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International Journal of Medical Sciences And Clinical Research

Peer Reviewed | Open Access | E-ISSN: 2771-2265
Published Article

Patients’ Beliefs Regarding the Causes of Hypertension and Treatment Adherence as Predisposing Factors for Complications and Uncontrolled Blood Pressure

Patients’ Beliefs Regarding the Causes of Hypertension and Treatment Adherence as Predisposing Factors for Complications and Uncontrolled Blood Pressure

Authors

  • Nidhal Awad Obaid Alibraheemi
    Family Medicine Specialist, C.A.B.S. (Family Medicine), Ministry of Health- Karbala Health Directorate, Iraq
  • Mohanad Qasim Mahfoodh Abdullah
    Family Medicine Specialist, C.A.B.S. (Family Medicine), Ministry of Health- Karbala Health Directorate, Iraq
  • Sarah Sabah Hasan Alshami
    Family Medicine Specialist, C.A.B.S. (Family Medicine), Ministry of Health- Karbala Health Directorate, Iraq

DOI:

https://doi.org/10.37547/ijmscr/Volume06Issue08-04

Keywords:

Hypertension Patient beliefs Medication adherence Blood pressure control

Abstract

Background: Hypertension is a highly prevalent non-communicable disease and a leading risk factor for cardiovascular morbidity and mortality. Despite effective treatments, blood pressure control remains suboptimal globally, partly due to patient beliefs and poor adherence, which contribute to the development of complications. Misconceptions about the causes and management of hypertension are particularly common in low- and middle-income countries.

Aim of the study: To identify patients’ misconceptions about hypertension which may increase the risk of complications.

Patients and Methods: A prospective cross-sectional study was conducted at Karbala Health Directorate primary health care centers, over a ten-month period. Two hundred adult patients with hypertension attending the primary health center were included. Data were collected using a structured questionnaire addressing sociodemographic characteristics, clinical history, beliefs about hypertension, and adherence to therapy assessed by the Modified Morisky Medication Adherence Scale. Blood pressure control and the presence of complications were recorded. Statistical analysis was performed to explore associations between patient beliefs, adherence, blood pressure control, and complications.

Results: The mean age of participants was 54.3 years, with 52% male and 48% female. Misconceptions were widespread, with 60 % of patients believing stress was the main cause of hypertension, 45 % attributing it to blood viscosity, and 38 % to dietary fat intake. Only 40 % of patients achieved controlled blood pressure. High adherence to therapy was observed in 28 % of patients, medium adherence in 34 %, and low adherence in 38 %. More than half of the participants (56 %) experienced hypertension-related complications, most commonly kidney problems (22 %), heart attacks (18 %), and heart failure (16 %). Patients with low adherence were significantly more likely to have uncontrolled blood pressure and complications compared with those with high adherence (p<0.05).

Conclusions: Patient misconceptions about hypertension were common and significantly influenced adherence to treatment, blood pressure control, and the occurrence of complications. Consistent adherence to therapy was protective, highlighting the importance of patient education and culturally sensitive interventions to improve hypertension outcomes.

Recommendations: Educational programs targeting patient beliefs, culturally adapted health messages, support for adherence, and training for healthcare providers should be prioritized. Community engagement and further research in larger populations are essential to confirm these findings and evaluate the impact of interventions.

References

Patient education programs should be used in primary care centers and hospital settings to correct common misconceptions about hypertension.

Health education campaigns should address culturally rooted beliefs (such as blood viscosity and stress) using locally tailored language and examples.

Support adherence by strategies such as medication counseling, pill boxes, reminder systems, and family involvement.

Physicians and nurses should be trained to identify and address patient misconceptions during consultations making health education part of routine care.

Public health campaigns through mass media, mosques, and community gatherings could help disseminate accurate information about hypertension.

Conduct further studies to confirm these associations and to evaluate the impact of educational interventions on long-term outcomes.

Study Limitations

The sample size was drawn from a single medical center, which may limit the generalizability of the findings to the wider hypertensive population in Iraq.

The cross-sectional design and lack of follow up cannot establish causal relationships between beliefs, adherence, outcome and improvements after interventions.

Adherence was assessed using self-reported tools (MMAS-8) which contains subjective measures.

Some unmeasured factors, such as income level, or access to healthcare services, could not be fully evaluated.

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