Knowledge, Attitudes, and Practices of Hypertensive Patients with Aortic Dissection and Aortic Aneurysm Towards Aortic Dissection and Its Prevention: A Mediation Analysis

Purpose: To investigate the knowledge, attitudes, and practices (KAP) of hypertensive patients with aortic dissection (AD) and aortic aneurysm regarding AD and its prevention. Patients and Methods: This cross-sectional study was conducted at Henan Chest Hospital between September 15, 2023, and December 15, 2023. Patients with hypertension and either Stanford type A or B AD, ascending aortic aneurysm, or abdominal aortic aneurysm were invited to participate. Results: A total of 619 participants were included, of whom 521 (84.17%) were male. Their knowledge, attitude, and practice scores were 4.12± 1.25 (range: 0– 22), 35.41± 3.92 (range: 10– 50), and 28.07± 2.96 (range: 8– 40), respectively. Mediation analysis revealed that knowledge directly influenced attitudes (β = 0.338, P = 0.010), and attitudes directly influenced practices (β = 0.458, P = 0.005). Moreover, knowledge had an indirect effect on practices through attitudes (β = 0.155, P = 0.006). In the subgroup of patients with confirmed aortic dissection (n = 605), the mediation pattern was replicated. Conclusion: Hypertensive patients with AD and aortic aneurysm demonstrated markedly insufficient disease-related knowledge alongside relatively favorable attitudes and moderately engaged self-reported practices toward AD prevention. This imbalance suggests that certain preventive behaviors may occur despite limited disease-specific understanding, indicating a possible separation between knowledge and action. However, given the cross-sectional and self-reported nature of the data, the findings should be interpreted as descriptive patterns rather than evidence of causal relationships or intervention effectiveness.