Knowledge and Practice Regarding Stroke Prevention and Associated Factors Among Hypertensive Patients at Selected...

Stroke is a leading cause of death and disability worldwide, and hypertension is its strongest modifiable risk factor. The protection that treatment offers, however, depends on whether patients recognize their own risk and sustain preventive behavior. This has not been examined in Addis Ababa, where patients have comparatively good access to specialist follow-up. We assessed knowledge and practice regarding stroke prevention at two public hospitals in the city, and the characteristics associated with each.

An institution-based cross-sectional study was conducted from 1 February to 20 August 2022 among 283 hypertensive adults attending cardiac follow-up at two federal teaching hospitals. Knowledge was measured with the 32-item Stroke Prevention Knowledge Questionnaire and dichotomized at ≥ 60% correct; practice was measured with the 52-item Health-Promoting Lifestyle Profile II (HPLP-II) and analyzed as a continuous score. Binary logistic and multivariable linear regression were used respectively; all tests were two-sided with α = 0.05.

Seventy-seven participants (27.2%) had good overall knowledge; 137 (48.4%), 101 (35.7%) and 59 (20.8%) reached the domain thresholds for prevention measures, warning signs and risk factors, and 110 (38.9%) named no warning sign. Educational attainment (above Grade 12 vs. no formal schooling-adjusted odds ratio: 50.43, 95% confidence interval [CI]: 10.98-231.53), religion and family history of stroke were independently associated with good knowledge. The mean HPLP-II score was 136.97 ± 26.71, within the "good" band, but physical activity scored lowest. Educational attainment, widowhood and good knowledge (adjusted mean difference: 13.20, 95% CI: 6.81-19.60) were independently associated with practice.

Knowledge of stroke prevention was poor despite favorable lifestyle scores, and educational attainment was associated with both. Attendance at a specialist clinic is not evidence that a patient understands their risk; counseling should verify comprehension rather than assume it.