EVALUATION OF HYPERTENSION AWARENESS AND TREATMENT ADHERENCE
DOI:
https://doi.org/10.46827/ejphs.v9i2.260Keywords:
hypertension, treatment adherence, health literacy, physician-patient relations, complementary therapiesAbstract
Background and Objectives: The aim of this study was to determine hypertension (HT) awareness in the adult population, to identify symptom-oriented misconceptions in illness perception, and to examine the effects of sociodemographic factors (gender, educational status) on medical treatment adherence and the use of traditional methods. Materials and Methods: This cross-sectional and descriptive study included 343 adult participants (180 males, 163 females) residing in Samsun province. Data were collected via a structured questionnaire inquiring about the participants' sociodemographic characteristics, epidemiological HT awareness, and the treatment adherence of 131 patients diagnosed with HT. Pearson Chi-square and Fisher's Exact tests were used for statistical analyses. Results: The prevalence of physician-diagnosed HT in the sample was found to be 38.2% (n=131). Although 74.3% of the participants knew the diagnostic threshold (140/90 mmHg), 69.4% identified "headache" as the primary symptom. Even though 87.8% of the HT patients knew that medications should be taken every day, the rate of regular medication adherence remained at 65.6%. Of the patients, 12.2% took their medications only when they were symptomatic, and 63.4% used garlic/lemon as an alternative treatment. Although the rate of knowing disease complications increased with higher education levels, the habit of adding salt without tasting the food was most common (66.5%) among university graduates. It was determined that male patients attended outpatient control visits more regularly (p=0.025) and received more information from physicians regarding medication side effects (p=0.014) compared to female patients. Conclusion: Although theoretical awareness regarding HT is high in the community, this does not always translate into treatment adherence and proper lifestyle modifications. The tendency of patients to manage an asymptomatic chronic disease like a symptom-oriented (headache) acute condition, and their inclination towards traditional methods, are major barriers. To enhance therapeutic success, there is a need to strengthen patient-physician communication in the clinic and to implement behavioral interventions.
References
Farrar J, Frieden T. WHO global report on hypertension 2025. The Lancet. 2025 Nov 15;406(10517):2318–9. doi:10.1016/S0140-6736(25)02208-1
Mishra SR, Satheesh G, Khanal V, Nguyen TN, Picone D, Chapman N, et al. Closing the Gap in Global Disparities in Hypertension Control. Hypertension. 2025 Mar;82(3):407–10. doi:10.1161/HYPERTENSIONAHA.124.24137
Cheraghi Z, Azmi-Naei B, Cheraghi P, Doosti-Irani A. The global prevalence of uncontrolled hypertension: a systematic review and meta-analysis. BMC Public Health. 2025 Dec 17;25:4259. doi:10.1186/s12889-025-25553-4
Sengul S, Akpolat T, Erdem Y, Derici U, Arici M, Sindel S, et al. Changes in hypertension prevalence, awareness, treatment, and control rates in Turkey from 2003 to 2012. J Hypertens. 2016 Jun;34(6):1208–17. doi:10.1097/HJH.0000000000000901
Erdem Y, Arici M, Altun B, Turgan C, Sindel S, Erbay B, et al. The relationship between hypertension and salt intake in Turkish population: SALTURK study. Blood Press. 2010 Oct;19(5):313–8. doi:10.3109/08037051003802541
Bayram F, Demi̇r Ö, Sabuncu T, Eren MA, Gedi̇k AV, Çorapçioğlu D, et al. Prevalence and Awareness of Hypertension in Seven Distinct Geographic Regions of Turkey: The SEMT HT Study. Endocrinol Res Pract. 2021 Mar 1;25(1):1–10. doi:10.25179/tjem.2020-78532
Castillo AD, Godoy-Izquierdo D, Vázquez ML, Godoy JF. Illness beliefs about hypertension among non-patients and healthy relatives of patients. Health (N Y). 2013 Apr 19;5(4):47–58. doi:10.4236/health.2013.54A007
Şafak ED, Yüksel H, Kırış Y, Alper NM, Mazıcıoğlu MM. Determination of Drug Use Behaviors and Related Reasons of Adult Patients Applying to Family Health Centers. Healthcare. 2025 Nov 10;13(22). doi:10.3390/healthcare13222850
Pamukcu B. Profile of hypertension in Turkey: from prevalence to patient awareness and compliance with therapy, and a focus on reasons of increase in hypertension among youths. J Hum Hypertens. 2022 May;36(5):437–44. doi:10.1038/s41371-020-00480-6
McEvoy JW, McCarthy CP, Bruno RM, Brouwers S, Canavan MD, Ceconi C, et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension: Developed by the task force on the management of elevated blood pressure and hypertension of the European Society of Cardiology (ESC) and endorsed by the European Society of Endocrinology (ESE) and the European Stroke Organisation (ESO). Eur Heart J. 2024 Oct 7;45(38):3912–4018. doi:10.1093/eurheartj/ehae178
Farah RI, Alawwa IA, Khateeb DQ, Hwidi BE, Albdour KM, Bani Monia OG, et al. Factors Affecting the Level of Adherence to Hypertension Medications: A Cross-Sectional Study Using the Hill-Bone Questionnaire. Patient Prefer Adherence. 2024 Apr 20;18:893–904. doi:10.2147/PPA.S457026
Wang Z, Hu Y, Huang B, Zheng G, Li B, Liu Z. Is There a Relationship Between Online Health Information Seeking and Health Anxiety? A Systematic Review and Meta-Analysis. Health Commun. 2024 Nov;39(12):2524–38. doi:10.1080/10410236.2023.2275921
Organization WH. Adherence to Long-term Therapies: Evidence for Action. Geneva: World Health Organization; 2003. 206 p.
Sawicka K, Szczyrek M, Jastrzębska I, Prasał M, Zwolak A, Daniluk J. Hypertension – The Silent Killer. J Pre-Clin Clin Res. 2011 Dec 30;5(2):43–6.
Autret A, Valade D, Debiais S. Placebo and other psychological interactions in headache treatment. J Headache Pain. 2012 Apr;13(3):191–8. doi:10.1007/s10194-012-0422-0
El Khoudary SR, Aggarwal B, Beckie TM, Hodis HN, Johnson AE, Langer RD, et al. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement from the American Heart Association. Circulation. 2020 Dec 22;142(25):e506–32. doi:10.1161/CIR.0000000000000912
Tamargo J, Rosano G, Walther T, Duarte J, Niessner A, Kaski JC, et al. Gender differences in the effects of cardiovascular drugs. Eur Heart J Cardiovasc Pharmacother. 2017 Jul 1;3(3):163–82. doi:10.1093/ehjcvp/pvw042
Tang Y, Lei Y, Xu M, Tu Q, Mao X, Huang N, et al. Meta-analysis on the safety and efficacy of long-term garlic consumption as an adjunctive treatment for hypertension. Front Nutr. 12:1656809. doi:10.3389/fnut.2025.1656809
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