Hypertension self-care practices and associated factors among people with hypertension on follow-up in selected public healthcare facilities in the Ashanti Region, Ghana. A multicentre cross-sectional survey

Background Hypertension self-care practices are essential for controlling blood pressure and preventing cardiovascular complications and mortality. However, research on adherence to self-care practices among people with hypertension in Ghana is limited. This study assessed hypertension self-care practices and associated factors among people with hypertension attending follow-up in selected public healthcare facilities in the Ashanti Region, Ghana. Methods This multicentre cross-sectional study was conducted in three randomly selected public healthcare facilities in the Ashanti Region from 1 st March to 30 th June 2025. A multistage sampling method was employed to recruit 545 people with hypertension on follow-up. Data on hypertension self-care practices, hypertension knowledge, socio-demographic and clinical characteristics, and psychosocial factors were collected using an interviewer-administered questionnaire and supplemented by a review of medical records. IBM-SPSS Statistics was used for data analysis. Descriptive statistics were used to summarize variables, while a binary logistic regression model was performed to identify the factors associated with hypertension self-care practices. Adjusted odds ratios (AORs) with corresponding 95% confidence intervals (CIs) were reported, and statistical significance was set at p <0.05. Results Of the 545 people with hypertension recruited, 510 participated in the study, yielding a response rate of 93.6%. Overall, 58.4% (95% CI: 54%-63%) of participants demonstrated good self-care practices. Among the individual practices, smoking cessation had the highest adherence (96.7%, n=493), whereas physical activity had the lowest adherence (22%, n=112). In multivariable analysis, comorbidities (AOR=0.56, 95% CI: 0.36-0.87) and depression (AOR=0.11, 95% CI: 0.05-0.23) were independently associated with lower odds of practising good self-care, whereas good self-efficacy (AOR=12.71, 95% CI: 6.64-24.30) was independently associated with higher odds. Conclusion Adherence to hypertension self-care practices was moderate; however, deficiencies were observed in salt reduction and physical activity. Comorbidity, depression and self-efficacy were associated factors of hypertension self-care practices. Interventions should prioritise mental health screening, strengthen self-efficacy through behavioural support, and provide tailored care for individuals with comorbidities to improve sustained self-management.