Knowledge of Hypertension and Self-Blood Pressure Measurement Skills in Spain

BackgroundHypertension is a major cardiovascular risk factor that is insufficiently controlled. Management, which is challenging due to the asymptomatic nature of the disease and limited patient awareness, depends on lifestyle factors, comorbidities, and health literacy. Self-measurement of blood pressure may improve blood pressure control and patient engagement, although evidence regarding the accuracy of these measurements remains limited. The aim of this study was to analyse the level of knowledge about hypertension and self-blood pressure measurement skills among individuals with this condition.MethodsA descriptive cross-sectional observational study was conducted in Spain in 2025 in urban and rural primary care centres, including 151 patients aged over 18 years with diagnosed hypertension and preserved cognitive capacity. Sociodemographic, clinical, and blood pressure self-measurement data were collected. Knowledge about hypertension was assessed using the Hypertension Knowledge Questionnaire, which includes 15 items covering the disease, risk factors, treatment, and complications.ResultsMost participants were unaware of the diagnostic blood pressure threshold for hypertension, defined according to European guidelines as ≥ 140/90 mmHg, and 94% exhibited poor control of systolic blood pressure. Educational level was significantly associated with better knowledge of cardiovascular, renal, and cerebrovascular complications, as well as with more accurate self-blood pressure measurement practices. However, no association was observed between educational level and overall blood pressure control. Sex-based differences were identified, with better diastolic blood pressure control among women.ConclusionsHigher educational level is associated with improved knowledge of hypertension and higher quality of self-blood pressure measurement, but not with better blood pressure control. The persistence of poor blood pressure control despite adequate knowledge and skills suggests that factors beyond education, particularly comorbidities such as chronic kidney disease and sociodemographic inequalities, may play a major role. Health education remains important to support self-management; however, it should be integrated within a broader, multifactorial and individualized approach to hypertension care in primary health care in the Spanish context.