SOCIOCULTURAL DETERMINANTS OF HYPERTENSION MANAGEMENT IN PAKISTAN

Abstract

Background: Hypertension, defined as sustained elevated blood pressure (systolic ≥130 mm Hg and/or diastolic ≥90 mm Hg), is a leading global health concern, significantly contributing to cardiovascular diseases, kidney failure, and mortality. In low- and middle-income countries like Pakistan, where healthcare systems are under-resourced, sociocultural factors pose significant barriers to effective hypertension management. This study investigates the sociocultural determinants influencing hypertension management in Thatta, a rural district of Pakistan, to inform culturally appropriate healthcare interventions.

Objective: To explore the sociocultural determinants affecting adherence to hypertension management among patients in rural Thatta, Pakistan.

Methods: A descriptive cross-sectional study was conducted among 260 hypertensive patients attending the outpatient department of Civil Hospital Thatta. Participants were selected using simple random sampling. Data were collected through pre-tested questionnaires and analyzed using SPSS version 29. Inclusion criteria consisted of adults aged ≥18 years with a confirmed diagnosis of hypertension, while individuals with severe comorbidities were excluded. Ethical approval was obtained, and informed consent was secured from all participants before data collection.

Results: The majority of participants were aged 36-45 years (31.2%) and male (63.1%). Traditional high-salt foods were identified as a major barrier by 47.3% of participants, while 11% relied on traditional remedies over prescribed medications. Social gatherings contributed to non-compliance in 30% of cases, and 6% of women cited cultural norms limiting physical activity as barriers. Lower educational attainment and lack of social support further impeded adherence to treatment guidelines, with 43.8% having completed matriculation and only 2.3% holding postgraduate qualifications.

Conclusion: Sociocultural factors, including dietary habits, reliance on traditional medicine, gender-specific barriers, and limited education, significantly influence hypertension management in Thatta. Addressing these barriers through culturally sensitive and context-specific interventions is essential to improve patient outcomes and reduce the burden of hypertension in similar rural settings.