Knowledge, attitudes and practices related to hypertension among residents of a disadvantaged rural community in southern Zimbabwe

BACKGROUND: Hypertension contributes significantly to cardiovascular and renal diseases. It can be controlled by lifestyle modifications, however in poor communities there is lack of awareness, and treatment and control of hypertension is often poor. The aim of this study was to determine hypertension knowledge, attitudes and practices in a disadvantaged rural community in Matebeleland South province of Zimbabwe. METHODS: We conducted a descriptive cross-sectional survey on hypertensive patients in the community. A pre-tested and validated interviewer-administered questionnaire was used to collect demographic, awareness, treatment and control data among consenting hypertensive patients. RESULTS: 304 respondents were enrolled into the study (mean age, 59 years), and a majority were women (65.4%). The treatment default rate was 30.9%, and 25% of respondents on medication did not know their blood pressure control status. Knowledge on hypertension was poor, with 64.8% of respondents stating that stress was its main cause, 85.9% stated that palpitations were a symptom of hypertension and 59.8% of respondents added salt on the table. The more education respondents had received, the more likely they were knowledgeable about hypertension (odds ratio for secondary education, 3.68 [95% CI: 1.61–8.41], and for tertiary education, 7.52 [95% CI: 2.76–20.46], compared to those without formal education). Those who believed in herbal medicines (50.7%) and those who used traditional medicines (14.5%) were 53% (95% CI: 0.29–0.76) and 68% (95% CI: 0.29–0.76) less likely to be knowledgeable about hypertension compared to those who did not believe in or use traditional medicines, respectively. CONCLUSION: Members of the community had poor knowledge on hypertension. This was associated with a lack of education and with strong beliefs in herbal and traditional medicines in the community, which influenced attitudes and practices on hypertension. Dietary risk factors were linked to poor knowledge. Hypertensive medicine shortages at the clinic resulted in worsened hypertension care and poor hypertension outcomes in the community.