Nestled amidst the awe-inspiring peaks of the Himalayas, District Kinnaur in Himachal Pradesh is not only a testament to natural beauty but also a backdrop to a significant public health concern—hypertension. Hypertension, characterized by elevated blood pressure, stands as a silent yet pervasive threat, playing a central role in the global burden of cardiovascular diseases [1,2]. Despite its prevalence and consequential impact on morbidity and mortality, public awareness and understanding of hypertension often fall short.

In the specific context of District Kinnaur, where the landscape mirrors the diversity of its population, an exploration of hypertension awareness becomes imperative. The subtle, often asymptomatic nature of hypertension underscores the critical role of community awareness in prevention, early detection, and management [3,4]. Indian studies by [5] and [6] have previously highlighted substantial gaps in hypertension awareness and control, emphasizing the need for context-specific interventions [5,6].

Globally, hypertension significantly contributes to the burden of non-communicable diseases, posing a considerable challenge to public health [1]. The Himalayan region, with its distinctive socio-cultural dynamics and geographical intricacies, provides a unique context for understanding hypertension-related knowledge gaps and devising targeted strategies.

This study endeavors to unravel the intricacies of awareness and knowledge among the residents of District Kinnaur regarding the risk factors, preventive measures, treatment options, and complications associated with hypertension. Through a comprehensive assessment of the community's understanding of hypertension, we seek to inform public health initiatives that are attuned to the specific needs of this region.

To evaluate the awareness and knowledge regarding Risk factors, Preventive measures, treatment options and complications of Hypertension among general public of District Kinnaur, Himachal Pradesh.

• Research Approach -Descriptive

• Research Design- Cross-sectional survey design

• Study area: District Kinnaur, Himachal Pradesh

• Study duration- between August 2023 to November 2023

• Study population: The study's target population encompassed all adults aged 18 and above who had been residents of District Kinnaur,  Himachal Pradesh for a minimum of 12 months

• Sample size- A robust sample size of 400 adults was determined using a 95% confidence level, an estimated knowledge level of 50% regarding Hypertension , a precise 5% absolute error margin, and a conservative 5% non-response rate. 

• Study tool: A google form questionnaire consisting of questions regarding socio-demography and knowledge regarding Hypertension was created. The questionnaire was initially pre-tested on a small number of participants to identify any difficulty in understanding by the respondents. 

• Description of Tool- 

1. Demographic data survey instrument: The demographic form elicited information on participants’ background: age, marital status, religion, employment, education and many more.

2. Questionnaire: The questionnaire contains 20 structured knowledge related questions regarding Hypertension. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero. Scoring was done on the basis of marks as >80%(16-20)=very good,60-79%(12-15) =Good,41-59% ( 8-11)=Fair,<40% (< 8)=poor

• Validity of tool - by the experts in this field

• Data collection- Data was collected under the guidance of supervisors. The google form questionnaire was circulated among the residents of District Kinnaur, Himachal Pradesh for responses using online modes like e-mail and social media platforms like Whatsapp groups, Facebook, Instagram and Linkedin till the 400 responses were collected. 

• Data analysis- Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analyzed with Epi Info V7 Software with appropriate statistical test in terms of frequencies and percentage. 

• Ethical Considerations- Participants confidentiality and anonymity was maintained. 

The goal of the current study was to assess knowledge regarding Hypertension among general public of District Kinnaur, Himachal Pradesh through a non-experimental descriptive survey. A total of 400 respondents including 242 (60.5%) Male patients and 158 (39.5%) female patients were participated in the study. Table [1]

Table-1: Knowledge regarding Hypertension among study participants

Table [2] In the present study 35.25% (141)  participants had very good knowledge (16-20 marks) towards Hypertension , 38% (152) had good knowledge (12-15 marks), 18.25% (73) had fair knowledge  (8-11 marks) and 8.5% (34) having poor knowledge  (<8 marks).

Maximum =20 Minimum=6

Table 2: Knowledge score regarding Hypertension among study participants

The cross-sectional survey conducted in District Kinnaur, Himachal Pradesh, aimed to comprehensively assess the awareness and knowledge of the general public regarding risk factors, preventive measures, treatment options, and complications associated with hypertension. The study, involving 400 participants, provides valuable insights into the nuanced understanding of hypertension in this unique geographical and sociocultural context.

The findings indicate a commendable level of awareness among the participants, with 35.25% demonstrating very good knowledge, 38% exhibiting good knowledge, 18.25% possessing fair knowledge, and 8.5% having poor knowledge concerning hypertension. These results align with and contribute to existing literature on hypertension awareness in India, as highlighted by [5] and [6], emphasizing the need for tailored interventions in diverse populations [5,6]. Other Indian studies by [7] and [8] also underscore the escalating burden of hypertension and the importance of community-based interventions [7,8].

The study participants demonstrated a substantial understanding of common risk factors associated with hypertension, with 78% accurately identifying these factors. Comparable studies in India by [6,5,7,8] underscored the significance of lifestyle choices and familial predisposition as key contributors to hypertension, reinforcing the importance of targeted education[5-8].

Encouragingly, 77.75% of participants could identify lifestyle choices contributing to hypertension, and 54.5% were aware of dietary recommendations. These results resonate with global recommendations emphasizing lifestyle modifications for blood pressure management [4]. Studies by [8] and [9]also highlight the role of dietary patterns and lifestyle modifications in hypertension prevention and management[8,9].

An area for improvement is the understanding of "white coat syndrome," with only 44% of participants familiar with its impact on blood pressure readings. Addressing this gap is crucial for accurate blood pressure assessments and preventing unnecessary anxiety associated with clinical settings [4].

While the study demonstrates positive findings, there are notable areas for improvement. For instance, only 57% were aware of resources or healthcare professionals to consult in case of a hypertension diagnosis. This indicates a potential gap in knowledge regarding available support systems and underscores the need for targeted awareness campaigns [5,6,8]. Studies by [7] and emphasize the need for community-level interventions and healthcare infrastructure strengthening to address hypertension [7,9].

Comparing these findings with studies conducted in India, the results are consistent with an increasing awareness of hypertension-related issues. [5] reported a substantial burden of hypertension in urban and rural populations, highlighting the need for community-based interventions [5]. [6] emphasized the association between sociodemographic factors and hypertension prevalence, further emphasizing the importance of tailored interventions in diverse populations [6,7] stressed the need for comprehensive strategies, considering the increasing burden of hypertension in India [7,8] highlighted the role of community awareness and lifestyle modifications in hypertension prevention, aligning with the present study's emphasis on community-level interventions [8].

Limitations and Future Directions:

It is essential to acknowledge certain limitations, including the cross-sectional design, which provides a snapshot rather than a dynamic understanding of evolving knowledge and practices. Additionally, reliance on self-reported knowledge may not entirely reflect practical behaviors.

Implications for Public Health:

The study's outcomes have implications for public health initiatives in District Kinnaur. Strengthening awareness campaigns, particularly in areas identified for improvement, can empower the community to make informed decisions about hypertension management. Community engagement programs, utilizing local networks and platforms, could play a pivotal role in disseminating targeted information.

In conclusion, the study reveals a promising level of awareness and knowledge among the general public in District Kinnaur regarding hypertension. The identified gaps emphasize the need for ongoing educational initiatives tailored to the community's specific needs. By addressing these gaps, public health interventions can contribute to the overall well-being of the residents of District Kinnaur.

The authors declare that they have no conflict of interest.

No funding sources

The study was approved by the Civil Hospital Palampur.

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