Comparison of knowledge, attitude and practices among apparent treatment resistant hypertensive patients and non-apparent treatment resistant hypertensive patients in a tertiary care center

Objectives Apparent treatment-resistant hypertension (aTRH) is defined as uncontrolled hypertension (HTN) despite the use of three or more antihypertensive medication classes or controlled HTN after treatment with four or more antihypertensive medication classes. The increasing prevalence of HTN as well as aTRH is mainly due to a lack of understanding about the disease, insufficient patient education programs, low economic status, etc., which might even lead to medication non-adherence. Assessing HTN knowledge, attitude, and practice (KAP) is crucial for controlling HTN. There is a paucity of information about KAP among aTRH patients in India. Therefore, this area has been targeted for specific assessment and interventions. The objective of the study is to evaluate KAP among aTRH patients. Material and Methods A total of 100 patients were recruited for this study, 50 patients aged ≥18 years with aTRH as cases and 50 patients aged ≥18 years with non-aTRH as controls. All participants were interviewed using a validated questionnaire, which had information regarding demographic profile, knowledge, attitude, and practices in management of HTN, and was administered by the investigator to the participants in the language understood by them. Results We observed that diabetes (26%) was the most common co-morbidity, followed by chronic kidney disease (CKD) (22%), obesity (22%), coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), and depression in the aTRH group. The total number of co-morbidities was higher in the aTRH group as compared to the non-aTRH. We found that the non-aTRH group had statistically significant better KAP mean score compared to aTRH patients (p <0.001). Conclusion We found that the KAP scores of the non-aTRH group were better than aTRH group, which explains their good blood pressure control. Hence, educating about HTN and its related attitudes and practices should be our primary goal to decrease the prevalence of aTRH and its related morbidities and mortalities.