Studying Patient Understanding and Control of Hypertension

High blood pressure, or hypertension, poses a significant global health threat. According to the World Health Organization, about 1.4 billion adults between the ages of 30-79 worldwide had hypertension in 2024, with about two-thirds of this population living in low and middle-income countries. In Ghana, for example, more than one in four adults have hypertension, and the condition is the leading cause of hospital admissions. Studying patients’ understanding of hypertension, along with the effectiveness and accessibility of current blood pressure control methods, can help address barriers with patient communication and the medical technologies that are crucial to successful treatment. 

Professor Valencia Koomson recently contributed to a study published in the International Journal of Hypertension that investigated how patients in Ghana understand hypertension and use at-home monitoring apps that track their blood pressure. The researchers found that better communication about hypertension is needed to help patients improve control of their blood pressure and recommended implementing strategies to make mobile-health technology more affordable.  

More accessible communication and technology

Known as the “silent killer,” hypertension can go undetected for a long time, leading to an increased risk of heart attack, stroke, heart failure, and more. In Ghana, patients typically visit clinics every 2-3 months, leaving long periods of time in which blood pressure is unassessed. Self-monitoring blood pressure has emerged as a useful tool for patients to regularly track their blood pressure at home using mobile health applications, but in rural and underserved communities, digital literacy and access remain significant barriers to using this technology.  

“Self-monitoring health apps can do wonders for catching and addressing health issues before they become a more serious problem,” Koomson explained. “But the impact of this technology is limited if it isn’t accessible to those who need it the most, or if patients don’t understand the information they’re receiving.” 

Koomson and her collaborators, Mark Tettey from the University of Ghana Medical School and Jacques Kpodonu from Beth Israel Deaconess Medical Center, studied how 32 patients in Ghana with newly diagnosed hypertension understood their condition and used the self-monitoring technology, aiming to identify where communication can be improved and how new medical technology is perceived. 

The benefits and challenges of at-home health monitoring apps 

The team’s study found that about 69% of participants reported difficulty understanding medical terms used at clinics. As previous studies show that low health literacy is associated with poor health outcomes, the researchers recommended investing in strategies to improve communication, especially in low- and middle-income countries like Ghana, where health literacy rates are often lower.  

“Research shows that limited knowledge of hypertension medical terms results in patients less likely to engage in health-promoting behaviors, like taking medication or implementing lifestyle changes,” Koomson said. “Clear, accessible communication about hypertension—and other health conditions—lays the groundwork for patients to take control of their health journeys.”  

Compared to clinical settings, participants felt less anxious when self-monitoring blood pressure at home. At-home monitoring also allowed participants to more easily link fluctuations to diet, activity, or medication, ultimately helping them better understand and control their blood pressure.  

However, about 60% of participants were concerned about the cost of mobile data required to use the health applications. The researchers recommended that policymakers partner with phone providers to subsidize health-related data usage, allowing the technology to be used more frequently and be more accessible to lower-income patients. 

“Studying the understanding, barriers, and successes of hypertension treatment and control methods is the first step to improving and making them more accessible,” Koomson said. “Our study helps to inform a starting point for addressing a widely spread issue that threatens the lives of millions every year.” 

Learn more about Associate Professor Valencia Koomson.