake and knowledge of hypertension (2 = 4.140; p = 0.002). Further analysis showed that participants who reported not to drink alcohol had a higher level of knowledge score (39%) compared to those who confirmed to consume alcohol (25%). A majority (91%) of those who reported to be trying to lose weight had a good knowledge of hypertension. Also, a negative association was revealed between participants’ knowledge of hypertension and gaining weight recently (2 = 1.171; p = 0.279). This finding could imply that participants’ knowledge of hypertension was not adequate to enable them to make healthy choices about weight management.

Conclusion: This study confirms that a relation exists between the knowledge of hypertension, demographic factors and lifestyle practices among participants. Thus, hypertension is a chronic but preventable disease; and thus adequate knowledge of the disease and lifestyle modification are important features in its effective control and management.