Introduction

Hypertension (HTN) is a chronic systemic disease that mainly affects blood vessels. This occurs due to an imbalance of factors causing vasodilation and vasoconstriction, which results in constant high blood pressure. It is considered a silent killer because most patients who suffer from this disease are asymptomatic. The most affected organs which may lead to death are the heart and brain. According to the American College of Cardiology/American Heart Association (ACC/AHA), someone is defined as having HTN if he/she has a systolic blood pressure ≥ 130 mmHg and a diastolic blood pressure ≥ 80 mmHg ^1-3.

According to the World Health Organization (WHO), in 2021, the age range of patients diagnosed with HTN was 30-79 years, most of whom came from middleand low-income countries. Cerebrovascular diseases, with 51 %, followed by heart diseases with 45 %, were the leading causes of death ⁴.

In 2019, according to the Encuesta Demográfica y de Salud Familiar (ENDES - Demographic and Family Health Survey), % of respondents had a diagnosis of HTN, the coast had the highest percentage of people diagnosed with HTN and it mostly affected the female population, with 11.70 % ⁵.

Currently, several agencies such as the WHO and the Pan American Health Organization (PAHO), together with the governments of each country, have projected the reduction of HTN cases thanks to the knowledge, promotion, prevention and management of such disease. If people had the appropriate information, they would take preventive measures or decide which continuous treatment to follow if they were diagnosed with HTN, so that it could be controlled without complications in the future. However, there is still a barrier concerning this information, which causes a lack of knowledge of HTN ².

Chumo, in a hospital in Lima, identified the level of knowledge of HTN in outpatients aged 30 to 39 years, out of whom 97.70 % of the respondents had a low level of knowledge ⁶. Ataucusi et al., in a nursing home for older adults, found that 82 % of the respondents had a low level of knowledge of HTN ⁷.

Centurión found that, out of all the patients of a health center (HC) in Chiclayo, 70 %, 20 % and 10 % had a medium, low and high level of knowledge of HTN, respectively ⁸. Díaz et al. found that, out of all users of a HC, 49 %, 41 % and 10 % had a high, medium and low level of knowledge of HTN, respectively ⁹. Ramírez stated that, in a health micro network, 26.3 %, 50 % and 23.60 % showed a high, medium and low level of knowledge of HTN, respectively ¹⁰.

Studies conducted to date suggest that there are different levels of knowledge of HTN since patients diagnosed with HTN have more knowledge of the disease than those who do not suffer from it. Peru shows similar data based on studies which were mostly conducted in health facilities. Therefore, this research is aimed to determine the level of knowledge of HTN in another population group such as the teachers of Institución Educativa Pública (Public Educational Institution) No. 20799 Daniel Alcides Carrión, located in Chancayllo, which will contribute to learn the level of knowledge of this pathology in the Peruvian population.

Materials and methods

Results

The teachers’ mean age was 42.78 ± 8.44 and the largest age group consisted of adults (aged 31 to 59 years), totaling 94 %. It was observed that 96 % of the participants had a high level of knowledge of HTN (Table 2).

A higher percentage of high level of knowledge of HTN could be observed in the three dimensions assessed: general aspects, risk factors and preventive measures, with 90.74 %, 85.19 % and 87.04 %, respectively. Additionally, low levels of knowledge of HTN were not observed in such dimensions (Table 3).

It was observed that the largest age group consisted of adults, totaling 94 %. Concerning the education level, 66 % (n = 36) had a professional title and, according to the grade level taught, the percentages were similar in preschool, primary and secondary schools. The history of HTN showed that 53.70 % (n = 29) had a personal or family history of HTN and 46.30 % did not have any history of HTN (Table 4).

Among the teachers who showed a high level of knowledge of HTN, the largest age group were adults, totaling 96.10 %. All males (n = 14) had a high level of knowledge of HTN. As for teachers’ education level, 94.10 % (n = 16) and 96.30 % (n = 35) had a master’s degree and a professional title, respectively, and they showed a high level of knowledge of HTN. Only a low percentage of both groups had a medium level. Out of the teachers who had a family history of HTN, 90.50 % (n = 19) and only 9.50 % (n = 2) showed a high and medium level of knowledge of HTN, respectively. All the teachers with a personal history of HTN (diagnosed with HTN) showed a high level of knowledge of HTN. All primary teachers had a high level of knowledge of HTN.

A significant association between the level of knowledge of HTN and the age group, sex, education level, personal or family history and grade level taught was not found according to the chi-square test, showing results p > 0.05 (Table 4).

Discussion

It was shown that 96.30 % and only 3.70 % of the teachers had a high and medium level of knowledge of HTN, respectively. The results differ from those of the study conducted by Chumo, which was performed with outpatients aged 30 to 39 years, out of whom 97.70 % and 2.30 % had a low and high level of knowledge of HTN, respectively ⁶. On the other hand, Orihuela et al. found that 6.70 % of older adults had a high level of knowledge of HTN. This difference is explained by the training of this research population—i.e., teachers—compared with the population of other studies ¹¹. Likewise, in the research work carried out by Huamán in Red de Salud Utcubamba (Utcubamba Health Network), it was observed that most users (89.70 %) had a low level of knowledge while 4 % had a medium level of knowledge of HTN ¹².

In the study conducted by Wolde et al., 55.30 %, 17.90 % and 26.80 % had a low, medium and high level of knowledge of HTN, respectively. This differs from our study—in which 96.30 % of the teachers had a high level of knowledge of HTN—because 47.27 % of the population studied by Wolde were illiterate ¹³. Anyanti et al. found in their research that 41.90 % of the respondents had a good level of knowledge of HTN; however, this percentage was lower than that of the present study since the population studied by Anyanti did not pursue higher education ¹⁴.

The study conducted by Alejos et al. differs from our study in that patients with HTN showed a low (52.50 %) and high (7.50 %) level of knowledge of HTN since most of them only completed primary and secondary school. In the present research, it was observed that the teachers had a high knowledge of HTN, whether they suffered from HTN or not, which may be related to their education level, socioeconomic status and lifestyle ¹⁵. The study conducted by Fanelli et al. found a low level of knowledge of HTN as only 15 % had a good level. Such result differs from this study since the assessed population consisted of a community of people with different education levels, lifestyle and socioeconomic status ¹⁶.

The results of our study, conducted in teachers with a professional title—which accounted for 66.70 %—and a high level of knowledge of HTN, differ from the study by Montes et al. since only 14 % of its participants were teachers with a professional title and the rest had different jobs. Montes reported that 43.31 % of the participants had a medium level of knowledge of HTN, which differs from our study since 96 % had a high level of knowledge of HTN. This is because not the entire population studied by Montes had higher education; therefore, it can be inferred that higher education has an impact on the knowledge of the disease ¹⁷.

In the study conducted by Pastor, 83 % of the population was diagnosed with HTN and had an adequate level of knowledge of HTN. This agrees with our study because those diagnosed or having relatives with this disease mostly had a high level of knowledge of HTN ¹⁸. On the contrary, Ojeda found that the highest percentage of patients diagnosed with HTN had a medium level (64.60 %) followed by a high level (14.80 %) of knowledge of HTN ¹⁹. Furthermore, Soplopuco et al. found that 62.80 % of the study subjects had an inadequate knowledge of HTN though they had been diagnosed with the disease, which also differs from our study ²⁰.

Palacios researched the association between the level of knowledge of HTN and self-care among older adults, finding a low level of knowledge. This differs from our study because the teachers had a high level of knowledge of HTN (96.30 %). Such situation may be due to the fact that both study populations are not the same since the population of adult teachers pursued higher education and the population of the study by Palacios consisted of older adults and only 8 % had higher education ²¹.

Concerning the level of knowledge of HTN according to age, 96.10 % and 3.90 % of the adult teachers (31 to 59 years) had a high and medium level of knowledge, respectively. Furthermore, the study by Baglietto-Hernández et al. conducted in a group of patients aged 45 to 60 years showed that 80 % had a good level of knowledge of HTN ²². In her study, Pérez showed that people between 30 and 60 years who visited an occupational medicine clinic had a medium (46.70 %), low (34.70 %) and high (18.50 %) level of knowledge of HTN ²³. The study conducted by Melnikov revealed that older patients with more years of education generally had more knowledge of HTN. Such results are somewhat similar to those of this study as it was observed that the older the population, the higher the level of knowledge of HTN, although there was no statistical significance ²⁴.

A high level of knowledge of HTN was observed in both sexes in the current research, which differs from the study conducted by Centurión, whose population evidenced that 66 % of both males and females had a medium level of knowledge and 14 % a high level of knowledge of HTN. This is probably because the population studied by Centurión were not as educated as the teachers from our study ⁸.

As to the level of knowledge of HTN associated with a history of HTN, there is evidence of a high level of knowledge in teachers both with and without a family or personal history; therefore, having a high level of knowledge of HTN does not depend upon having a family or personal history of HTN (p > 0.05). In a study conducted in patients diagnosed with HTN, Córdova et al. found a medium level followed by a high level of knowledge of HTN; this differs from our study since all the teachers with a history of HTN showed a high level of knowledge of HTN ²⁵. Arámbulo researched the association between adherence to treatment and knowledge of HTN, finding that those who had an adequate knowledge of HTN had better adherence to the treatment as well. On the contrary, our results showed that teachers who did not have a personal and family history of HTN had a high level of knowledge of the disease ²⁶. The study conducted by Rampamba et al., in which more than a half of its population had a personal and family history of HTN, revealed that most of them had neither education nor knowledge of HTN ²⁷. This differs from our research, which found a high level of knowledge of HTN in a population with higher education, whether they had a personal or family history of HTN or not.

Estrada et al. showed that those who had a higher education level had a good level of knowledge of HTN compared with those who had a lower education level: this is similar to the result of this study since the high level of knowledge of HTN prevailed in teachers who had a higher education level ²⁸. Samajen et al. and Campoverde researched populations with basic education and the result was a poor level of knowledge of HTN. This differs from the present study, wherein its population pursued higher education and had a high level of knowledge of HTN, which demonstrates that education is related to knowledge, though the statistical analysis was not significant (p > 0.05). In this case, it is worth delving into the topic in future studies with specific methodology ^29,30. (Table 5)

On the other hand, one of the limitations of this study was the fact that the collected data could not be extrapolated to other educational institutions due to its limited sample size, even though it included almost the entire population of teachers of the educational institution, so the results are only valid for said population. Likewise, another limitation was that the survey did not specify the history of HTN, for example, when such disease was diagnosed.

The strength of this research was being one of the few studies about the level of knowledge of HTN conducted in teachers in Peru.

In conclusion, the level of knowledge of HTN among teachers of Institución Educativa Pública No. 20799 in year 2021 was mainly high, and it did not show a significant association between the level of knowledge of HTN and the age group, sex, education level, personal or family history and grade level taught.

Further research is needed—with this study carried out in a population different from that of health institutions as background—so that other approaches regarding the level of knowledge of HTN can be taken to have a broader view of the topic.