Hypertension knowledge gaps: A patient-caregiver comparison from a tertiary care centre in Northern India

Hypertension is the leading modifiable risk factor for cardiovascular disease, yet awareness and control remain low, particularly in low- and middle-income countries (LMICs). In India, caregivers play a central role in patient support, but their comparative knowledge has been underexplored. This study assessed hypertension-related knowledge among patients and caregivers in a tertiary care setting in Northern India.

A cross-sectional study was conducted over 7 months (October 2024-April 2025) in the cardiology out-patient department of a tertiary hospital in Punjab, India. Adults living with hypertension and their accompanying caregivers were consecutively enrolled. A structured questionnaire assessed sociodemographic factors and blood pressure (BP) monitoring practices, and the knowledge scores were compared between patients and caregivers, and associations with sociodemographic variables were examined.

Of 3,501 participants, 2,032 (58%) were patients, and 1,469 (42%) were caregivers. The cohort was predominantly male (56.6%), urban (69%) and educated up to the 12th grade (69%). Only 22.5% reported regular BP monitoring. Awareness of the hypertension definition (50.2%), the normal BP range (67%) and key risk factors, such as alcohol (41.2%), obesity (37%) and smoking (34.2%), was limited. Caregivers consistently demonstrated higher knowledge than patients (mean score: 8.7 versus 8.5/15; p=0.004), with better performance associated with higher education, urban residence and skilled occupations.

Caregivers demonstrated greater knowledge of hypertension than patients, underscoring their potential as partners in disease management. Persistent gaps in awareness of risk factors, complications and follow-up emphasize the need for family-centred education, caregiver-focused counselling and accessible self-monitoring to strengthen hypertension control in LMICs.