Self-care practices and perceived social support among adults with hypertension attending an urban health training centre in Hyderabad, India

Abstract

Background: Hypertension is a major public health concern in urban settings due to lifestyle factors such as unhealthy diet, physical inactivity, and stress. Effective self-care practices including medication adherence and lifestyle modifications are essential for maintaining blood pressure control and preventing complications. However, adherence to these practices remains inconsistent. Hence, understanding self-care behaviours among adults is important for strengthening hypertension management strategies. The study objective is to determine the self-care practices among hypertensive individuals aged 30 years and above to assess perceived social support among hypertensive individuals. Materials and methods: A cross-sectional study was conducted over a period of six months among 240 hypertensive individuals aged 30 years and above at an Urban Health Training Center (UHTC) affiliated with a tertiary care teaching hospital in Hyderabad. Participants were selected from a sampling frame of 500 using simple random sampling from a follow-up register. Data were collected using a structured questionnaire incorporating the H-SCALE for assessing medication adherence, diet, physical activity, tobacco exposure, alcohol intake, and weight management, and MSPSS scale for evaluating perceived social support. Results: Among the 240 study participants (Mean Age ± SD: 55.2 ± 12.7 years; 51.7% male), 48.8% had good self-care practices. Domain wise adherence was the highest for alcohol restriction (72.5%), tobacco non-use (67.9%), medication adherence (65.8%) and low-salt diet (62.5%), and lowest for physical activity (42.9%) and weight management (10.8%). After adjusting the sociodemographic and clinical variables using multivariable logistic regression, family history of hypertension emerged as the significant independent predictor with affected individuals less likely to engage in self-care than those without a family history (AOR = 0.48; 95% CI: 0.30–0.78; p = 0.003). Among the good self-care practitioners, family-domain MSPSS scores were significantly higher (p = 0.001). Conclusion: Nearly half of hypertensive adults demonstrated suboptimal self-care, particularly in weight management and physical activity. Family history independently worsened outcomes, whereas family support improved adherence. These findings underscore the importance of integrating family-centred, theory-driven behavioural interventions into routine hypertension management to meaningfully improve patient outcomes.