Cardiovascular disease risk Reduction Behavior, Knowledge and Risk Perception of Adult hypertensive patients in Addis Ababa, Ethiopia.
No Thumbnail Available
Date
2023
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Ababa University
Abstract
Background: Adverse cardiovascular disease (CVD) outcomes among hypertensives are
determined by several key patient factors such as knowledge, self-risk perception of CVD
outcomes, and patients’ risk reduction behaviors. Cardiovascular disease remains the leading cause
of death and disabilities worldwide. Uncontrolled hypertension is a major and well-established
risk factor for adverse CVD outcomes resulting in high morbidity and mortality. These outcomes
could largely be prevented if the patients possess good working knowledge, accurate risk-
perception, and consistently engage in risk reduction behaviors. However, despite the widely
prevalent behavioral risks for adverse CVD outcomes among hypertensives in Ethiopia, the
patients’ risk reduction behavioral status, knowledge, and risk-perception are largely unknown.
Therefore, the purpose of this study was to examine CVD risk reduction behaviors and their
determinants among adult hypertensives.
Objective: The general objective of the study was to determine the status of CVD risk reduction
behaviors and its associations with sociodemographic and clinical profiles, knowledge, and risk
perception of adult hypertensives attending follow-up at a tertiary hospital in Addis Ababa,
Ethiopia.
Method and Materials: A cross-sectional design was used. A sample of 384 hypertensives was
selected using a systematic random sampling technique from the hypertension clinic registry. Epi
data version 3.10 was used for managing the data, and SPSS version 25.0 was used for analysis.
Descriptive statistics were used to determine participants’ CVD risk reduction behavioral status.
Bivariate chi-square tests and ordinal logistic regression analyses were run to identify variables
associated with participants' ranked CVD risk reduction behavioral status at the p-value < .05
cutoff for statistical significance.
Result: Of the total of 384 study participants, 377 (98.18%) were included in the analysis. The
mean age (±SD) was 53.61 ± 12.80-year, range (30-82 years), 51.2% were males, Three-fourths
(75.3%) were married, and 42.7% had less than high school education. The mean (±SD) duration
of HTN was 8.01 ± 6.07 years. Nearly three-quarters (72.1%) of them were attending bi-monthly
follow-up care for HTN. Less than half (45.1%) achieved target BP control.
xiii
Fewer than half (58.62%) of the participants had adequate knowledge of CVD risk factors (mean
[±SD], 19.92 ± 3.40, range: 7-26). The majority (58.62%) of the participants had a low subjective
risk perception of CVD events. Approximately three-fourths (72.4%) had a moderate nl-FRS 10
year CVD risk estimated. Agreement between participants perceived-risk and the nl-FRS was poor
(kappa = 0.0002, standard error = 0.023, p =0.99) with a high (76%) CVD risk-perception
inaccuracy primarily due to underestimation. The majority (56.5%) of them were at low CV risk
reduction practices. The absence of comorbidities (p < .001), clinic visits every 3 months for
hypertension (p = .041), normal body mass index (p = .008), hypertension duration of 5–9 years
(p = .034), and young age adults (p = .041) were the characteristics statistically significantly
associated with the high CVD risk reduction practice.
Conclusion: Participants’ CVD risk reduction practice was low with a variety of unmanaged risk
factors and few cardioprotective behaviors. The absence of co-morbidities, maintaining a healthy
weight, having HTN for 5–9 years, scheduled clinic visits every three months, and being a young
adult were predictive of high-risk reduction behaviors. Target blood pressure control was lower,
particularly among overweight and obese hypertensives, and with comorbid diabetes and chronic
kidney disease. Although about half of participants had adequate knowledge of CVD risk factors
most had inaccurate and low subjective risk perceptions of CVD events compared to moderate
objective risks identified using the nl-FRS. Planned education on HTN and CVD risk factors is
essential to improve patients’ CVD risk perception and behavioral adoption to reduce adverse
CVD events
Description
Keywords
Hypertension, blood pressure control, clinical profile, comorbidity, body mass index, risk perception.