The Impact of Hypertension Knowledge Level on Blood Pressure Control and Treatment Adherence: A Cross-Sectional Analytical Study

Abstract

This study aimed to evaluate the effect of hypertension-related knowledge level on blood pressure control and treatment adherence in individuals followed with a diagnosis of essential hypertension. In this cross-sectional analytical study, 200 patients aged 18–80 years who had been diagnosed with hypertension for at least 6 months and were receiving at least one antihypertensive medication were included. Hypertension knowledge level was assessed using the validated Turkish version of the Hypertension Knowledge-Level Scale (HK-LS). Blood pressure measurements were performed according to standardized protocols, and patients were classified as having controlled or uncontrolled hypertension. Treatment adherence was evaluated using a structured medication adherence questionnaire. The mean age of participants was 59.8±11.6 years, and blood pressure was controlled in 47% of patients. The mean HK-LS score was 14.3±4.2 and was significantly higher in the controlled hypertension group (p<0.001). HK-LS scores showed a significant negative correlation with systolic (r=-0.32, p<0.001) and diastolic blood pressure (r=-0.24, p=0.002). Quartile analysis demonstrated a stepwise increase in blood pressure control rates with increasing knowledge levels (p for trend <0.001). ROC analysis identified an HK-LS cut-off value of ≥15 points with good discriminative ability for predicting blood pressure control (AUC=0.76). In multivariate analysis, hypertension knowledge level, medication adherence, and home blood pressure monitoring were independent predictors of blood pressure control. These findings indicate that higher hypertension knowledge is significantly and independently associated with better blood pressure control, suggesting that improving patient education and health literacy may enhance clinical outcomes. Prospective interventional studies are needed to clarify causality.