Hypertension Awareness, Medication Adherence, and Blood Pressure Control in Primary Care: A Cross-sectional Study

Abstract

Objectives: The aim of the study is to evaluate hypertension awareness, treatment adherence, and blood pressure (BP) control among primary care patients with diagnosed hypertension and to identify factors associated with BP control. Methods: This cross-sectional study was conducted in a family medicine outpatient clinic in Karaman between January and March 2024, including 200 hypertensive patients. Data were collected through structured face-to-face interviews and clinical assessments. BP was measured using a calibrated digital sphygmomanometer after at least 5 min of seated rest; the average of two measurements was recorded. BP control was defined as systolic BP (SBP) <140 mmHg and diastolic BP <90 mmHg. Multivariable linear and logistic regression analyses were performed to identify factors associated with BP outcomes. Results: Among 200 participants (mean age: 59.9±9.2 years; 58.0% female), BP control was observed in 88.0% attending regular primary care follow-up. Most were overweight or obese (89.7%), and 82.5% reported regular medication use. However, 45.5% could not name their antihypertensive drugs, and only 30.5% correctly identified guideline-recommended BP targets. The most common response to elevated BP was lemon water consumption (51.1%). Controlled BP was significantly associated with physical activity (p=0.009), no salt addition to food (p=0.029), awareness of BP targets (p=0.020), and monotherapy use (p=0.024). In multivariable linear regression, age (β=0.304, p=0.003) and physical inactivity (β=−4.479, p=0.016) were independently associated with higher SBP. In parsimonious logistic regression, physical activity was the only independent predictor of BP control (odds ratio=2.76, p=0.027). No significant associations were found with body mass index, waist circumference, or education level. Conclusion: While pharmacological BP control was achieved in this cohort, major deficits in hypertension awareness, medication literacy, and lifestyle behaviors were identified. Sustainable management requires comprehensive patient education and behavior-focused interventions alongside effective treatment.