Knowledge, Attitude, and Practice of Residents of Khartoum State about Hypertension: A Community-Based Cross-Sectional Study

Background: Hypertension is one of the most important risk factors for cardiovascular disease, cerebrovascular accidents, and renal diseases, contributing to substantial morbidity, mortality, and socioeconomic burden worldwide [1]. In Sudan, the prevalence in urban communities rose from 7.5% in 1990 to 27.6% by 2018 [5]. Adequate population-level knowledge, attitudes, and practices (KAP) are essential for effective prevention and control. This study assessed hypertension-related KAP among adult residents of Khartoum State and identified independent predictors of hypertension history, knowledge, blood-pressure monitoring, and physical activity. Methods: A descriptive cross-sectional community-based study was conducted in Khartoum State, Sudan (n = 240). Data were collected via a researcher-developed, self-administered online questionnaire not previously validated or standardised; a full English-language version is provided as Supplementary File 1. A composite knowledge score (0-4) was derived; scores >=3 were classified as 'high knowledge.' Chi-square tests and Firth's penalised logistic regression provided adjusted odds ratios (AOR) with 95% confidence intervals (CI). Results: The sample was predominantly male (57.1%) and young (73.8% aged 18-25 years). Self-reported hypertension prevalence was 7.9% (n=19). Only 15.8% correctly identified the normal blood-pressure range. Salt restriction awareness was high (85.0%), as was recognition of the importance of regular blood-pressure measurement (82.5%). Despite this, only 20.4% practised a low-salt diet and fewer than 24% exercised regularly. Older age (>=36 years) strongly predicted hypertension (AOR 30.73, 95% CI 4.84-195.26; p<0.001), while university-level education was protective (AOR 0.26, 95% CI 0.07-0.95; p=0.041) and predicted high knowledge (AOR 2.93, 95% CI 1.14-7.52; p=0.026). Hypertension history dominated blood-pressure monitoring (AOR 22.29, 95% CI 5.63-88.34; p<0.001) and male sex predicted regular exercise (AOR 2.53, 95% CI 1.31-4.87; p=0.006). Conclusions: A critical knowledge-practice gap exists. While attitudes toward prevention are positive and theoretical knowledge is moderate, preventive behaviours remain poor. These findings should be interpreted in the context of a researcher-developed, non-validated questionnaire. Education-focused and behaviour-change interventions are urgently needed, targeting younger, less-educated, and asymptomatic individuals.