Factors influencing blood pressure control among patients with hypertension in Rwanda: the role of patients and caretakers

BACKGROUND: Hypertension (HTN) is a leading cause of cardiovascular diseases and premature death, disproportionately affecting low- and middle-income countries. Family support plays a crucial role in Blood pressure (BP) management, yet little is known about caretakers' knowledge and practices, and their impact on BP control in Rwanda. The study aims to evaluate the patients' and caretakers' factors that affect patients' blood pressure control in Rwanda. METHODS: A cross-sectional quantitative study was conducted in three districts in Rwanda, Burera, Bugesera, and Rubavu, representing the rural and urban populations. Patient medical records (N = 463) were reviewed, and 292 primary caretakers completed surveys. Data included demographics, BP control, adherence to scheduled appointments, caretaker knowledge, and practices. Using SPSS version 26, statistical analysis was performed using chi-square tests, independent sample T Test, and binary logistics with significance set at P < 0.05. RESULTS: Among the reviewed patients' files, 53.7% had poorly controlled BP, though 76.1% adhered to scheduled appointments. Urban caretakers exhibited higher knowledge and better practices (p = 0.004, P = 0.001, respectively), but rural patients had better adherence to the scheduled visits (p = 0.000). Caretakers with higher education and socioeconomic status demonstrated better knowledge and practice (P = 0.003, P = 0.006). No statistically significant correlation was found between BP control and caretakers' knowledge or practices, suggesting systemic barriers may play a greater role in HTN management. Financial constraints, transportation difficulties, and lack of nutritious food were major challenges reported by caretakers. CONCLUSION: Improving HTN outcomes requires enhanced systemic healthcare support, and targeted socio-economic interventions to empower caretakers in supporting patients with HTN. Further research is needed on the impact of local dietary habits on BP control.