ASSESSEMENT ON KNOWLEDGE, ATTITUDES, AND PRACTICES OF ELDERLY WOMEN IN MANAGEMENT AND PREVENTION OF HIGH BLOOD PRESSURE

1.1 Background of the Study Worldwide, hypertension, often referred to as the "silent killer," remains one of the leading global health challenges, contributing significantly to cardiovascular morbidity and mortality. According to the World Health Organization (WHO, 2023), over 1.28 billion adults worldwide suffer from hypertension, with nearly two-thirds residing in low- and middle-income countries. Sub-Saharan Africa bears a disproportionate burden, with regional prevalence estimates ranging from 30% to 46% among adults, making it the continent with the highest hypertension rates globally (Ataklte et al., 2022). The burden is particularly alarming among women over 60, who experience age-related vascular changes, limited access to healthcare, and persistent gaps in awareness, prevention, and management practices. Medically, according to the American Heart Association, hypertension is diagnosed when a person's systolic blood pressure (SBP) exceeds 140 millimeters of mercury (mm Hg) and their diastolic blood pressure (DBP) is above 90 mm Hg (Kofi, 2015). An individual's knowledge about hypertension and their behavioral response to it play a vital role in the effective management of the condition and in reducing the risk of long-term health complications. People living with hypertension must be well-informed about the nature of their illness, able to identify the associated risk factors, and understand the importance of long-term adherence to prescribed medication (Malik, Yoshida, Erkin, Salim, & Hamajima, 2016). Patients’ understanding and attitudes significantly influence how they manage chronic conditions like hypertension. Increased knowledge has been shown to enhance treatment adherence in conditions such as hypertension and hyperlipidemia. A patient’s level of awareness and their perspective on the disease can affect their ability to control blood pressure and influence morbidity and mortality outcomes (Jimoh et al., 2017). Knowledge, in this context, becomes a crucial driver for behavioral change and the adoption of a healthier lifestyle. Managing hypertension requires attention to multiple factors—social, economic, and environmental. Enhanced awareness through health education and promotion is crucial, as it can lead to positive lifestyle modifications in individuals living with hypertension. Consequently, it is essential for individuals to adopt behaviors and lifestyles that help them maintain good health (Zungu & Djumbe, 2019). Yet, many people remain unaware of the dangers posed by hypertension or how to prevent it. A lack of adequate knowledge can lead to unnecessary anxiety and improper use of medical services. If hypertension is left unmanaged—especially in rural regions where literacy rates are low—it can contribute to the rising incidence of stroke, heart failure, glaucoma, kidney failure, and other chronic conditions (Osuala, 2017). Due to widespread illiteracy in rural communities, a significant number of individuals have limited understanding of hypertension, hold negative attitudes toward the condition, and fail to follow appropriate management practices (Osuala, 2017). At present, the general level of awareness regarding blood pressure control, preventive measures, and lifestyle habits in these communities remains largely unknown. However, individuals with a better understanding of hypertension are more likely to engage in practices such as home blood pressure monitoring, which supports adherence to treatment and improves blood pressure control. A strong grasp of the condition and its associated risks is essential for improving the quality of life for individuals living with hypertension (Malik et al., 2016). Hypertension is broadly categorized into two types: primary and secondary. Primary hypertension—also known as essential hypertension—affects approximately 95% of those diagnosed, and has no identifiable underlying cause. In contrast, secondary hypertension is less common and is triggered by an identifiable medical condition (Kofi, 2015). Although specific causes of hypertension are not always identified, several contributing factors have been recognized, including age, high salt consumption, low potassium intake, sedentary lifestyle, stress, and anxiety (Kofi, 2015). This study aims to assess the knowledge, attitudes, and practices of older women in relation to managing and preventing high blood pressure and other chronic diseases. Hypertension has become a major public health issue in many developing countries, particularly as societies undergo an epidemiological transition from communicable to non-communicable diseases (Ahmad & Ahmad, 2015). The World Health Organization (WHO, 2019) estimates that deaths from non-communicable diseases like hypertension are expected to rise by 17% globally over the next decade—with the African region projected to experience the sharpest increase, at 27% (Kofi, 2015). ________________________________________ 1.2 Statement of the Problem In Nigeria, a large proportion of the population remains unaware that they are living with hypertension, a condition characterized by elevated blood pressure. Many people are not only uninformed about their hypertensive status but are also unaware of how increasingly common the condition has become. Even among those who are aware, few actively take steps to reduce their exposure to risk factors. At present, there are no comprehensive government programs dedicated to the management of hypertension, possibly because of the relatively low mortality rates attributed to the condition. However, as scientific and technological advancements accelerate and lifestyle patterns continue to evolve, this reality is likely to change in the near future (Kofi, 2015). A lack of awareness about hypertension may foster negative attitudes toward the condition, which in turn can hinder self-care practices—especially among older women who are more vulnerable to the disease (Ahmad & Ahmad, 2015). There is a strong link between how well patients understand their illness and how effectively they can manage it. Greater knowledge and a positive mindset toward hypertension are associated with better blood pressure control, reduced risk of cardiovascular disease, improved adherence to prescribed medications, and ultimately, lower rates of illness and death. 1.3 Objective of the study The general objective of the study is to assess the Knowledge, Attitudes, and Practices of Elderly Women Regarding the Management and Prevention of Hypertension. Specifically, the study will be guided under the following: i. To examine if elderly women have knowledge on the management of high blood pressure. ii. To find out if health care personnel have a positive attitude towards elderly women with high blood pressure. iii. To investigate the preventive measures elderly woman can use to prevent high blood pressure. iv. To investigate the different ways elderly women manage their high blood pressure. 1.4 Research Questions The following questions have been prepared for the study: i. Do elderly women have knowledge on the management of high blood pressure? ii. Do health care personnel have a positive attitude towards elderly women with high blood pressure? iii. What are the preventive measures elderly woman can use to prevent high blood pressure? iv. What are the different ways elderly women can manage their high blood pressure? 1.5 Research hypotheses The following hypothesis have been formulated for the study: H01: Elderly women do not have knowledge on the management of high blood pressure. H02: Health care personnel do not have a positive attitude towards elderly women with high blood pressure. 1.6 Significance of the study The study will be significant to ministry of health as this will expose them to the need of creating awareness on high blood pressure and also training health care personnel on knowledge, practice and attitude of patients and how to treat and handle patient with high blood pressure. This study will be significant to the academic community as it will contribute to the existing literature. 1.7 Scope of the study This study will examine if elderly women have knowledge on the management of high blood pressure. The study will also find out if health care personnel have a positive attitude towards elderly women with high blood pressure. The study will further investigate the preventive measures elderly woman can use to prevent high blood pressure. Lastly, the study will investigate the different ways elderly women manage their high blood pressure. Hence this study will be delimited to Ondo State. 1.8 Limitation of the study Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. Insufficient funds tend to impede the efficiency of the researcher in sourcing for the relevant materials, literature, or information and in the process of data collection (internet, questionnaire, and interview), which is why the researcher resorted to a moderate choice of sample size. More so, the researcher will simultaneously engage in this study with other academic work. As a result, the amount of time spent on research will be reduced. 1.9 Definition of terms Knowledge: facts, information, and skills acquired through experience or education; the theoretical or practical understanding of a subject. Attitude: a settled way of thinking or feeling about something. Practice: the actual application or use of an idea, belief, or method, as opposed to theories relating to it. Management: the process of dealing with or controlling things or people. Prevention: the action of stopping something from happening or arising. High blood pressure: blood pressure that is higher than normal.