Patients' views of high blood pressure, its treatment and risks

To examine the understanding and beliefs of a sample of Australian patients about high blood pressure and its therapy, and to examine the accuracy of their assessment of their own risk.

A cross sectional study in two general practices in Perth, Western Australia. Interviews were conducted with 55 consecutive patients aged 40-80 years of age with uncomplicated hypertension. Qualitative and quantitative data were collected on patients' beliefs about the nature, symptoms, causes and treatment of high blood pressure as well as their adherence to antihypertensive medications during the preceding month. Patients also estimated their own risk of stroke or myocardial infarction.

Two-thirds of the patients (65%) described high blood pressure within an appropriate biomedical definition. Forty-five percent attributed a variety of symptoms to their high blood pressure while 55% believed that stress was a cause of their high blood pressure. Three-quarters (73%) were fully adherent to their medications in the preceding month. Seventy-one percent and 62% of patients were aware that stroke and heart attack respectively are possible consequences of high blood pressure. They significantly overestimated their risk of stroke and myocardial infarction.

One-third of treated hypertensive patients are poorly informed about the causes and effects of hypertension, and overestimate their risk of both stroke and heart attack, as well as the benefit derived from treatment.