Stroke prevalence and associated factors among older patients with hypertension attending public healthcare facilities in Greater Kampala Metropolitan Area, Uganda

Stroke prevalence and associated factors among older patients with hypertension attending public healthcare facilities in Greater Kampala Metropolitan Area, Uganda | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Stroke prevalence and associated factors among older patients with hypertension attending public healthcare facilities in Greater Kampala Metropolitan Area, Uganda Bridget Nagawa Tamale, Christine Muhumuza, Aisha Nalugya, John Bosco Isunju, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5867126/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Globally, stroke is one of the top three leading causes of death and disability. Although several stroke risk factors are modifiable, including hypertension, factors associated with stroke among older patients with hypertension in Uganda remain underexplored. This study assessed the prevalence and factors associated with stroke among older patients with hypertension in public healthcare facilities in the Greater Kampala Metropolitan Area, Uganda. Methods A cross-sectional study was conducted among 383 older patients with hypertension. Systematic sampling was used to recruit study participants, and STATA 15.0 was used for analysis. Descriptive statistics were used to present continuous variables, while frequencies and proportions were used to present categorical data. Bivariate analyses identified associations between independent variables and stroke. Multivariable analyses controlled for confounders. A modified Poisson regression analysis with robust standard errors estimated prevalence ratios. Results Of the 383 respondents, 71.0% (272/383) were aged 60–69 years (mean age 66.8 ± 7.1), 80.9% (310/383) were female, and 42.8% (164/383) had a primary education level (1–7 years). About 31.9% (122/383) exercised regularly, 94.8% (363/383) consumed carbohydrates frequently, 5.2% (20/383) had ever smoked, and 42.0% (151/383) had ever consumed alcohol. The prevalence of stroke was 18.3% (70/383). The factors associated with stroke included being aged 80 years and above (APR = 2.68, 95% CI: 1.59–4.51), having 8–13 years of formal education (secondary education)(APR = 0.37, 95% CI: 0.14–0.98), possessing health insurance (APR = 3.34, 95% CI: 1.19–9.37), having high knowledge of stroke (APR = 24.72, 95% CI: 6.20-98.55), and receiving stroke-related health information (APR = 1.78, 95% CI: 1.05–3.02). Conclusion and recommendation: This study demonstrated a high prevalence of stroke among older patients with hypertension. Public health education and community outreach should be expanded to underserved populations, while age-specific hypertension management and affordable healthcare services are essential. Engaging men and leveraging stroke survivors as peer educators can further strengthen prevention efforts. Future research should explore barriers to prevention and develop tailored interventions for diverse populations Stroke Prevalence Older patients Hypertension Uganda Figures Figure 1 Figure 2 Background Stroke is the second leading cause of death and the third leading cause of disability worldwide, following heart disease ( 1 , 2 ). According to the Global Stroke Fact Sheet 2022, high systolic blood pressure stands as the single most significant risk factor for stroke, accounting for 79.6 million DALYs (67.7–90.8), or 55.5% of total stroke DALYs (48.2–62.0) worldwide ( 3 ). World Health Organisation (WHO) estimates that by 2030, 80% of all strokes will occur in people living in low and middle-income countries including Uganda, where it will account for 7.9% of all mortality ( 4 , 5 ). This disproportionate burden has posed an unprecedented challenge for families with limited resources ( 6 ). Stroke rates are increasing in Sub-Saharan Africa, especially Uganda, where stroke awareness and therapeutic interventions are very limited ( 7 ). Although poorly documented, stroke is currently estimated to be the sixth highest-ranking cause of death and disability in Uganda ( 8 ). Notably, older individuals with hypertension are at a heightened risk of stroke owing to lifestyle factors (diet, physical activity), socio-economic status, access to healthcare, and genetic predispositions. Interventions have primarily focused on hypertension management, lifestyle modifications, and access to timely medical care ( 9 , 10 ). As evidenced by existing research, stroke mortality and morbidity among patients with hypertension could be considerably reduced by implementing organized stroke care, which encompasses evidence-based clinical practice guidelines, continuous quality improvement philosophy, and programs ( 11 , 12 ). The current challenge lies in effectively implementing these interventions, especially in resource-scarce regions such as Uganda. In line with this, the World Stroke Organization (WSO) aims to minimize the global burden of stroke through prevention, treatment, and long-term care. In 2014, Lindsay et al. developed a Global Stroke Services Action Plan, founded on recommendations from the 10 stroke guidelines, receiving scores above 60% on two ( 13 ). This Action Plan outlines essential components of stroke care across various healthcare models ( 13 ). Moreover, in Uganda, stroke care is guided by several policies and frameworks that aim to improve healthcare delivery. For instance, the National Multisectoral Strategic Plan for the Prevention and Control of Non-Communicable Diseases (NCDs) 2018–2023 seeks to reduce risk factors and mortality associated with NCDs, including stroke, by enhancing prevention and control measures ( 14 ). Additionally, the National Health Policy (2010–2020) and the Universal Health Coverage (UHC) Roadmap 2019 emphasize the need for equitable, accessible, and quality healthcare for all Ugandans, including stroke prevention and management. Despite the existence of these frameworks, Uganda still lacks a comprehensive, coordinated stroke care policy that integrates prevention, treatment, and long-term care. Currently, stroke management is addressed within the broader Uganda Clinical Guidelines ( 15 ), but more targeted efforts are needed to develop and implement stroke-specific policies and care pathways in the country. While extensive studies devoted to the management and prevention of stroke, the global burden of stroke would not be reduced without efforts targeting understanding the stroke burden among high-risk groups such as older patients with hypertension ( 16 ). Therefore, this study aimed to assess the prevalence and factors associated with stroke among older patients with hypertension attending public healthcare facilities in GKMA, Uganda. It also established the practices towards stroke prevention among older patients with hypertension. Generated evidence informed the design of more precise interventions to combat, control, and prevent stroke among patients with hypertension. Methods Study setting and design This was a cross-sectional study conducted in public healthcare facilities in GKMA that manage NCDs including hypertension. GKMA includes three districts that is, Kampala, Wakiso, and Mukono districts. According to the Uganda Bureau of Statistics Population projection 2021, the population of Kampala is 1,709,900, the population of Mukono is 720,100, and the population of Wakiso is 3,105,700 ( 17 ). Uganda’s health facilities are classified into seven levels based on the services they provide and the catchment area they are intended to serve. The health facilities are designated as Health Centre Level One (HC I) to Health Centre Level Four (HC IV); General Hospital, Regional Referral Hospital, and National Referral Hospital. In the districts of Wakiso, Mukono, and Kampala, there are 72, 40, and 26 public healthcare facilities, respectively ( 18 ). MOH mandates public healthcare facilities to prevent, manage, and control NCDs, including stroke and hypertension, through educating the community on healthy lifestyles and early detection of diseases; screening for NCDs; follow-up cases; and promoting community-based rehabilitation; and appropriate referral ( 19 ). KCCA clinics run integrated NCD clinics twice a week. In these clinics, all patients with NCDs (both HIV positive and negative) are seen. These include patients with hypertension, diabetes, and chronic lung diseases, among others. The clinics are manned by medical officers, clinical officers, and nurses. In both clinics, an approximate number of 20–40 patients are seen per clinic visit. Study population and eligibility criteria This study was conducted among older patients with hypertension attending public healthcare facilities in GKMA. This study defined older patients as those aged 60 years and above. This definition is recommended by the United Nations as well as the Uganda National Plan of Action For Older Persons ( 20 ). Patient with hypertension aged 60 years and above who were receiving treatment at public healthcare facilities in the GKMA and had given their informed consent to participate were included in the study. Patients who were critically ill, incapacitated, or otherwise unable to endure the study procedures were excluded. Sample size estimation The sample size was determined using the Kish Leslie formula ( 21 ). Based on an assumption of a prevalence of 33.7% of stroke among adult Ugandans in rural and urban Mukono district ( 22 ), a 5% margin of error, and a 95% confidence interval, a sample of 344 participants was achieved. After accounting for a non-response (nr) rate of 10%, we obtained a final sample size of 383 respondents. Sampling methods Systematic sampling was used to select study participants. A list of 19 public healthcare facilities with NCD clinics in Kampala (6 facilities), Wakiso (8 facilities), and Mukono (5 facilities) districts was obtained from the respective District and/or Municipal Health Departments. From this list, seven ( 7 ) high-volume health facilities were selected to ensure a substantial number of older patients with hypertension were included in the study (Table 1 ). High-volume facilities were defined by the frequency of NCD clinic services (offered twice a week) and the number of patients with hypertension seen per clinic visit, typically ranging from 20 to 60 patients. Table 1 Number of public healthcare facilities with NCD clinics in GKMA District No. of PHF with NCD clinics High-volume NCD clinics selected Kampala 6 2 Mukono 5 2 Wakiso 8 3 Total 19 7 At each selected facility, a list of all older patients with hypertension attending the clinic on the day of data collection was compiled by the clinic officer/nurse in charge. Systematic sampling was then applied to recruit participants. The sampling interval (K) was determined by dividing the total number of older patients with hypertension present at each facility (N) by the desired sample size for that facility (n) using the formula: K = N/n. For example, if a facility had 40 older patients with hypertension and the desired sample size for that facility was 20, the sampling interval K would be K = 40/20 = 2. This meant that every 2nd patient on the list was selected. A random starting point was chosen within the first sampling interval, and every subsequent K th patient was included in the sample. This process was repeated at each facility, ensuring proportional representation based on the number of older hypertensive patients at each site. The total number of respondents for each facility was determined proportionate to the relative number of older hypertensive patients attending that facility, compared to the total number of older hypertensive patients across all facilities. The formula used was: N = \(\:\frac{Number\:of\:older\:hypertensives\:in\:a\:given\:HCF\:}{total\:number\:of\:older\:hypertensives\:in\:all\:HCFs}\times\:calculated\:sample\:size\) Study variables and measurements The primary outcome variable for this study is having a stroke, measured as a binary variable (Yes/No) indicating whether a participant has experienced a stroke. This was determined through self-reported data, with participants being asked the specific question, “Have you ever suffered a stroke?” Recognizing that not all participants may be familiar with the medical term "stroke," the question was operationalized to include a descriptive explanation for those who needed clarification. For participants who were uncertain or unfamiliar with the term, stroke was described in accessible terms, including symptoms such as sudden weakness or numbness in the face, arm, or leg (especially on one side of the body), difficulty speaking or understanding speech, sudden trouble seeing, walking, or loss of balance. Participants who understood the term “stroke” were asked directly, while those who required further explanation received this description to ensure accurate responses. The prevalence of stroke in the study was calculated as the proportion of patients with hypertension aged 60 years and above who reported having experienced a stroke. This method was also used by Sanuade, Dodoo ( 23 ) to assess the prevalence and correlates of stroke among older adults in Ghana. Independent variables included: 1) socio-demographic factors (such as age, sex, education level, marital status, religion, employment status, and dependents); 2) patient factors (such as patient beliefs, and attitudes regarding stroke, and patients’ knowledge on stroke ; 3) lifestyle factors (e.g., alcohol intake, diet, physical activity), 4) hypertension treatment-related factors (including drug regimen, duration of hypertensive treatment, route of medication, cost of the drug, drug adverse-related complications, number of drugs, and frequency per day among others), and 5) Health system factors (including distance to the health facility, waiting time, availability of drugs, follow-up and monitoring of patients, patient-health worker relationship, and availability of insurance services). Patients’ knowledge of stroke was adapted from a study by Woldetsadik, Kassa ( 24 ) among hypertensive patients at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. The knowledge section comprised 3 questions assessing the potential risk, warning signs, and risk factors related to knowledge about stroke. Questions included 1) knowledge of signs of stroke such as sudden onset of dizziness; sudden onset of headache; sudden onset of memory loss; sudden onset of half body weakness; sudden onset of loss of consciousness; sudden onset of double vision; and sudden onset of speech problems, and 2) knowledge of risk factors such as high blood pressure; smoking; diabetes mellitus; cardiac disease; obesity; high cholesterol; excessive alcohol intake; physical activity; and the presence of a family member having a stroke. Responses included: “Yes,” “No,” “I don't know;” with “Yes” responses coded as 1 and all other responses coded as 0. A composite score was generated based on the summation of all the correct responses. Thereafter, the median score (2.0) was used as a cut-off. Those who obtained a score equal to or above the median were considered to have a high knowledge of stroke. Physical activity was measured as exercising more than 3 times a week, at moderate intensity or more than 30 minutes each time, or engaging in moderate including walking and severe physical work. Data collection procedures and tools Data was collected by Research Assistants (RAs) with minimum education qualification of a bachelor’s degree in Humanities, Statistics, Environmental or Public Health, or any other related discipline as well as prior experience in conducting face-to-face interviews. These RAs underwent a 3-day training to get acquainted with the study protocol, and the ethical issues about the study. A semi-structured questionnaire developed based on a thorough literature review of existing literature related to stroke prevalence and predictors in similar populations ( 25 , 26 ) was used to obtain data. This questionnaire was administered through face-to-face interviews, and it elicited information on the: socio-demographic characteristics, patient-related factors, lifestyle factors, hypertension treatment-related factors, and health system factors. The study questionnaire underwent validation by a team of stroke experts to ensure its accuracy and relevance ( 27 ). The experts reviewed the content to confirm that it covered all necessary aspects of stroke prevalence, predictors, and related factors, and provided feedback to refine the questions. Their validation ensured that the questionnaire was both reliable and valid for assessing stroke-related prevalence and risk factors in the target population. This questionnaire was developed in English and translated into Luganda, the most commonly spoken local language in GKMA. Pretesting of the questionnaires was done in public healthcare facilities in Mityana district before being used for the study to ensure clarity and suitability. The data collection process; The data collection team was divided into three teams of two, with each team in one district. One team of two research assistants collected data at each facility on the specific clinic days in the selected health facilities. At each health facility, permission was sought from the health facility in charge. With the in-charge’s support, eligible participants were identified, and if no eligible respondent was present at the time of the study, an appointment was made at a convenient time. If eligible respondents were present, informed consent was sought using a consent form. Data was collected from patients after they had been seen by the physician in the specialized hypertension clinics. However, recognizing that some participants may have limitations in verbal communication, I adapted this approach to ensure inclusivity. If a patient in the specialized hypertension clinic was unable to directly participate, their designated caregiver was interviewed instead. Informed consent was also sought from the caretaker ensuring their understanding of the study. The questionnaire was then administered at a place of convenience and privacy to the participant. This lasted 20–30 minutes per participant. Data management and analysis Data were entered using the Kobo collect mobile application preloaded on Android-enabled mobile phones. RAs were required to upload the data daily to the cloud server for quality control purposes. Data was then downloaded into MS Excel 2016, cleaned, and analyzed using STATA 15.0 statistical software. Data cleaning involved the removal of unwanted or duplicate observations from the dataset (de-duplication), fixing structural errors such as typos, or incorrect capitalization, filtering unwanted outliers, handling missing data, and validation. Descriptive statistics such as mean and standard deviation were used to present continuous variables, while frequencies and proportions were used to present categorical data. Both bivariate and multivariable analyses were conducted to ascertain significant variables. In the bivariate analysis, a significance level of p < 0.1 was used, while in the multivariable analysis, the significance level was set at p < 0.05. The rationale for using a p-value cutoff of 0.1 in the bivariate analysis is to include potentially relevant variables that may have a weaker association with the outcome but could still be important in the context of the study ( 28 , 29 ). This approach allows for a more comprehensive exploration of potential predictors before applying more stringent criteria in the multivariable analysis. Since the outcome had a prevalence that exceeded 10%, a modified Poisson regression analysis with robust standard errors was used to report prevalence ratios. Multicollinearity effect was assessed; A correlation coefficient of ≥ 0.4 was considered high; if two variables exceeded this threshold, only one was retained in the model to avoid multicollinearity. To assess for interaction, the chunk test was used to compare a full model with interaction terms and a simplified model with only basic variables. Interaction terms were retained in the model if the test yielded a significant p-value < 0.05. Confounding was assessed on all variables that dropped out of the model using stepwise elimination, with assessment prioritized from the most significant to the least significant variable that dropped out. The results were presented in tables, graphs, and figures as appropriate. Quality control and assurance The RAs were trained for 3 days to ensure that they fully understand the protocol and the data collection tools. Pretesting of the questionnaires was done in public healthcare facilities in Mityana district, before being used for the study to ensure clarity and suitability in assessing the stroke prevalence and associated factors. Mityana district was selected for the pretest due to its resemblance to the GKMA in key characteristics such as demographics, healthcare infrastructure, and socioeconomic status. During the pretest, we identified and addressed any issues related to question comprehension, response accuracy, and overall questionnaire flow. Feedback from the pretesting allowed us to refine the questions to ensure that the questions were understandable and relevant to the target population. Research assistants were supervised during the entire data collection period to ensure quality data. This supervision involved regular check-ins, on-the-spot reviews of collected data, and immediate feedback to address any issues or inconsistencies. Daily debrief meetings were held to identify challenges that arose during the data collection process and address them accordingly. The questionnaire embedded in the Kobo Collect app was programmed to ensure the completeness of the data entered. During programming, mandatory fields and skip patterns were inserted into the tool. Back translation was conducted to ensure that the meaning of the questions is not lost. After data collection, the data was cleaned in Excel 2016. Results Socio-demographics characteristics of respondents Out of the 383 respondents, the majority 71.0% (272/383) were aged 60–69 years with a mean age being 66.8 ± 7.1 years. More than three-quarters of the respondents 80.9% (310/383) were female, 39.9% (153/383) were catholic, 42.8% (164/383) had a primary education level, and 71.5% (274/383) had dependents (Table 2 ). Table 2 Socio-demographics characteristics of respondents Variable Attribute Frequency Percentage (%) Age of the respondents (Mean = 66.8 ± 7.1 60–69 years 272 71.0 70–79 years 80 20.9 80 and above years 31 8.1 Sex of the respondent Female 310 80.9 Male 73 19.1 Religion Anglican 84 21.9 Catholic 153 39.9 Muslim 43 11.2 Pentecostal (born again) 87 22.7 SDA 16 4.2 Education Level No Formal education 152 39.7 Primary (1–7 years) 164 42.8 Secondary (8–13 years) 43 11.2 Tertiary 24 6.3 Employment Status Employed by someone 7 1.8 Self-employed 127 33.2 Unemployed 249 65.0 Marital Status Divorced/ Separated 92 24.0 Living together / Cohabiting 23 6.0 Married 140 36.6 Never Married/ Single 4 1.0 Widowed 124 32.4 Dependents No 109 28.5 Yes 274 71.5 Number of dependents (n = 274) 1 14 5.1 2–4 115 42.0 5 and above 145 52.9 Patient and hypertension treatment-related factors of respondents More than two-thirds, 69.2% (265/383) of the respondents were diagnosed with hypertension more than 2 years ago, and 98.4% (377/383) were taking any hypertension medication. Of those who were taking hypertension medication, 35.5% (136/377) were taking both medical and traditional medicines, 99.7% (376/377) had an oral antihypertension treatment, and 66.8% (252/377) had used the hypertension treatment for more than 2 years (Table 3 ). Table 3 Patient and hypertension treatment-related factors of respondents Variable Attribute Frequency Percentage (%) Duration since diagnosed with hypertension Below 1 year 22 5.7 1–2 years 96 25.1 Above 2 years 265 69.2 Currently taking any medications for hypertension No 6 1.6 Yes 377 98.4 Hypertension Medication taken (n = 377) Both 136 35.5 Medical 240 62.7 Traditional or alternative medicines 1 0.3 Frequency of monitoring blood pressure Always 267 69.7 Never 3 0.8 Sometimes 113 29.5 Route of administration for your hypertension treatment (n = 377) Oral 376 99.7 Injectable 1 0.3 If oral, number of tablets taken per day (n = 376) 1 170 45.2 2–4 196 52.1 5 and more 10 2.7 Period on hypertension medication (n = 377) Below 1 year 37 9.8 1–2 years 88 23.3 Above 2 years 252 66.8 Person/entity paying for the medications Self 243 63.4 Relative 74 19.3 Health facility provides free 145 37.9 Insurance 3 0.8 Challenges faced while taking antihypertensive medication* Drug is expensive 240 62.7 Do not understand prescription 4 1.0 Too many tablets 3 0.8 The drug is hard to swallow 18 4.7 Drugs are not always available 95 24.8 Normally forget to take it because I am always busy 18 4.7 * Multiple response Lifestyle factors of respondents About 31.9% (122/383) of the respondents always carried out physical exercise in a week, 94.8% (363/383) consumed carbohydrates, 5.2% (20/383) had ever smoked tobacco, and 42.0% (151/383) had ever drunk alcohol (Table 4 ). Table 4 Lifestyle factors of respondents Variable Attribute Frequency Percentage (%) Number of days physically active for a total of at least one hour per day bin the past seven days 0 days 109 28.4 1 day 31 8.1 2 days 72 18.8 3 days 41 10.7 4 days 26 6.8 5 days 11 2.9 6 days 11 2.9 7 days 82 21.4 Frequency of carrying out physical exercise in a week Always 122 31.9 Never 94 24.5 Rarely 42 11.0 Sometimes 125 32.6 Food commonly consumed* Carbohydrates 363 94.8 Proteins 291 76.0 Fruit 230 60.1 Vegetables 330 86.2 Ever smoked tobacco No 363 94.8 Yes 20 5.2 Still smokes tobacco (n = 20) No 16 80.0 Yes 4 20.0 Ever drunk alcohol No 222 58.0 Yes 161 42.0 Still takes alcohol (n = 161) No 121 75.2 Yes 40 24.8 * Multiple response Health facility-related factors More than three quarters 78.1% (299/383) of the respondents had visited the health facility 1 month ago, 36.0% (138/383) mentioned that antihypertensive medication was always available, and 69.5% (266/383) paid for antihypertensive medication. Only 1.0% (4/383) of the respondents were on health insurance, 93.0% (356/383) mentioned that the relationship between health workers and patients at the health facility was always good, and 46.7% (179/383) perceived the distance from their home to the health facility as being near (Table 5 ). Table 5 Health facility-related factors Variable Attribute Frequency Percentage (%) Last time visited the health facility (Months) 1 month 299 78.1 More than 1 month 84 21.9 Period the health worker recommended the patient report back to the facility (Months) 1 month 304 79.4 More than 1 month 79 20.6 Perception about the availability of antihypertensive medication in the health facility Always available 138 36.0 Available but expensive 125 32.7 Not always available 120 31.3 Pays for antihypertensive medication at this facility No 117 30.5 Yes 266 69.5 Perception about the cost of medication at this facility Affordable 141 36.8 Don't Know 51 13.3 Expensive 191 49.9 On health insurance No 379 99.0 Yes 4 1.0 Perception about the relationship between health workers and patients in this health facility Always good 356 93.0 Not good 1 0.3 Sometimes good 26 6.8 Time taken when traveling from home to the health facility 30 minutes and below 195 50.9 Above 30 minutes 188 49.1 Perception about the distance from your home to the health facility Can’t say 3 0.8 Far 201 52.5 Near 179 46.7 Challenges faced while accessing this health facility* Transport is expensive 218 56.9 Traffic congestion on the road 46 12.0 Motion sickness while traveling 44 11.5 I cannot come on my own(disabled) 13 3.4 None 134 35.0 * Multiple response Prevalence of stroke and stroke-related knowledge among respondents The prevalence of stroke among respondents was 18.3% (70/383). The prevalence of stroke was 15.4% (42/272) in those aged 60–69, 22.5% (18/80) for those aged 70–79, and 32.2% (10/31) for those aged 80 and above. Of the respondents that had ever had a stroke, 10.4% (40/70) had it more than a year ago and 78.6% (55/383) still had any stroke-related symptoms. Regarding knowledge levels, 58.7% (225/383) of the respondents had high knowledge of stroke and 53.3% (204/383) had ever received stroke-related information (Table 6 ). Table 6 Prevalence of stroke and stroke-related knowledge among respondents Variable Attribute Frequency Percentage (%) Ever gotten a stroke No 313 81.7 Yes 70 18.3 Duration since diagnosed with stroke (n = 70) Below 1 year 30 7.8 1 year and above 40 10.4 Still has any stroke-related symptoms (n = 70) No 15 21.4 Yes 55 78.6 Ever received any stroke-related health information No 168 43.9 Not sure 11 2.9 Yes 204 53.3 Source of the stroke-related health information* VHT 8 2.1 Health care provider 183 47.8 Internet/Media 11 2.9 Perceived risk of experiencing a stroke No 281 73.4 Yes 102 26.6 Obesity 4 1.0 High cholesterol 19 5.0 Excessive alcohol intake 11 2.9 Physical inactivity 8 2.1 Presence of a family member having a stroke 10 2.6 Don’t know 235 61.4 * Multiple response Knowledge on the signs and symptoms of stroke among respondents Figure 1 shows the distribution of respondents' knowledge regarding the signs of stroke. The most frequently recognized sign was the sudden onset of half-body weakness (42.3%; 162/383), followed by sudden onset of headache (34.7%; 133/383), and sudden onset of dizziness (34.5%; 132/383). Other signs included sudden onset of loss of consciousness (21.4%; 82/383), sudden onset of speech problems (10.2%; 39/383), sudden onset of double vision (9.9%; 38/383), and sudden onset of memory loss (7.3%; 28/383), which were less frequently mentioned by respondents. Knowledge on stroke risk factors among respondents Figure 2 shows the distribution of respondents' knowledge regarding stroke risk factors. The most frequently recognized risk factor was high blood pressure (33.9%; 130/383). This was followed by diabetes mellitus (7.8%; 30/383) and high cholesterol (5.0%; 19/383). Other factors such as cardiac disease (3.9%; 15/383), smoking (3.7%; 14/383), and excessive alcohol intake (2.9%; 11/383) were mentioned less frequently. Physical inactivity (2.1%; 8/383), the presence of a family member having a stroke (2.6%; 10/383), and obesity (1.0%; 4/383) were the least recognized risk factors. Majority of respondents (61.4%; 235/383) indicated that they did not know any stroke risk factors. Predictors of stroke among older hypertensive patients attending public healthcare facilities in GKMA After controlling for age, sex, religion, and education level, being 80 and above years, having 8–13 years of formal education (secondary education), having health insurance, having high knowledge of stroke, and receiving any stroke-related health information were significantly associated with stroke. Respondents aged 80 and above years (APR = 2.68, 95% CI:1.59–4.51) had a 168% higher prevalence of stroke as compared to those aged 60–69 years. Respondents with 8–13 years of formal education (secondary education) (APR = 0.37, 95% CI: 0.14–0.98) had a 63% lower prevalence of stroke as compared to those with no formal education. Respondents with health insurance (APR = 3.34, 95% CI: 1.19–9.37) had a 234% higher prevalence of stroke as compared to those without health insurance. The prevalence of stroke among respondents with high knowledge of stroke (APR = 24.72, 95% CI: 6.20-98.55) was 24.72 times higher than those with low knowledge. The prevalence of stroke among respondents who had ever received any stroke-related health information (APR = 1.78, 95% CI: 1.05–3.02) was 1.84 times higher than their counterparts (Table 7 ). Table 7 Predictors of stroke among older hypertensive patients attending public healthcare facilities in GKMA Variable Attribute Ever had a stroke Crude PR (95% CI) P-values Adjusted PR (95% CI) P-values Yes (n = 70) No (n = 313) Age of the respondent 60–69 42 (15.4) 230 (84.6) 1 1 70–79 18 (22.5) 62 (77.5) 1.46 (0.89–2.39) 0.135 1.28 (0.82–2.01) 0.278 80 and above 10 (32.3) 21 (67.7) 2.09 (1.17–3.74) 0.013 2.68 (1.59–4.51) < 0.001* Sex of the respondent Female 56 (18.1) 254 (81.9) 1 1 Male 14 (19.2) 59 (80.8) 1.06 (0.63–1.80) 0.824 1.34 (0.81–2.21) 0.246 Religion Anglican 16 (19.0) 68 (81.0) 1 1 Catholic 24 (15.7) 129 (84.3) 0.82 (0.46–1.46) 0.508 0.60 (0.35–1.03) 0.064 Muslim 9 (20.9) 34 (79.1) 1.10 (0.53–2.28) 0.800 0.86 (0.45–1.67) 0.663 Pentecostal (born again) 15 (17.2) 72 (82.8) 0.9 (0.48–1.71) 0.760 0.65 (0.35–1.20) 0.171 SDA 6 (37.5) 10 (62.5) 1.97 (0.91–4.26) 0.085 1.11 (0.55–2.28) 0.763 Education Level No Formal education 25 (16.4) 127 (83.6) 1 1 Primary 36 (22.0) 128 (78.0) 1.33 (0.84–2.11) 0.219 1.14 (0.74–1.75) 0.561 Secondary 4 (9.3) 39 (90.7) 0.56 (0.21–1.54) 0.264 0.37 (0.14–0.98) 0.046* Tertiary 5 (20.8) 19 (79.2) 1.27 (0.54–2.99) 0.590 0.90 (0.41–1.96) 0.788 Employment Status Employed by someone 2 (28.6) 5 (71.4) 1 Self-employed 19 (15.0) 108 (85.0) 0.52 (0.15–1.82) 0.308 Unemployed 49 (19.7) 200 (80.3) 0.69 (0.21–2.28) 0.542 Has dependents No 19 (17.4) 90 (82.6) 1 Yes 51 (18.6) 223 (81.4) 1.07 (0.66–1.72) 0.788 Duration since diagnosed with hypertension Below 1 year 4 (18.2) 18 (81.8) 1 1–2 years 15 (15.6) 81 (84.4) 0.86 (0.31–2.34) 0.767 Above 2 years 51 (19.2) 214 (80.8) 1.06 (0.42–2.66) 0.904 Frequency of monitoring blood pressure Always 47 (17.6) 220 (82.4) 1 Never 1 (33.3) 2 (66.7) 1.89 (0.37–9.60) 0.441 Sometimes 22 (19.5) 91 (80.5) 1.11 (0.70–1.75) 0.665 Frequency of carrying out physical exercise in a week Always 21 (17.2) 101 (82.8) 1 Never 15 (16.0) 79 (84.0) 0.93 (0.50–1.70) 0.807 Rarely 9 (21.4) 33 (78.6) 1.24 (0.62–2.50) 0.539 Sometimes 25 (20.0) 100 (80.0) 1.16 (0.69–1.96) 0.575 Ever smoked tobacco No 66 (18.2) 297 (81.8) 1 Yes 4 (20.0) 16 (80.0) 1.10 (0.44–2.72) 0.836 Ever drunk alcohol No 39 (17.6) 183 (82.4) 1 Yes 31 (19.3) 130 (80.7) 1.10 (0.71–1.68) 0.673 Perception about the availability of antihypertensive medication in the health facility Always available 20 (14.5) 118 (85.5) 1 Available but expensive 26 (20.8) 99 (79.2) 1.43 (0.84–2.44) 0.182 Not always available 24 (20.0) 96 (80.0) 1.38 (0.80–2.37) 0.244 Pays for antihypertensive medication at this facility No 24 (20.5) 93 (79.5) 1 Yes 46 (17.3) 220 (82.7) 0.84 (0.54–1.31) 0.451 Perception about the cost of medication at this facility Affordable 23 (16.3) 118 (83.7) 1 Don't Know 10 (19.6) 41 (80.4) 1.20 (0.61–2.35) 0.591 Expensive 37 (19.4) 154 (80.6) 1.19 (0.74–1.91) 0.477 Health insurance No 68 (17.9) 311 (82.1) 1 1 Yes 2 (50.0) 2 (50.0) 2.79 (1.02–7.61) 0.046 3.34 (1.19–9.37) 0.022* Perception about the relationship between health workers and patients in this health facility Always good 62 (17.4) 294 (82.6) 1 1 Not good/ sometimes good 8 (29.6) 19 (70.4) 1.70 (0.91–3.18) 0.095 1.66 (0.99–2.78) 0.053 Time taken when traveling from home to the health facility 30 minutes and below 37 (19.0) 158 (81.0) 1 Above 30 minutes 33 (17.6) 155 (82.4) 0.92 (0.60–1.41) 0.720 Knowledge of stroke Low 2 (1.3) 156 (98.7) 1 1 High 68 (30.2) 157 (69.8) 23.87 (5.93–96.16) < 0.001 24.72 (6.20-98.55) < 0.001* Ever received any stroke-related health information No 19 (11.3) 149 (88.7) 1 1 Not sure 1 (9.1) 10 (90.9) 0.80 (0.12–5.47) 0.823 1.57 (0.31–7.81) 0.584 Yes 50 (24.5) 154 (75.5) 2.17 (1.33–3.53) 0.002 1.78 (1.05–3.02) 0.031* Discussion This study assessed the preventive practices, prevalence, and factors associated with stroke among older patients with hypertension attending public healthcare facilities in the GKMA, Uganda. The prevalence of stroke among these patients was found to be 18.3%. This prevalence is considered high when compared to the global average stroke prevalence among older adults, which typically ranges from 5–10% according to the WHO and other epidemiological studies ( 3 , 30 ). This study’s stroke prevalence is comparable to a study in Ethiopia which found an 18.18% prevalence among adult patients with hypertension ( 31 ), but higher than studies conducted in Nigeria, Sidama, and Shanghai which reported incidences of 13.2%, 3.15%, and 10.8% respectively ( 25 , 32 ). The current study identified an increasing prevalence of stroke with age among older patients with hypertension: 15.4% in those aged 60–69, 22.5% in those aged 70–79, and 32.2% in those aged 80 and above. This study's finding aligns with a study done by Fekadu, Chelkeba ( 33 ) in Jimma in Ethiopia. However, compared to findings from ( 25 ) in Shanghai, this study’s prevalence rates are notably higher across all age groups. This discrepancy can be attributed to several factors, including the facility-based nature of the current study compared to the population-based study, differences in healthcare infrastructure and access, variations in hypertension management and control, and the reliance on self-reported stroke diagnoses. The higher stroke prevalence in the current study indicates the urgent need for improved public health interventions to enhance hypertension management and stroke prevention strategies in urban areas. Furthermore, this study revealed that the factors associated with stroke among older patients with hypertension were being aged 80 and above years, having 8–13 years of formal education (secondary education), having health insurance, high knowledge of stroke, and receiving stroke-related health information. The association between age and stroke prevalence is consistent with findings from other studies ( 25 , 34 ), which also show a significant relationship between being aged 80 and above and stroke prevalence. Additionally, having a secondary education level was significantly associated with stroke prevalence, as observed in a study by ( 24 ) in Ethiopia. However, while some studies have identified health insurance as a protective factor against stroke ( 35 – 37 ), this study found a higher prevalence of stroke among insured individuals. It is important to note that this study did not directly assess whether health insurance might be contributing to longer life expectancy among the elderly, thereby potentially creating a perception of higher stroke prevalence in insured older patients with hypertension. Increasing age was found to be significantly associated with prevalence of stroke. As people age, the long-term effects of hypertension contribute to significant vascular damage, increasing arterial stiffness and promoting atherosclerosis ( 38 , 39 ). Both conditions worsen with age, raising the likelihood of cerebrovascular events such as stroke. Moreover, aging is associated with a decline in endothelial function and a rise in chronic inflammation, both of which exacerbate the vulnerability to stroke ( 40 ). In older patients, inadequate treatment acceptance in routine practice could contribute to the increased stroke risk ( 41 – 43 ). In this study, it was observed that having 8–13 years of formal education (secondary education) was associated with a lower prevalence of stroke, aligning with the understanding that education enhances health literacy, enabling individuals to better manage hypertension and make healthier lifestyle choices ( 44 , 45 ). Educated individuals are more likely to engage in regular physical activity, maintain a balanced diet, and avoid risk factors such as smoking and excessive alcohol consumption ( 46 , 47 ). Interestingly, the study found that individuals with health insurance had a higher prevalence of stroke. While health insurance is generally considered a protective factor against severe health outcomes, some studies have suggested that insured individuals are more likely to seek medical attention and receive formal diagnoses for conditions, leading to higher reported prevalence rates. For instance, studies such as those by ( 41 , 48 ) have highlighted the potential for insurance to improve access to healthcare, thus increasing the diagnosis of non-communicable diseases like stroke. However, in low-resource settings, insured individuals may still face challenges such as inadequate management of risk factors, which could contribute to higher stroke prevalence ( 49 – 51 ). This study supports these findings, indicating that having insurance does not always guarantee better health outcomes, especially in contexts where healthcare quality is uneven. Additionally, despite the assumption that those with health insurance might also have higher educational attainment, this study shows that insurance coverage remains generally low in the population, and having insurance does not necessarily correlate with secondary education in this context. Many people with insurance may not necessarily represent those with higher education levels. Thus, the higher prevalence of stroke in insured individuals may reflect increased healthcare engagement and diagnostic reporting rather than poorer health outcomes. In addition, this study found that respondents with higher stroke knowledge were more likely to have experienced a stroke compared to those with lower knowledge. This result is not surprising, as individuals who have suffered a stroke are more likely to acquire detailed information about the condition through personal experience and medical care. Experiencing a stroke often increases awareness of symptoms, risk factors, and preventive measures, as patients receive health education during their diagnosis, treatment, and recovery process. This aligns with findings from Sirisha, Jala ( 52 ), which highlight that individuals with firsthand experience of a condition are more likely to have greater knowledge about it. However, the important implication of this finding lies in the need to increase stroke awareness among individuals who have not yet experienced a stroke. Those with lower stroke knowledge may be unaware of their risk factors or early symptoms, which could lead to delayed healthcare-seeking behavior and poorer outcomes. Public health efforts should therefore focus on sensitizing this group, particularly among older patients with hypertension, through targeted health education campaigns to ensure that they recognize stroke risks and engage in preventive measures early on. Besides, this study found a higher prevalence of stroke among respondents who had received stroke-related health information. It is important to note that receiving stroke-related health information itself is not a risk factor for stroke. Rather, individuals who are at a higher risk for stroke or have already experienced a stroke are more likely to seek out or be provided with this information by healthcare professionals. Healthcare providers often prioritize stroke education for patients who have significant risk factors or have already had a stroke, as part of their ongoing care and management ( 53 , 54 ). This can lead to a higher observed prevalence of stroke in this informed group, as these individuals are more engaged with the healthcare system and more likely to have their stroke risk factors identified and managed. The higher prevalence, therefore, reflects the correlation between increased stroke risk and the likelihood of receiving targeted health education, not causality between the two. The implication of this finding is that targeted stroke-related health education plays a key role in improving awareness among individuals at higher risk of stroke. However, it also highlights the need for broader public health efforts to ensure that stroke education reaches individuals who may not have experienced a stroke or exhibit visible risk factors but could still be at risk. Expanding stroke prevention campaigns to a wider population, including those who are not yet engaged with healthcare services or who do not perceive themselves as being at risk, can help in early detection and prevention. Strengths and Limitations Strengths This study represents a pioneering effort to assess prevalence and factors associated with stroke among older patients with hypertension attending public healthcare facilities in GKMA, Uganda. Its novelty lies in providing a foundational understanding that can inform future research, policy-making, and targeted interventions within the region. A relatively large sample size of 383 respondents was recruited, enhancing the generalizability of the findings to similar populations. This robust sample size strengthens the validity of inferences drawn about the target population. Furthermore, the study employed established frameworks such as the WHO Social Determinants of Health, ensuring methodological rigor and grounding its insights in a well-recognized theoretical context. Limitations This study has several limitations. Stroke measurement relied on self-reports, cross-referenced with medical records where possible, but the absence of a standardized tool to assess stroke may have affected the reliability of the prevalence estimates. Survivor bias may have influenced findings, as only individuals who survived a stroke were included. The analysis excluded some variables from the conceptual framework, potentially limiting comprehensiveness. Socio-economic status was not directly assessed, though proxies like education level and health insurance were included. Recall bias may have affected data accuracy, but efforts were made to focus on recent and objective details. As a facility-based study, stroke prevalence may be underestimated, excluding individuals with fatal strokes or those not seeking care at public facilities. Finally, findings are specific to public healthcare facility users in the GKMA and may not represent the broader population. Conclusions and recommendations This study showed a high prevalence of stroke among older patients with hypertension. The factors associated with stroke were age (80 years and above), having 8–13 years of formal education (secondary education), possession of health insurance, high knowledge of stroke, and receipt of stroke-related health information. Notably, while higher knowledge of stroke and receipt of health information was associated with an increased likelihood of stroke, this relationship highlights that individuals at greater risk are more likely to seek out and receive education about stroke. Thus, rather than indicating that knowledge or education is a risk factor, it suggests that these factors serve as indicators of engagement with the healthcare system and recognition of risk. Based on the study findings, several recommendations are proposed to improve stroke prevention and management among older adults. Public health education programs should be enhanced to increase awareness of stroke prevention methods, particularly targeting older adults and individuals with hypertension. Expanding public education initiatives to underserved populations through community outreach is critical to reach those with limited knowledge or access to healthcare services. Age-specific hypertension management programs should be developed, focusing on older adults at higher risk, including those aged 80 and above. Access to healthcare services should be improved by creating affordable and comprehensive healthcare plans that cover preventive and management services for older adults. Male engagement in hypertension management should be encouraged through targeted outreach campaigns to address low health-seeking behavior among men. Individuals with stroke experience can be trained as peer educators in chronic care clinics to support stroke prevention and management efforts. Lastly, further research should be conducted to identify specific barriers to stroke prevention and develop tailored interventions to meet the needs of different populations. Abbreviations CDC Centre for Disease Control DALYs Disability Adjusted Life Years GKMA Greater Kampala Metropolitan Area GOU Government of Uganda MoH Ministry of Health NCD Non-Communicable Disease SDGs Sustainable Development Goals SSA Sub- Saharan Africa WHO World Health Organization Declarations Ethics approval and consent to participate Study approval was obtained from the Makerere University School of Public Health (MakSPH) Research and Ethics Committee and the Uganda National Council for Science and Technology (UNCST). In addition, administrative clearance was obtained from the respective district authorities. Following this, permission to interview patients was requested from the in-charges of the respective public healthcare facilities. All methods were performed in accordance with the with relevant guidelines and regulations such as Declaration of Helsinki. Participation was voluntary, and written informed consent was obtained after explaining the study’s aims, benefits, and risks. The highest precautions to ensure and protect participants’ privacy, confidentiality, and anonymity were taken. Participants were interviewed in private places, and their information was kept confidential. Anonymity was protected by employing identification codes and retaining data in secure storage. Access to the collected data was restricted to the study team. This was achieved by using password-protected digital files and secure physical storage for any hard copies. Only authorized personnel had access to the data, ensuring a high level of security and confidentiality. Consent for publication Not applicable Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author upon reasonable request. Competing interests The authors declare that they have no competing interests Funding Research reported in this publication was supported by the National Institute of Neurological Disorders and Stroke of the National Institute of Health under Award Number R01N8118544. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Authors' contributions BNT, CM, AN, JBI, RKM, DN, AL, SNM, MNK, TS, and CNK participated in the conceptualization and development of this manuscript. All authors read and approved this manuscript before submission to this journal. Acknowledgments We appreciate the hard work of the research assistants Evelyn Ssanyu Mugisha, Ruth Katushabe, and Miranda Namaala, whose assistance was instrumental in the successful completion of the data collection process. Special thanks to Kampala Capital City Authority (KCCA), Wakiso district, and Mukono district, as well as the respective health facility in-charges, for their cooperation and facilitation of the research activities. References Martins SCO, Sacks C, Hacke W, Brainin M, de Assis Figueiredo F, Pontes-Neto OM, et al. Priorities to reduce the burden of stroke in Latin American countries. The Lancet Neurology. 2019;18(7):674-83. Feigin VL, Stark BA, Johnson CO, Roth GA, Bisignano C, Abady GG, et al. Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet Neurology. 2021;20(10):795-820. WSO. Global Stroke Fact Sheet 2022 2022 [Available from: https://www.world-stroke.org/assets/downloads/WSO_Global_Stroke_Fact_Sheet.pdf. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. The lancet. 2012;380(9859):2095-128. Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. The lancet. 2014;383(9913):245-55. WHO. World Stroke Day 2022 2022 [Available from: https://www.who.int/srilanka/news/detail/29-10-2022-world-stroke-day-2022#:~:text=Stroke%20is%20the%20leading%20cause,a%20stroke%20in%20their%20lifetime. Mugwano I, Kaddumukasa M, Mugenyi L, Kayima J, Ddumba E, Sajatovic M, et al. Poor drug adherence and lack of awareness of hypertension among hypertensive stroke patients in Kampala, Uganda: a cross sectional study. BMC research notes. 2016;9(1):1-8. IHME. Institute for Health Metrics Evaluation (IHME). 2022 [Available from: https://www.healthdata.org/research-analysis/health-by-location/profiles/uganda. Amini M, Zayeri F, Salehi M. Trend analysis of cardiovascular disease mortality, incidence, and mortality-to-incidence ratio: results from global burden of disease study 2017. BMC public health. 2021;21:1-12. Bashaar M, Saleem F, Thawani V, Azmi Hassali M, Hashemi T. Evaluation of hypertension related knowledge, attitudes and practices at community level in Kabul. Pharm Pharmacol Int J. 2019;7(3):106-12. World Stroke Organisation. Global Stroke Guidelines and Action Plan: A Road Map for Quality Stroke Care. 2016. Dar NZ, Khan SA, Ahmad A, Maqsood S, Khan SA. Awareness of stroke and health-seeking practices among hypertensive patients in a tertiary care hospital: a cross-sectional survey. Cureus. 2019;11(5). Lindsay P, Furie KL, Davis SM, Donnan GA, Norrving B. World Stroke Organization global stroke services guidelines and action plan. International Journal of Stroke. 2014;9(SA100):4-13. MOH. NATIONAL MULTISECTORAL STRATEGIC PLAN FOR THE PREVENTION AND CONTROL OF NONCOMMUNICABLE DISEASES (2018 – 2023): UGANDA. 2018. MOH. Uganda Clinical Guidelines 2016. 2016. Das S, Das SK. Knowledge, attitude and practice of stroke in India versus other developed and developing countries. Annals of Indian Academy of Neurology. 2013;16(4):488. UBOS. UGANDA BUREAU OF STATISTICS 2022 [Available from: https://www.ubos.org/wp-content/uploads/publications/05_20232022_Statistical_Abstract.pdf. MOH. NATIONAL HEALTH FACILITY MASTER LIST 2018. 2018. MOH. SERVICE STANDARDS AND SERVICE DELIVERY STANDARDS FOR THE HEALTH SECTOR. 2016. GOU. NATIONAL PLAN OF ACTION FOR OLDER PERSONS 2012/13-2016/17. 2012. Kish L. Sampling organizations and groups of unequal sizes. American sociological review. 1965:564-72. Kaddumukasa M, Mugenyi L, Kaddumukasa MN, Ddumba E, Devereaux M, Furlan A, et al. Prevalence and incidence of neurological disorders among adult Ugandans in rural and urban Mukono district; a cross-sectional study. BMC neurology. 2016;16(1):1-9. Sanuade OA, Dodoo FN-A, Koram K, de-Graft Aikins A. Prevalence and correlates of stroke among older adults in Ghana: Evidence from the Study on Global AGEing and adult health (SAGE). PloS one. 2019;14(3):e0212623. Woldetsadik FK, Kassa T, Bilchut WH, Guadie YG, Eriku GA. Stroke Related Knowledge, Prevention Practices and Associated Factors Among Hypertensive Patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2021. Frontiers in Neurology. 2022;13:839879. Liu J, Chen Y, Jin C, Chen D, Gao G, Li F. Analysis of prevalence and influencing factors of stroke in elderly hypertensive patients: Based on the screening plan for the high-risk population of stroke in Jiading District, Shanghai. Plos one. 2021;16(8):e0255279. Mekonen HH, Birhanu MM, Mossie TB, Gebreslassie HT. Factors associated with stroke among adult patients with hypertension in Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia, 2018: A case-control study. PLoS One. 2020;15(2):e0228650. Tsang S, Royse CF, Terkawi AS. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi journal of anaesthesia. 2017;11(Suppl 1):S80. Greenland S, Senn SJ, Rothman KJ, Carlin JB, Poole C, Goodman SN, et al. Statistical tests, P values, confidence intervals, and power: a guide to misinterpretations. European journal of epidemiology. 2016;31(4):337-50. Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source code for biology and medicine. 2008;3:1-8. WHO. Global Health Estimates 2019: Disease burden by Cause, Age, Sex, by Country and by Region, 2000-2019. 2019 [Available from: https://www.who.int/data/global-health-estimates. Misgana S, Asemahagn MA, Atnafu DD, Anagaw TF. Incidence of stroke and its predictors among hypertensive patients in Felege Hiwot comprehensive specialized hospital, Bahir Dar, Ethiopia, a retrospective follow-up study. European Journal of Medical Research. 2023;28(1):227. Owolabi M, Agunloye A. Risk factors for stroke among patients with hypertension: A case–control study. Journal of the neurological sciences. 2013;325(1-2):51-6. Fekadu G, Chelkeba L, Kebede A. RETRACTED ARTICLE: Risk factors, clinical presentations and predictors of stroke among adult patients admitted to stroke unit of Jimma university medical center, south west Ethiopia: prospective observational study. BMC neurology. 2019;19(1):183. Rupasinghe CD, Bokhari SA, Lutfi I, Noureen M, Islam F, Khan M, et al. Frequency of stroke and factors associated with it among old age hypertensive patients in Karachi, Pakistan: a cross-sectional study. Cureus. 2022;14(3). Oso AA, Adefurin A, Benneman MM, Oso OO, Taiwo MA, Adebiyi OO, et al. Health insurance status affects hypertension control in a hospital based internal medicine clinic. International Journal of Cardiology Hypertension. 2019;1:100003. MacDonald MR, Zarriello S, Swanson J, Ayoubi N, Mhaskar R, Mirza A-S. Secondary prevention among uninsured stroke patients: A free clinic study. SAGE Open Medicine. 2020;8:2050312120965325. Li S, Bruen BK, Lantz PM, Mendez D. Peer reviewed: impact of health insurance expansions on nonelderly adults with hypertension. Preventing chronic disease. 2015;12. Kim H-L. Arterial stiffness and hypertension. Clinical Hypertension. 2023;29(1):31. Harvey A, Montezano AC, Touyz RM. Vascular biology of ageing—Implications in hypertension. Journal of molecular and cellular cardiology. 2015;83:112-21. Finger CE, Moreno-Gonzalez I, Gutierrez A, Moruno-Manchon JF, McCullough LD. Age-related immune alterations and cerebrovascular inflammation. Molecular psychiatry. 2022;27(2):803-18. Boehme AK, Esenwa C, Elkind MS. Stroke risk factors, genetics, and prevention. Circulation research. 2017;120(3):472-95. Li C, Engström G, Hedblad B, Berglund Gr, Janzon L. Blood pressure control and risk of stroke: a population-based prospective cohort study. Stroke. 2005;36(4):725-30. Bushnell CD, Colón-Emeric CS. Secondary stroke prevention strategies for the oldest patients: possibilities and challenges. Drugs & aging. 2009;26:209-30. Miller TA. Health literacy and adherence to medical treatment in chronic and acute illness: a meta-analysis. Patient education and counseling. 2016;99(7):1079-86. Gaffari-Fam S, Babazadeh T, Oliaei S, Behboodi L, Daemi A. Adherence to a health literacy and healthy lifestyle with improved blood pressure control in Iran. Patient preference and adherence. 2020:499-506. Viinikainen J, Bryson A, Böckerman P, Kari JT, Lehtimäki T, Raitakari O, et al. Does better education mitigate risky health behavior? A mendelian randomization study. Economics & Human Biology. 2022;46:101134. Ng R, Sutradhar R, Yao Z, Wodchis WP, Rosella LC. Smoking, drinking, diet and physical activity—modifiable lifestyle risk factors and their associations with age to first chronic disease. International journal of epidemiology. 2020;49(1):113-30. Kalita J, Bharadwaz MP, Aditi A. Prevalence, contributing factors, and economic implications of strokes among older adults: a study of North-East India. Scientific Reports. 2023;13(1):16880. Fenny AP, Enemark U, Asante FA, Hansen KS. Patient satisfaction with primary health care–a comparison between the insured and non-insured under the National Health Insurance Policy in Ghana. Global journal of health science. 2014;6(4):9. Bittoni MA, Wexler R, Spees CK, Clinton SK, Taylor CA. Lack of private health insurance is associated with higher mortality from cancer and other chronic diseases, poor diet quality, and inflammatory biomarkers in the United States. Preventive medicine. 2015;81:420-6. Goal 6: Ensure access to water and sanitation for all. Sirisha S, Jala S, Vooturi S, Yada PK, Kaul S. Awareness, recognition, and response to stroke among the general public—an observational study. Journal of Neurosciences in Rural Practice. 2021;12(04):704-10. Sur NB, Kozberg M, Desvigne-Nickens P, Silversides C, Bushnell C. Improving stroke risk factor management focusing on health disparities and knowledge gaps. Stroke. 2024;55(1):248-58. Kernan WN, Viera AJ, Billinger SA, Bravata DM, Stark SL, Kasner SE, et al. Primary care of adult patients after stroke: a scientific statement from the American Heart Association/American Stroke Association. Stroke. 2021;52(9):e558-e71. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5867126","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":405586292,"identity":"7c30f16b-dcfc-4323-ac67-dac0b0a5c12b","order_by":0,"name":"Bridget Nagawa Tamale","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA20lEQVRIiWNgGAWjYBACAzBZwCAHopiJ08IG0WhMupbEBqK1mMs3P93ww8Amfe2M9GePCxjs5Bkk0i/g1WLZxmZ2s8cgLXfbjRxz4xkMyYYNEjkF+B12jMHsBo/BYZAWNmkeBuYEBomcBAJa2L/d/GPwP93sRvozoJZ6YrTwmN3mMTiQYHYjwQyo5TBQS/oBAn7JKbstY5BsuO3MG3NjHoPjhm08b/DqYDBnPr7t5psKO3mz48AQ46moludnT3+AXw8SYAMnBjYGHgNStIABO/G2jIJRMApGwYgAALouQTrT3NOzAAAAAElFTkSuQmCC","orcid":"","institution":"Makerere University","correspondingAuthor":true,"prefix":"","firstName":"Bridget","middleName":"Nagawa","lastName":"Tamale","suffix":""},{"id":405586293,"identity":"1113d61b-0ea7-4263-9cce-fe6d5fe90602","order_by":1,"name":"Christine Muhumuza","email":"","orcid":"","institution":"Makerere University","correspondingAuthor":false,"prefix":"","firstName":"Christine","middleName":"","lastName":"Muhumuza","suffix":""},{"id":405586294,"identity":"59510d29-8f65-4757-afc7-4276fbe6617f","order_by":2,"name":"Aisha Nalugya","email":"","orcid":"","institution":"Makerere University","correspondingAuthor":false,"prefix":"","firstName":"Aisha","middleName":"","lastName":"Nalugya","suffix":""},{"id":405586295,"identity":"6660e040-62a6-4dfd-a063-11dd465632f0","order_by":3,"name":"John Bosco Isunju","email":"","orcid":"","institution":"Makerere University","correspondingAuthor":false,"prefix":"","firstName":"John","middleName":"Bosco","lastName":"Isunju","suffix":""},{"id":405586296,"identity":"82ef6a82-7ef0-4074-a021-5b3dd6a2cf7f","order_by":4,"name":"Richard K Mugambe","email":"","orcid":"","institution":"Makerere University","correspondingAuthor":false,"prefix":"","firstName":"Richard","middleName":"K","lastName":"Mugambe","suffix":""},{"id":405586297,"identity":"6f9905ad-0bdf-45d5-9415-363819ecd20f","order_by":5,"name":"Doreen Nakalembe","email":"","orcid":"","institution":"Makerere University","correspondingAuthor":false,"prefix":"","firstName":"Doreen","middleName":"","lastName":"Nakalembe","suffix":""},{"id":405586298,"identity":"e50f340d-d852-4435-9207-ea161ff79977","order_by":6,"name":"Asadi Lusabe","email":"","orcid":"","institution":"Makerere University","correspondingAuthor":false,"prefix":"","firstName":"Asadi","middleName":"","lastName":"Lusabe","suffix":""},{"id":405586299,"identity":"743d0a84-0758-4c92-91d4-f6d8ff4e1967","order_by":7,"name":"Scovia Nalugo Mbalinda","email":"","orcid":"","institution":"Makerere University","correspondingAuthor":false,"prefix":"","firstName":"Scovia","middleName":"Nalugo","lastName":"Mbalinda","suffix":""},{"id":405586300,"identity":"0f0ae36e-7979-4e93-989d-e154dd2b96ef","order_by":8,"name":"Martin N Kaddumukasa","email":"","orcid":"","institution":"Makerere University","correspondingAuthor":false,"prefix":"","firstName":"Martin","middleName":"N","lastName":"Kaddumukasa","suffix":""},{"id":405586301,"identity":"de23f00e-ea88-4cec-b486-14313744608b","order_by":9,"name":"Tonny Ssekamatte","email":"","orcid":"","institution":"Makerere University","correspondingAuthor":false,"prefix":"","firstName":"Tonny","middleName":"","lastName":"Ssekamatte","suffix":""},{"id":405586302,"identity":"8be6b8f7-c4dc-4e10-b7b7-7b9b289f4534","order_by":10,"name":"Christine Nalwadda Kayemba","email":"","orcid":"","institution":"Makerere University","correspondingAuthor":false,"prefix":"","firstName":"Christine","middleName":"Nalwadda","lastName":"Kayemba","suffix":""}],"badges":[],"createdAt":"2025-01-20 15:23:32","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5867126/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5867126/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":75308357,"identity":"6fcdf3fc-0582-401c-b696-7776da344a67","added_by":"auto","created_at":"2025-02-03 08:46:48","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":9553,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eKnowledge regarding the signs and symptoms of stroke among respondents\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"Onlinedrawingimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-5867126/v1/49bee83df9f5d5fb592cc2c1.png"},{"id":75308359,"identity":"a908ed0a-81dd-478f-86f0-08d5a145bd70","added_by":"auto","created_at":"2025-02-03 08:46:48","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":8572,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eKnowledge on stroke risk factors among respondents\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"Onlinedrawingimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-5867126/v1/dd938082c549e12aa341c84b.png"},{"id":75399330,"identity":"d2c3e085-d213-4839-80a1-e303e0901173","added_by":"auto","created_at":"2025-02-04 07:32:25","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1817034,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5867126/v1/e058b016-b878-49f6-8ab3-a1243f0a65ec.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Stroke prevalence and associated factors among older patients with hypertension attending public healthcare facilities in Greater Kampala Metropolitan Area, Uganda","fulltext":[{"header":"Background","content":"\u003cp\u003eStroke is the second leading cause of death and the third leading cause of disability worldwide, following heart disease (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). According to the Global Stroke Fact Sheet 2022, high systolic blood pressure stands as the single most significant risk factor for stroke, accounting for 79.6\u0026nbsp;million DALYs (67.7\u0026ndash;90.8), or 55.5% of total stroke DALYs (48.2\u0026ndash;62.0) worldwide (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). World Health Organisation (WHO) estimates that by 2030, 80% of all strokes will occur in people living in low and middle-income countries including Uganda, where it will account for 7.9% of all mortality (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). This disproportionate burden has posed an unprecedented challenge for families with limited resources (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Stroke rates are increasing in Sub-Saharan Africa, especially Uganda, where stroke awareness and therapeutic interventions are very limited (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Although poorly documented, stroke is currently estimated to be the sixth highest-ranking cause of death and disability in Uganda (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eNotably, older individuals with hypertension are at a heightened risk of stroke owing to lifestyle factors (diet, physical activity), socio-economic status, access to healthcare, and genetic predispositions. Interventions have primarily focused on hypertension management, lifestyle modifications, and access to timely medical care (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). As evidenced by existing research, stroke mortality and morbidity among patients with hypertension could be considerably reduced by implementing organized stroke care, which encompasses evidence-based clinical practice guidelines, continuous quality improvement philosophy, and programs (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). The current challenge lies in effectively implementing these interventions, especially in resource-scarce regions such as Uganda. In line with this, the World Stroke Organization (WSO) aims to minimize the global burden of stroke through prevention, treatment, and long-term care. In 2014, Lindsay et al. developed a Global Stroke Services Action Plan, founded on recommendations from the 10 stroke guidelines, receiving scores above 60% on two (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). This Action Plan outlines essential components of stroke care across various healthcare models (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMoreover, in Uganda, stroke care is guided by several policies and frameworks that aim to improve healthcare delivery. For instance, the National Multisectoral Strategic Plan for the Prevention and Control of Non-Communicable Diseases (NCDs) 2018\u0026ndash;2023 seeks to reduce risk factors and mortality associated with NCDs, including stroke, by enhancing prevention and control measures (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Additionally, the National Health Policy (2010\u0026ndash;2020) and the Universal Health Coverage (UHC) Roadmap 2019 emphasize the need for equitable, accessible, and quality healthcare for all Ugandans, including stroke prevention and management. Despite the existence of these frameworks, Uganda still lacks a comprehensive, coordinated stroke care policy that integrates prevention, treatment, and long-term care. Currently, stroke management is addressed within the broader Uganda Clinical Guidelines (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e), but more targeted efforts are needed to develop and implement stroke-specific policies and care pathways in the country.\u003c/p\u003e \u003cp\u003eWhile extensive studies devoted to the management and prevention of stroke, the global burden of stroke would not be reduced without efforts targeting understanding the stroke burden among high-risk groups such as older patients with hypertension (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Therefore, this study aimed to assess the prevalence and factors associated with stroke among older patients with hypertension attending public healthcare facilities in GKMA, Uganda. It also established the practices towards stroke prevention among older patients with hypertension. Generated evidence informed the design of more precise interventions to combat, control, and prevent stroke among patients with hypertension.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy setting and design\u003c/h2\u003e \u003cp\u003eThis was a cross-sectional study conducted in public healthcare facilities in GKMA that manage NCDs including hypertension. GKMA includes three districts that is, Kampala, Wakiso, and Mukono districts. According to the Uganda Bureau of Statistics Population projection 2021, the population of Kampala is 1,709,900, the population of Mukono is 720,100, and the population of Wakiso is 3,105,700 (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Uganda\u0026rsquo;s health facilities are classified into seven levels based on the services they provide and the catchment area they are intended to serve. The health facilities are designated as Health Centre Level One (HC I) to Health Centre Level Four (HC IV); General Hospital, Regional Referral Hospital, and National Referral Hospital. In the districts of Wakiso, Mukono, and Kampala, there are 72, 40, and 26 public healthcare facilities, respectively (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). MOH mandates public healthcare facilities to prevent, manage, and control NCDs, including stroke and hypertension, through educating the community on healthy lifestyles and early detection of diseases; screening for NCDs; follow-up cases; and promoting community-based rehabilitation; and appropriate referral (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). KCCA clinics run integrated NCD clinics twice a week. In these clinics, all patients with NCDs (both HIV positive and negative) are seen. These include patients with hypertension, diabetes, and chronic lung diseases, among others. The clinics are manned by medical officers, clinical officers, and nurses. In both clinics, an approximate number of 20\u0026ndash;40 patients are seen per clinic visit.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy population and eligibility criteria\u003c/h3\u003e\n\u003cp\u003eThis study was conducted among older patients with hypertension attending public healthcare facilities in GKMA. This study defined older patients as those aged 60 years and above. This definition is recommended by the United Nations as well as the Uganda National Plan of Action For Older Persons (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Patient with hypertension aged 60 years and above who were receiving treatment at public healthcare facilities in the GKMA and had given their informed consent to participate were included in the study. Patients who were critically ill, incapacitated, or otherwise unable to endure the study procedures were excluded.\u003c/p\u003e\n\u003ch3\u003eSample size estimation\u003c/h3\u003e\n\u003cp\u003eThe sample size was determined using the Kish Leslie formula (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Based on an assumption of a prevalence of 33.7% of stroke among adult Ugandans in rural and urban Mukono district (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e), a 5% margin of error, and a 95% confidence interval, a sample of 344 participants was achieved. After accounting for a non-response (nr) rate of 10%, we obtained a final sample size of \u003cb\u003e383\u003c/b\u003e respondents.\u003c/p\u003e\n\u003ch3\u003eSampling methods\u003c/h3\u003e\n\u003cp\u003eSystematic sampling was used to select study participants. A list of 19 public healthcare facilities with NCD clinics in Kampala (6 facilities), Wakiso (8 facilities), and Mukono (5 facilities) districts was obtained from the respective District and/or Municipal Health Departments. From this list, seven (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e) high-volume health facilities were selected to ensure a substantial number of older patients with hypertension were included in the study (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). High-volume facilities were defined by the frequency of NCD clinic services (offered twice a week) and the number of patients with hypertension seen per clinic visit, typically ranging from 20 to 60 patients.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eNumber of public healthcare facilities with NCD clinics in GKMA\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDistrict\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo. of PHF with NCD clinics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHigh-volume NCD clinics selected\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKampala\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMukono\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWakiso\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e19\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e7\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAt each selected facility, a list of all older patients with hypertension attending the clinic on the day of data collection was compiled by the clinic officer/nurse in charge. Systematic sampling was then applied to recruit participants. The sampling interval (K) was determined by dividing the total number of older patients with hypertension present at each facility (N) by the desired sample size for that facility (n) using the formula: K\u0026thinsp;=\u0026thinsp;N/n. For example, if a facility had 40 older patients with hypertension and the desired sample size for that facility was 20, the sampling interval K would be K\u0026thinsp;=\u0026thinsp;40/20\u0026thinsp;=\u0026thinsp;2. This meant that every 2nd patient on the list was selected. A random starting point was chosen within the first sampling interval, and every subsequent K\u003csup\u003eth\u003c/sup\u003e patient was included in the sample. This process was repeated at each facility, ensuring proportional representation based on the number of older hypertensive patients at each site.\u003c/p\u003e \u003cp\u003eThe total number of respondents for each facility was determined proportionate to the relative number of older hypertensive patients attending that facility, compared to the total number of older hypertensive patients across all facilities. The formula used was:\u003c/p\u003e \u003cp\u003eN = \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\frac{Number\\:of\\:older\\:hypertensives\\:in\\:a\\:given\\:HCF\\:}{total\\:number\\:of\\:older\\:hypertensives\\:in\\:all\\:HCFs}\\times\\:calculated\\:sample\\:size\\)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ch3\u003eStudy variables and measurements\u003c/h3\u003e\n\u003cp\u003eThe primary outcome variable for this study is having a stroke, measured as a binary variable (Yes/No) indicating whether a participant has experienced a stroke. This was determined through self-reported data, with participants being asked the specific question, \u0026ldquo;Have you ever suffered a stroke?\u0026rdquo; Recognizing that not all participants may be familiar with the medical term \"stroke,\" the question was operationalized to include a descriptive explanation for those who needed clarification. For participants who were uncertain or unfamiliar with the term, stroke was described in accessible terms, including symptoms such as sudden weakness or numbness in the face, arm, or leg (especially on one side of the body), difficulty speaking or understanding speech, sudden trouble seeing, walking, or loss of balance. Participants who understood the term \u0026ldquo;stroke\u0026rdquo; were asked directly, while those who required further explanation received this description to ensure accurate responses. The prevalence of stroke in the study was calculated as the proportion of patients with hypertension aged 60 years and above who reported having experienced a stroke. This method was also used by Sanuade, Dodoo (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e) to assess the prevalence and correlates of stroke among older adults in Ghana. Independent variables included: 1) socio-demographic factors (such as age, sex, education level, marital status, religion, employment status, and dependents); 2) patient factors (such as patient beliefs, and attitudes regarding stroke, and patients\u0026rsquo; knowledge on stroke ; 3) lifestyle factors (e.g., alcohol intake, diet, physical activity), 4) hypertension treatment-related factors (including drug regimen, duration of hypertensive treatment, route of medication, cost of the drug, drug adverse-related complications, number of drugs, and frequency per day among others), and 5) Health system factors (including distance to the health facility, waiting time, availability of drugs, follow-up and monitoring of patients, patient-health worker relationship, and availability of insurance services).\u003c/p\u003e \u003cp\u003ePatients\u0026rsquo; knowledge of stroke was adapted from a study by Woldetsadik, Kassa (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) among hypertensive patients at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. The knowledge section comprised 3 questions assessing the potential risk, warning signs, and risk factors related to knowledge about stroke. Questions included 1) knowledge of signs of stroke such as sudden onset of dizziness; sudden onset of headache; sudden onset of memory loss; sudden onset of half body weakness; sudden onset of loss of consciousness; sudden onset of double vision; and sudden onset of speech problems, and 2) knowledge of risk factors such as high blood pressure; smoking; diabetes mellitus; cardiac disease; obesity; high cholesterol; excessive alcohol intake; physical activity; and the presence of a family member having a stroke. Responses included: \u0026ldquo;Yes,\u0026rdquo; \u0026ldquo;No,\u0026rdquo; \u0026ldquo;I don't know;\u0026rdquo; with \u0026ldquo;Yes\u0026rdquo; responses coded as 1 and all other responses coded as 0. A composite score was generated based on the summation of all the correct responses. Thereafter, the median score (2.0) was used as a cut-off. Those who obtained a score equal to or above the median were considered to have a high knowledge of stroke. Physical activity was measured as exercising more than 3 times a week, at moderate intensity or more than 30 minutes each time, or engaging in moderate including walking and severe physical work.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData collection procedures and tools\u003c/h2\u003e \u003cp\u003eData was collected by Research Assistants (RAs) with minimum education qualification of a bachelor\u0026rsquo;s degree in Humanities, Statistics, Environmental or Public Health, or any other related discipline as well as prior experience in conducting face-to-face interviews. These RAs underwent a 3-day training to get acquainted with the study protocol, and the ethical issues about the study. A semi-structured questionnaire developed based on a thorough literature review of existing literature related to stroke prevalence and predictors in similar populations (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e) was used to obtain data. This questionnaire was administered through face-to-face interviews, and it elicited information on the: socio-demographic characteristics, patient-related factors, lifestyle factors, hypertension treatment-related factors, and health system factors.\u003c/p\u003e \u003cp\u003eThe study questionnaire underwent validation by a team of stroke experts to ensure its accuracy and relevance (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). The experts reviewed the content to confirm that it covered all necessary aspects of stroke prevalence, predictors, and related factors, and provided feedback to refine the questions. Their validation ensured that the questionnaire was both reliable and valid for assessing stroke-related prevalence and risk factors in the target population. This questionnaire was developed in English and translated into Luganda, the most commonly spoken local language in GKMA. Pretesting of the questionnaires was done in public healthcare facilities in Mityana district before being used for the study to ensure clarity and suitability.\u003c/p\u003e \u003cp\u003e \u003cb\u003eThe data collection process;\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe data collection team was divided into three teams of two, with each team in one district. One team of two research assistants collected data at each facility on the specific clinic days in the selected health facilities. At each health facility, permission was sought from the health facility in charge. With the in-charge\u0026rsquo;s support, eligible participants were identified, and if no eligible respondent was present at the time of the study, an appointment was made at a convenient time. If eligible respondents were present, informed consent was sought using a consent form. Data was collected from patients after they had been seen by the physician in the specialized hypertension clinics. However, recognizing that some participants may have limitations in verbal communication, I adapted this approach to ensure inclusivity. If a patient in the specialized hypertension clinic was unable to directly participate, their designated caregiver was interviewed instead. Informed consent was also sought from the caretaker ensuring their understanding of the study. The questionnaire was then administered at a place of convenience and privacy to the participant. This lasted 20\u0026ndash;30 minutes per participant.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eData management and analysis\u003c/h3\u003e\n\u003cp\u003eData were entered using the Kobo collect mobile application preloaded on Android-enabled mobile phones. RAs were required to upload the data daily to the cloud server for quality control purposes. Data was then downloaded into MS Excel 2016, cleaned, and analyzed using STATA 15.0 statistical software. Data cleaning involved the removal of unwanted or duplicate observations from the dataset (de-duplication), fixing structural errors such as typos, or incorrect capitalization, filtering unwanted outliers, handling missing data, and validation. Descriptive statistics such as mean and standard deviation were used to present continuous variables, while frequencies and proportions were used to present categorical data. Both bivariate and multivariable analyses were conducted to ascertain significant variables. In the bivariate analysis, a significance level of p\u0026thinsp;\u0026lt;\u0026thinsp;0.1 was used, while in the multivariable analysis, the significance level was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05. The rationale for using a p-value cutoff of 0.1 in the bivariate analysis is to include potentially relevant variables that may have a weaker association with the outcome but could still be important in the context of the study (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). This approach allows for a more comprehensive exploration of potential predictors before applying more stringent criteria in the multivariable analysis.\u003c/p\u003e \u003cp\u003eSince the outcome had a prevalence that exceeded 10%, a modified Poisson regression analysis with robust standard errors was used to report prevalence ratios. Multicollinearity effect was assessed; A correlation coefficient of \u0026ge;\u0026thinsp;0.4 was considered high; if two variables exceeded this threshold, only one was retained in the model to avoid multicollinearity. To assess for interaction, the chunk test was used to compare a full model with interaction terms and a simplified model with only basic variables. Interaction terms were retained in the model if the test yielded a significant p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05. Confounding was assessed on all variables that dropped out of the model using stepwise elimination, with assessment prioritized from the most significant to the least significant variable that dropped out. The results were presented in tables, graphs, and figures as appropriate.\u003c/p\u003e\n\u003ch3\u003eQuality control and assurance\u003c/h3\u003e\n\u003cp\u003eThe RAs were trained for 3 days to ensure that they fully understand the protocol and the data collection tools. Pretesting of the questionnaires was done in public healthcare facilities in Mityana district, before being used for the study to ensure clarity and suitability in assessing the stroke prevalence and associated factors. Mityana district was selected for the pretest due to its resemblance to the GKMA in key characteristics such as demographics, healthcare infrastructure, and socioeconomic status. During the pretest, we identified and addressed any issues related to question comprehension, response accuracy, and overall questionnaire flow. Feedback from the pretesting allowed us to refine the questions to ensure that the questions were understandable and relevant to the target population. Research assistants were supervised during the entire data collection period to ensure quality data. This supervision involved regular check-ins, on-the-spot reviews of collected data, and immediate feedback to address any issues or inconsistencies. Daily debrief meetings were held to identify challenges that arose during the data collection process and address them accordingly. The questionnaire embedded in the Kobo Collect app was programmed to ensure the completeness of the data entered. During programming, mandatory fields and skip patterns were inserted into the tool. Back translation was conducted to ensure that the meaning of the questions is not lost. After data collection, the data was cleaned in Excel 2016.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eSocio-demographics characteristics of respondents\u003c/h2\u003e \u003cp\u003eOut of the 383 respondents, the majority 71.0% (272/383) were aged 60\u0026ndash;69 years with a mean age being 66.8\u0026thinsp;\u0026plusmn;\u0026thinsp;7.1 years. More than three-quarters of the respondents 80.9% (310/383) were female, 39.9% (153/383) were catholic, 42.8% (164/383) had a primary education level, and 71.5% (274/383) had dependents (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocio-demographics characteristics of respondents\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAttribute\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAge of the respondents (Mean\u0026thinsp;=\u0026thinsp;66.8\u0026thinsp;\u0026plusmn;\u0026thinsp;7.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60\u0026ndash;69 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e272\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e71.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70\u0026ndash;79 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80 and above years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSex of the respondent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e310\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e80.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eReligion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAnglican\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCatholic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e153\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e39.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMuslim\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePentecostal (born again)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSDA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eEducation Level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo Formal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e152\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e39.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary (1\u0026ndash;7 years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e164\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e42.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary (8\u0026ndash;13 years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEmployment Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmployed by someone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSelf-employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e249\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e65.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eMarital Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced/ Separated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLiving together / Cohabiting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e140\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever Married/ Single\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDependents\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e274\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e71.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eNumber of dependents (n\u0026thinsp;=\u0026thinsp;274)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e42.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003ePatient and hypertension treatment-related factors of respondents\u003c/h2\u003e \u003cp\u003eMore than two-thirds, 69.2% (265/383) of the respondents were diagnosed with hypertension more than 2 years ago, and 98.4% (377/383) were taking any hypertension medication. Of those who were taking hypertension medication, 35.5% (136/377) were taking both medical and traditional medicines, 99.7% (376/377) had an oral antihypertension treatment, and 66.8% (252/377) had used the hypertension treatment for more than 2 years (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePatient and hypertension treatment-related factors of respondents\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAttribute\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eDuration since diagnosed with hypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBelow 1 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026ndash;2 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbove 2 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e265\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e69.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCurrently taking any medications for hypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e377\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e98.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eHypertension Medication taken (n\u0026thinsp;=\u0026thinsp;377)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e240\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e62.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTraditional or alternative medicines\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eFrequency of monitoring blood pressure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e267\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e69.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRoute of administration for your hypertension treatment (n\u0026thinsp;=\u0026thinsp;377)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e376\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e99.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInjectable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eIf oral, number of tablets taken per day (n\u0026thinsp;=\u0026thinsp;376)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e170\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e45.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e196\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 and more\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ePeriod on hypertension medication (n\u0026thinsp;=\u0026thinsp;377)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBelow 1 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026ndash;2 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbove 2 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e252\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e66.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003ePerson/entity paying for the medications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSelf\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e243\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e63.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRelative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHealth facility provides free\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInsurance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eChallenges faced while taking antihypertensive medication*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDrug is expensive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e240\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e62.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDo not understand prescription\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eToo many tablets\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe drug is hard to swallow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDrugs are not always available\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNormally forget to take it because I am always busy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003cb\u003e*\u003c/b\u003eMultiple response\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eLifestyle factors of respondents\u003c/h2\u003e \u003cp\u003eAbout 31.9% (122/383) of the respondents always carried out physical exercise in a week, 94.8% (363/383) consumed carbohydrates, 5.2% (20/383) had ever smoked tobacco, and 42.0% (151/383) had ever drunk alcohol (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLifestyle factors of respondents\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAttribute\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"7\" rowspan=\"8\"\u003e \u003cp\u003eNumber of days physically active for a total of at least one hour per day bin the past seven days\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 days\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 days\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 days\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 days\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 days\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 days\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 days\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eFrequency of carrying out physical exercise in a week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eFood commonly consumed*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCarbohydrates\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e363\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e94.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProteins\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e291\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e76.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFruit\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e230\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e60.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVegetables\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e330\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e86.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEver smoked tobacco\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e363\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e94.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eStill smokes tobacco (n\u0026thinsp;=\u0026thinsp;20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e80.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEver drunk alcohol\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e222\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e58.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e161\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e42.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eStill takes alcohol (n\u0026thinsp;=\u0026thinsp;161)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e75.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003cb\u003e*\u003c/b\u003eMultiple response\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eHealth facility-related factors\u003c/h2\u003e \u003cp\u003eMore than three quarters 78.1% (299/383) of the respondents had visited the health facility 1 month ago, 36.0% (138/383) mentioned that antihypertensive medication was always available, and 69.5% (266/383) paid for antihypertensive medication. Only 1.0% (4/383) of the respondents were on health insurance, 93.0% (356/383) mentioned that the relationship between health workers and patients at the health facility was always good, and 46.7% (179/383) perceived the distance from their home to the health facility as being near (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eHealth facility-related factors\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAttribute\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eLast time visited the health facility (Months)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e78.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore than 1 month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePeriod the health worker recommended the patient report back to the facility (Months)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e304\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e79.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore than 1 month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ePerception about the availability of antihypertensive medication in the health facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways available\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAvailable but expensive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot always available\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePays for antihypertensive medication at this facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e117\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e266\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e69.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ePerception about the cost of medication at this facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAffordable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e141\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDon't Know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExpensive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e191\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e49.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eOn health insurance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e379\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e99.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ePerception about the relationship between health workers and patients in this health facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e356\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e93.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSometimes good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTime taken when traveling from home to the health facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30 minutes and below\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e195\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e50.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbove 30 minutes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e188\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e49.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ePerception about the distance from your home to the health facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCan\u0026rsquo;t say\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFar\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNear\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e179\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e46.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eChallenges faced while accessing this health facility*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTransport is expensive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e218\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e56.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTraffic congestion on the road\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMotion sickness while traveling\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI cannot come on my own(disabled)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003cb\u003e*\u003c/b\u003eMultiple response\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003ePrevalence of stroke and stroke-related knowledge among respondents\u003c/h2\u003e \u003cp\u003eThe prevalence of stroke among respondents was 18.3% (70/383). The prevalence of stroke was 15.4% (42/272) in those aged 60\u0026ndash;69, 22.5% (18/80) for those aged 70\u0026ndash;79, and 32.2% (10/31) for those aged 80 and above. Of the respondents that had ever had a stroke, 10.4% (40/70) had it more than a year ago and 78.6% (55/383) still had any stroke-related symptoms. Regarding knowledge levels, 58.7% (225/383) of the respondents had high knowledge of stroke and 53.3% (204/383) had ever received stroke-related information (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePrevalence of stroke and stroke-related knowledge among respondents\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAttribute\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEver gotten a stroke\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e313\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e81.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDuration since diagnosed with stroke (n\u0026thinsp;=\u0026thinsp;70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBelow 1 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 year and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eStill has any stroke-related symptoms (n\u0026thinsp;=\u0026thinsp;70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e78.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEver received any stroke-related health information\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e168\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot sure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e204\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e53.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSource of the stroke-related health information*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVHT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHealth care provider\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e47.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInternet/Media\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"7\" rowspan=\"8\"\u003e \u003cp\u003ePerceived risk of experiencing a stroke\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e281\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e73.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eObesity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigh cholesterol\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExcessive alcohol intake\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePhysical inactivity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePresence of a family member having a stroke\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDon\u0026rsquo;t know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e235\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e61.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003cb\u003e*\u003c/b\u003eMultiple response\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eKnowledge on the signs and symptoms of stroke among respondents\u003c/h2\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the distribution of respondents' knowledge regarding the signs of stroke. The most frequently recognized sign was the sudden onset of half-body weakness (42.3%; 162/383), followed by sudden onset of headache (34.7%; 133/383), and sudden onset of dizziness (34.5%; 132/383). Other signs included sudden onset of loss of consciousness (21.4%; 82/383), sudden onset of speech problems (10.2%; 39/383), sudden onset of double vision (9.9%; 38/383), and sudden onset of memory loss (7.3%; 28/383), which were less frequently mentioned by respondents.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eKnowledge on stroke risk factors among respondents\u003c/h2\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the distribution of respondents' knowledge regarding stroke risk factors. The most frequently recognized risk factor was high blood pressure (33.9%; 130/383). This was followed by diabetes mellitus (7.8%; 30/383) and high cholesterol (5.0%; 19/383). Other factors such as cardiac disease (3.9%; 15/383), smoking (3.7%; 14/383), and excessive alcohol intake (2.9%; 11/383) were mentioned less frequently. Physical inactivity (2.1%; 8/383), the presence of a family member having a stroke (2.6%; 10/383), and obesity (1.0%; 4/383) were the least recognized risk factors. Majority of respondents (61.4%; 235/383) indicated that they did not know any stroke risk factors.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003ePredictors of stroke among older hypertensive patients attending public healthcare facilities in GKMA\u003c/h2\u003e \u003cp\u003eAfter controlling for age, sex, religion, and education level, being 80 and above years, having 8\u0026ndash;13 years of formal education (secondary education), having health insurance, having high knowledge of stroke, and receiving any stroke-related health information were significantly associated with stroke. Respondents aged 80 and above years (APR\u0026thinsp;=\u0026thinsp;2.68, 95% CI:1.59\u0026ndash;4.51) had a 168% higher prevalence of stroke as compared to those aged 60\u0026ndash;69 years. Respondents with 8\u0026ndash;13 years of formal education (secondary education) (APR\u0026thinsp;=\u0026thinsp;0.37, 95% CI: 0.14\u0026ndash;0.98) had a 63% lower prevalence of stroke as compared to those with no formal education. Respondents with health insurance (APR\u0026thinsp;=\u0026thinsp;3.34, 95% CI: 1.19\u0026ndash;9.37) had a 234% higher prevalence of stroke as compared to those without health insurance. The prevalence of stroke among respondents with high knowledge of stroke (APR\u0026thinsp;=\u0026thinsp;24.72, 95% CI: 6.20-98.55) was 24.72 times higher than those with low knowledge. The prevalence of stroke among respondents who had ever received any stroke-related health information (APR\u0026thinsp;=\u0026thinsp;1.78, 95% CI: 1.05\u0026ndash;3.02) was 1.84 times higher than their counterparts (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePredictors of stroke among older hypertensive patients attending public healthcare facilities in GKMA\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAttribute\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eEver had a stroke\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCrude PR (95% CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-values\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAdjusted PR (95% CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-values\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes (n\u0026thinsp;=\u0026thinsp;70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo (n\u0026thinsp;=\u0026thinsp;313)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAge of the respondent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60\u0026ndash;69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42 (15.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e230 (84.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70\u0026ndash;79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18 (22.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62 (77.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.46 (0.89\u0026ndash;2.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.135\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.28 (0.82\u0026ndash;2.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.278\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (32.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21 (67.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.09 (1.17\u0026ndash;3.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.68 (1.59\u0026ndash;4.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSex of the respondent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56 (18.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e254 (81.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (19.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59 (80.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.06 (0.63\u0026ndash;1.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.824\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.34 (0.81\u0026ndash;2.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.246\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eReligion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAnglican\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (19.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e68 (81.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCatholic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24 (15.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e129 (84.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.82 (0.46\u0026ndash;1.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.508\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.60 (0.35\u0026ndash;1.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.064\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMuslim\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (20.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34 (79.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.10 (0.53\u0026ndash;2.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.800\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.86 (0.45\u0026ndash;1.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.663\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePentecostal (born again)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (17.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e72 (82.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.9 (0.48\u0026ndash;1.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.760\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.65 (0.35\u0026ndash;1.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.171\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSDA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (37.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 (62.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.97 (0.91\u0026ndash;4.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.085\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.11 (0.55\u0026ndash;2.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.763\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eEducation Level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo Formal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (16.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e127 (83.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36 (22.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e128 (78.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.33 (0.84\u0026ndash;2.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.219\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.14 (0.74\u0026ndash;1.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.561\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (9.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39 (90.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.56 (0.21\u0026ndash;1.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.264\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.37 (0.14\u0026ndash;0.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.046*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (20.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19 (79.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.27 (0.54\u0026ndash;2.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.590\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.90 (0.41\u0026ndash;1.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.788\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEmployment Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmployed by someone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (28.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (71.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSelf-employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19 (15.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e108 (85.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.52 (0.15\u0026ndash;1.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.308\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49 (19.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e200 (80.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.69 (0.21\u0026ndash;2.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.542\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHas dependents\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19 (17.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e90 (82.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51 (18.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e223 (81.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.07 (0.66\u0026ndash;1.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.788\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eDuration since diagnosed with hypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBelow 1 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (18.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18 (81.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026ndash;2 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (15.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e81 (84.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.86 (0.31\u0026ndash;2.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.767\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbove 2 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51 (19.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e214 (80.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.06 (0.42\u0026ndash;2.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.904\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eFrequency of monitoring blood pressure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47 (17.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e220 (82.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (33.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (66.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.89 (0.37\u0026ndash;9.60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.441\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (19.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e91 (80.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.11 (0.70\u0026ndash;1.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.665\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eFrequency of carrying out physical exercise in a week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21 (17.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e101 (82.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e79 (84.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.93 (0.50\u0026ndash;1.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.807\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (21.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33 (78.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.24 (0.62\u0026ndash;2.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.539\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100 (80.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.16 (0.69\u0026ndash;1.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.575\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEver smoked tobacco\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66 (18.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e297 (81.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16 (80.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.10 (0.44\u0026ndash;2.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.836\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEver drunk alcohol\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39 (17.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e183 (82.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31 (19.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e130 (80.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.10 (0.71\u0026ndash;1.68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.673\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ePerception about the availability of antihypertensive medication in the health facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways available\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20 (14.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e118 (85.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAvailable but expensive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26 (20.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e99 (79.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.43 (0.84\u0026ndash;2.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.182\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot always available\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e96 (80.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.38 (0.80\u0026ndash;2.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.244\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePays for antihypertensive medication at this facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24 (20.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e93 (79.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46 (17.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e220 (82.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.84 (0.54\u0026ndash;1.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.451\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ePerception about the cost of medication at this facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAffordable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23 (16.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e118 (83.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDon't Know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (19.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41 (80.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.20 (0.61\u0026ndash;2.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.591\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExpensive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37 (19.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e154 (80.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.19 (0.74\u0026ndash;1.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.477\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHealth insurance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68 (17.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e311 (82.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.79 (1.02\u0026ndash;7.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.34 (1.19\u0026ndash;9.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.022*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePerception about the relationship between health workers and patients in this health facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62 (17.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e294 (82.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot good/ sometimes good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (29.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19 (70.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.70 (0.91\u0026ndash;3.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.095\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.66 (0.99\u0026ndash;2.78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.053\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTime taken when traveling from home to the health facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30 minutes and below\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37 (19.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e158 (81.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbove 30 minutes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33 (17.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e155 (82.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.92 (0.60\u0026ndash;1.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.720\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eKnowledge of stroke\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e156 (98.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68 (30.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e157 (69.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23.87 (5.93\u0026ndash;96.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e24.72 (6.20-98.55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEver received any stroke-related health information\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19 (11.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e149 (88.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot sure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (9.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 (90.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.80 (0.12\u0026ndash;5.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.823\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.57 (0.31\u0026ndash;7.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.584\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50 (24.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e154 (75.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.17 (1.33\u0026ndash;3.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.78 (1.05\u0026ndash;3.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.031*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study assessed the preventive practices, prevalence, and factors associated with stroke among older patients with hypertension attending public healthcare facilities in the GKMA, Uganda. The prevalence of stroke among these patients was found to be 18.3%. This prevalence is considered high when compared to the global average stroke prevalence among older adults, which typically ranges from 5\u0026ndash;10% according to the WHO and other epidemiological studies (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). This study\u0026rsquo;s stroke prevalence is comparable to a study in Ethiopia which found an 18.18% prevalence among adult patients with hypertension (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e), but higher than studies conducted in Nigeria, Sidama, and Shanghai which reported incidences of 13.2%, 3.15%, and 10.8% respectively (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). The current study identified an increasing prevalence of stroke with age among older patients with hypertension: 15.4% in those aged 60\u0026ndash;69, 22.5% in those aged 70\u0026ndash;79, and 32.2% in those aged 80 and above. This study's finding aligns with a study done by Fekadu, Chelkeba (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e) in Jimma in Ethiopia. However, compared to findings from (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e) in Shanghai, this study\u0026rsquo;s prevalence rates are notably higher across all age groups. This discrepancy can be attributed to several factors, including the facility-based nature of the current study compared to the population-based study, differences in healthcare infrastructure and access, variations in hypertension management and control, and the reliance on self-reported stroke diagnoses. The higher stroke prevalence in the current study indicates the urgent need for improved public health interventions to enhance hypertension management and stroke prevention strategies in urban areas.\u003c/p\u003e \u003cp\u003eFurthermore, this study revealed that the factors associated with stroke among older patients with hypertension were being aged 80 and above years, having 8\u0026ndash;13 years of formal education (secondary education), having health insurance, high knowledge of stroke, and receiving stroke-related health information. The association between age and stroke prevalence is consistent with findings from other studies (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e), which also show a significant relationship between being aged 80 and above and stroke prevalence. Additionally, having a secondary education level was significantly associated with stroke prevalence, as observed in a study by (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) in Ethiopia. However, while some studies have identified health insurance as a protective factor against stroke (\u003cspan additionalcitationids=\"CR36\" citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e), this study found a higher prevalence of stroke among insured individuals. It is important to note that this study did not directly assess whether health insurance might be contributing to longer life expectancy among the elderly, thereby potentially creating a perception of higher stroke prevalence in insured older patients with hypertension.\u003c/p\u003e \u003cp\u003eIncreasing age was found to be significantly associated with prevalence of stroke. As people age, the long-term effects of hypertension contribute to significant vascular damage, increasing arterial stiffness and promoting atherosclerosis (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e). Both conditions worsen with age, raising the likelihood of cerebrovascular events such as stroke. Moreover, aging is associated with a decline in endothelial function and a rise in chronic inflammation, both of which exacerbate the vulnerability to stroke (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e). In older patients, inadequate treatment acceptance in routine practice could contribute to the increased stroke risk (\u003cspan additionalcitationids=\"CR42\" citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e). In this study, it was observed that having 8\u0026ndash;13 years of formal education (secondary education) was associated with a lower prevalence of stroke, aligning with the understanding that education enhances health literacy, enabling individuals to better manage hypertension and make healthier lifestyle choices (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e). Educated individuals are more likely to engage in regular physical activity, maintain a balanced diet, and avoid risk factors such as smoking and excessive alcohol consumption (\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eInterestingly, the study found that individuals with health insurance had a higher prevalence of stroke. While health insurance is generally considered a protective factor against severe health outcomes, some studies have suggested that insured individuals are more likely to seek medical attention and receive formal diagnoses for conditions, leading to higher reported prevalence rates. For instance, studies such as those by (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e) have highlighted the potential for insurance to improve access to healthcare, thus increasing the diagnosis of non-communicable diseases like stroke. However, in low-resource settings, insured individuals may still face challenges such as inadequate management of risk factors, which could contribute to higher stroke prevalence (\u003cspan additionalcitationids=\"CR50\" citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e). This study supports these findings, indicating that having insurance does not always guarantee better health outcomes, especially in contexts where healthcare quality is uneven. Additionally, despite the assumption that those with health insurance might also have higher educational attainment, this study shows that insurance coverage remains generally low in the population, and having insurance does not necessarily correlate with secondary education in this context. Many people with insurance may not necessarily represent those with higher education levels. Thus, the higher prevalence of stroke in insured individuals may reflect increased healthcare engagement and diagnostic reporting rather than poorer health outcomes.\u003c/p\u003e \u003cp\u003eIn addition, this study found that respondents with higher stroke knowledge were more likely to have experienced a stroke compared to those with lower knowledge. This result is not surprising, as individuals who have suffered a stroke are more likely to acquire detailed information about the condition through personal experience and medical care. Experiencing a stroke often increases awareness of symptoms, risk factors, and preventive measures, as patients receive health education during their diagnosis, treatment, and recovery process. This aligns with findings from Sirisha, Jala (\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e), which highlight that individuals with firsthand experience of a condition are more likely to have greater knowledge about it. However, the important implication of this finding lies in the need to increase stroke awareness among individuals who have not yet experienced a stroke. Those with lower stroke knowledge may be unaware of their risk factors or early symptoms, which could lead to delayed healthcare-seeking behavior and poorer outcomes. Public health efforts should therefore focus on sensitizing this group, particularly among older patients with hypertension, through targeted health education campaigns to ensure that they recognize stroke risks and engage in preventive measures early on.\u003c/p\u003e \u003cp\u003eBesides, this study found a higher prevalence of stroke among respondents who had received stroke-related health information. It is important to note that receiving stroke-related health information itself is not a risk factor for stroke. Rather, individuals who are at a higher risk for stroke or have already experienced a stroke are more likely to seek out or be provided with this information by healthcare professionals. Healthcare providers often prioritize stroke education for patients who have significant risk factors or have already had a stroke, as part of their ongoing care and management (\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e). This can lead to a higher observed prevalence of stroke in this informed group, as these individuals are more engaged with the healthcare system and more likely to have their stroke risk factors identified and managed. The higher prevalence, therefore, reflects the correlation between increased stroke risk and the likelihood of receiving targeted health education, not causality between the two. The implication of this finding is that targeted stroke-related health education plays a key role in improving awareness among individuals at higher risk of stroke. However, it also highlights the need for broader public health efforts to ensure that stroke education reaches individuals who may not have experienced a stroke or exhibit visible risk factors but could still be at risk. Expanding stroke prevention campaigns to a wider population, including those who are not yet engaged with healthcare services or who do not perceive themselves as being at risk, can help in early detection and prevention.\u003c/p\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and Limitations\u003c/h2\u003e \u003cdiv id=\"Sec22\" class=\"Section3\"\u003e \u003ch2\u003eStrengths\u003c/h2\u003e \u003cp\u003eThis study represents a pioneering effort to assess prevalence and factors associated with stroke among older patients with hypertension attending public healthcare facilities in GKMA, Uganda. Its novelty lies in providing a foundational understanding that can inform future research, policy-making, and targeted interventions within the region. A relatively large sample size of 383 respondents was recruited, enhancing the generalizability of the findings to similar populations. This robust sample size strengthens the validity of inferences drawn about the target population. Furthermore, the study employed established frameworks such as the WHO Social Determinants of Health, ensuring methodological rigor and grounding its insights in a well-recognized theoretical context.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eThis study has several limitations. Stroke measurement relied on self-reports, cross-referenced with medical records where possible, but the absence of a standardized tool to assess stroke may have affected the reliability of the prevalence estimates. Survivor bias may have influenced findings, as only individuals who survived a stroke were included. The analysis excluded some variables from the conceptual framework, potentially limiting comprehensiveness. Socio-economic status was not directly assessed, though proxies like education level and health insurance were included. Recall bias may have affected data accuracy, but efforts were made to focus on recent and objective details. As a facility-based study, stroke prevalence may be underestimated, excluding individuals with fatal strokes or those not seeking care at public facilities. Finally, findings are specific to public healthcare facility users in the GKMA and may not represent the broader population.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e "},{"header":"Conclusions and recommendations","content":"\u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003cp\u003eThis study showed a high prevalence of stroke among older patients with hypertension. The factors associated with stroke were age (80 years and above), having 8\u0026ndash;13 years of formal education (secondary education), possession of health insurance, high knowledge of stroke, and receipt of stroke-related health information. Notably, while higher knowledge of stroke and receipt of health information was associated with an increased likelihood of stroke, this relationship highlights that individuals at greater risk are more likely to seek out and receive education about stroke. Thus, rather than indicating that knowledge or education is a risk factor, it suggests that these factors serve as indicators of engagement with the healthcare system and recognition of risk. Based on the study findings, several recommendations are proposed to improve stroke prevention and management among older adults. Public health education programs should be enhanced to increase awareness of stroke prevention methods, particularly targeting older adults and individuals with hypertension. Expanding public education initiatives to underserved populations through community outreach is critical to reach those with limited knowledge or access to healthcare services. Age-specific hypertension management programs should be developed, focusing on older adults at higher risk, including those aged 80 and above. Access to healthcare services should be improved by creating affordable and comprehensive healthcare plans that cover preventive and management services for older adults. Male engagement in hypertension management should be encouraged through targeted outreach campaigns to address low health-seeking behavior among men. Individuals with stroke experience can be trained as peer educators in chronic care clinics to support stroke prevention and management efforts. Lastly, further research should be conducted to identify specific barriers to stroke prevention and develop tailored interventions to meet the needs of different populations.\u003c/p\u003e \u003c/div\u003e"},{"header":"Abbreviations","content":"\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"623\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31.7308%;\"\u003e\n \u003cp\u003eCDC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68.2692%;\"\u003e\n \u003cp\u003eCentre for Disease Control\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31.7308%;\"\u003e\n \u003cp\u003eDALYs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68.2692%;\"\u003e\n \u003cp\u003eDisability Adjusted Life Years\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31.7308%;\"\u003e\n \u003cp\u003eGKMA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68.2692%;\"\u003e\n \u003cp\u003eGreater Kampala Metropolitan Area\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31.7308%;\"\u003e\n \u003cp\u003eGOU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68.2692%;\"\u003e\n \u003cp\u003eGovernment of Uganda\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31.7308%;\"\u003e\n \u003cp\u003eMoH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68.2692%;\"\u003e\n \u003cp\u003eMinistry of Health\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31.7308%;\"\u003e\n \u003cp\u003eNCD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68.2692%;\"\u003e\n \u003cp\u003eNon-Communicable Disease\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31.7308%;\"\u003e\n \u003cp\u003eSDGs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68.2692%;\"\u003e\n \u003cp\u003eSustainable Development Goals\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31.7308%;\"\u003e\n \u003cp\u003eSSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68.2692%;\"\u003e\n \u003cp\u003eSub- Saharan Africa\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31.7308%;\"\u003e\n \u003cp\u003eWHO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68.2692%;\"\u003e\n \u003cp\u003eWorld Health Organization\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStudy approval was obtained from the Makerere University School of Public Health (MakSPH) Research and Ethics Committee and the Uganda National Council for Science and Technology (UNCST). In addition, administrative clearance was obtained from the respective district authorities. Following this, permission to interview patients was requested from the in-charges of the respective public healthcare facilities. All methods were performed in accordance with the with relevant guidelines and regulations such as Declaration of Helsinki. Participation was voluntary, and written informed consent was obtained after explaining the study’s aims, benefits, and risks. The highest precautions to ensure and protect participants’ privacy, confidentiality, and anonymity were taken. Participants were interviewed in private places, and their information was kept confidential. Anonymity was protected by employing identification codes and retaining data in secure storage. Access to the collected data was restricted to the study team. This was achieved by using password-protected digital files and secure physical storage for any hard copies. Only authorized personnel had access to the data, ensuring a high level of security and confidentiality.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResearch reported in this publication was supported by the National Institute of Neurological Disorders and Stroke of the National Institute of Health under Award Number R01N8118544. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBNT, CM, AN, JBI, RKM, DN, AL, SNM, MNK, TS, and CNK participated in the conceptualization and development of this manuscript. All authors read and approved this manuscript before submission to this journal.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe appreciate the hard work of the research assistants Evelyn Ssanyu Mugisha, Ruth Katushabe, and Miranda Namaala, whose assistance was instrumental in the successful completion of the data collection process. Special thanks to Kampala Capital City Authority (KCCA), Wakiso district, and Mukono district, as well as the respective health facility in-charges, for their cooperation and facilitation of the research activities.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eMartins SCO, Sacks C, Hacke W, Brainin M, de Assis Figueiredo F, Pontes-Neto OM, et al. Priorities to reduce the burden of stroke in Latin American countries. The Lancet Neurology. 2019;18(7):674-83.\u003c/li\u003e\n\u003cli\u003eFeigin VL, Stark BA, Johnson CO, Roth GA, Bisignano C, Abady GG, et al. Global, regional, and national burden of stroke and its risk factors, 1990\u0026ndash;2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet Neurology. 2021;20(10):795-820.\u003c/li\u003e\n\u003cli\u003eWSO. Global Stroke Fact Sheet 2022 2022 [Available from: https://www.world-stroke.org/assets/downloads/WSO_Global_Stroke_Fact_Sheet.pdf.\u003c/li\u003e\n\u003cli\u003eLozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. The lancet. 2012;380(9859):2095-128.\u003c/li\u003e\n\u003cli\u003eFeigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990\u0026ndash;2010: findings from the Global Burden of Disease Study 2010. The lancet. 2014;383(9913):245-55.\u003c/li\u003e\n\u003cli\u003eWHO. World Stroke Day 2022 2022 [Available from: https://www.who.int/srilanka/news/detail/29-10-2022-world-stroke-day-2022#:~:text=Stroke%20is%20the%20leading%20cause,a%20stroke%20in%20their%20lifetime.\u003c/li\u003e\n\u003cli\u003eMugwano I, Kaddumukasa M, Mugenyi L, Kayima J, Ddumba E, Sajatovic M, et al. Poor drug adherence and lack of awareness of hypertension among hypertensive stroke patients in Kampala, Uganda: a cross sectional study. BMC research notes. 2016;9(1):1-8.\u003c/li\u003e\n\u003cli\u003eIHME. Institute for Health Metrics Evaluation (IHME). 2022 [Available from: https://www.healthdata.org/research-analysis/health-by-location/profiles/uganda.\u003c/li\u003e\n\u003cli\u003eAmini M, Zayeri F, Salehi M. Trend analysis of cardiovascular disease mortality, incidence, and mortality-to-incidence ratio: results from global burden of disease study 2017. BMC public health. 2021;21:1-12.\u003c/li\u003e\n\u003cli\u003eBashaar M, Saleem F, Thawani V, Azmi Hassali M, Hashemi T. Evaluation of hypertension related knowledge, attitudes and practices at community level in Kabul. Pharm Pharmacol Int J. 2019;7(3):106-12.\u003c/li\u003e\n\u003cli\u003eWorld Stroke Organisation. Global Stroke Guidelines and Action Plan: A Road Map for Quality Stroke Care. 2016.\u003c/li\u003e\n\u003cli\u003eDar NZ, Khan SA, Ahmad A, Maqsood S, Khan SA. Awareness of stroke and health-seeking practices among hypertensive patients in a tertiary care hospital: a cross-sectional survey. Cureus. 2019;11(5).\u003c/li\u003e\n\u003cli\u003eLindsay P, Furie KL, Davis SM, Donnan GA, Norrving B. World Stroke Organization global stroke services guidelines and action plan. International Journal of Stroke. 2014;9(SA100):4-13.\u003c/li\u003e\n\u003cli\u003eMOH. NATIONAL MULTISECTORAL STRATEGIC PLAN FOR THE PREVENTION AND CONTROL OF NONCOMMUNICABLE DISEASES (2018 \u0026ndash; 2023): UGANDA. 2018.\u003c/li\u003e\n\u003cli\u003eMOH. Uganda Clinical Guidelines 2016. 2016.\u003c/li\u003e\n\u003cli\u003eDas S, Das SK. Knowledge, attitude and practice of stroke in India versus other developed and developing countries. Annals of Indian Academy of Neurology. 2013;16(4):488.\u003c/li\u003e\n\u003cli\u003eUBOS. UGANDA BUREAU OF STATISTICS 2022 [Available from: https://www.ubos.org/wp-content/uploads/publications/05_20232022_Statistical_Abstract.pdf.\u003c/li\u003e\n\u003cli\u003eMOH. NATIONAL HEALTH FACILITY MASTER LIST 2018. 2018.\u003c/li\u003e\n\u003cli\u003eMOH. SERVICE STANDARDS AND SERVICE DELIVERY STANDARDS FOR THE HEALTH SECTOR. 2016.\u003c/li\u003e\n\u003cli\u003eGOU. NATIONAL PLAN OF ACTION FOR OLDER PERSONS 2012/13-2016/17. 2012.\u003c/li\u003e\n\u003cli\u003eKish L. Sampling organizations and groups of unequal sizes. American sociological review. 1965:564-72.\u003c/li\u003e\n\u003cli\u003eKaddumukasa M, Mugenyi L, Kaddumukasa MN, Ddumba E, Devereaux M, Furlan A, et al. Prevalence and incidence of neurological disorders among adult Ugandans in rural and urban Mukono district; a cross-sectional study. BMC neurology. 2016;16(1):1-9.\u003c/li\u003e\n\u003cli\u003eSanuade OA, Dodoo FN-A, Koram K, de-Graft Aikins A. Prevalence and correlates of stroke among older adults in Ghana: Evidence from the Study on Global AGEing and adult health (SAGE). PloS one. 2019;14(3):e0212623.\u003c/li\u003e\n\u003cli\u003eWoldetsadik FK, Kassa T, Bilchut WH, Guadie YG, Eriku GA. Stroke Related Knowledge, Prevention Practices and Associated Factors Among Hypertensive Patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2021. Frontiers in Neurology. 2022;13:839879.\u003c/li\u003e\n\u003cli\u003eLiu J, Chen Y, Jin C, Chen D, Gao G, Li F. Analysis of prevalence and influencing factors of stroke in elderly hypertensive patients: Based on the screening plan for the high-risk population of stroke in Jiading District, Shanghai. Plos one. 2021;16(8):e0255279.\u003c/li\u003e\n\u003cli\u003eMekonen HH, Birhanu MM, Mossie TB, Gebreslassie HT. Factors associated with stroke among adult patients with hypertension in Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia, 2018: A case-control study. PLoS One. 2020;15(2):e0228650.\u003c/li\u003e\n\u003cli\u003eTsang S, Royse CF, Terkawi AS. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi journal of anaesthesia. 2017;11(Suppl 1):S80.\u003c/li\u003e\n\u003cli\u003eGreenland S, Senn SJ, Rothman KJ, Carlin JB, Poole C, Goodman SN, et al. Statistical tests, P values, confidence intervals, and power: a guide to misinterpretations. European journal of epidemiology. 2016;31(4):337-50.\u003c/li\u003e\n\u003cli\u003eBursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source code for biology and medicine. 2008;3:1-8.\u003c/li\u003e\n\u003cli\u003eWHO. Global Health Estimates 2019: Disease burden by Cause, Age, Sex, by Country and by Region, 2000-2019. 2019 [Available from: https://www.who.int/data/global-health-estimates.\u003c/li\u003e\n\u003cli\u003eMisgana S, Asemahagn MA, Atnafu DD, Anagaw TF. Incidence of stroke and its predictors among hypertensive patients in Felege Hiwot comprehensive specialized hospital, Bahir Dar, Ethiopia, a retrospective follow-up study. European Journal of Medical Research. 2023;28(1):227.\u003c/li\u003e\n\u003cli\u003eOwolabi M, Agunloye A. Risk factors for stroke among patients with hypertension: A case\u0026ndash;control study. Journal of the neurological sciences. 2013;325(1-2):51-6.\u003c/li\u003e\n\u003cli\u003eFekadu G, Chelkeba L, Kebede A. RETRACTED ARTICLE: Risk factors, clinical presentations and predictors of stroke among adult patients admitted to stroke unit of Jimma university medical center, south west Ethiopia: prospective observational study. BMC neurology. 2019;19(1):183.\u003c/li\u003e\n\u003cli\u003eRupasinghe CD, Bokhari SA, Lutfi I, Noureen M, Islam F, Khan M, et al. Frequency of stroke and factors associated with it among old age hypertensive patients in Karachi, Pakistan: a cross-sectional study. Cureus. 2022;14(3).\u003c/li\u003e\n\u003cli\u003eOso AA, Adefurin A, Benneman MM, Oso OO, Taiwo MA, Adebiyi OO, et al. Health insurance status affects hypertension control in a hospital based internal medicine clinic. International Journal of Cardiology Hypertension. 2019;1:100003.\u003c/li\u003e\n\u003cli\u003eMacDonald MR, Zarriello S, Swanson J, Ayoubi N, Mhaskar R, Mirza A-S. Secondary prevention among uninsured stroke patients: A free clinic study. SAGE Open Medicine. 2020;8:2050312120965325.\u003c/li\u003e\n\u003cli\u003eLi S, Bruen BK, Lantz PM, Mendez D. Peer reviewed: impact of health insurance expansions on nonelderly adults with hypertension. Preventing chronic disease. 2015;12.\u003c/li\u003e\n\u003cli\u003eKim H-L. Arterial stiffness and hypertension. Clinical Hypertension. 2023;29(1):31.\u003c/li\u003e\n\u003cli\u003eHarvey A, Montezano AC, Touyz RM. Vascular biology of ageing\u0026mdash;Implications in hypertension. Journal of molecular and cellular cardiology. 2015;83:112-21.\u003c/li\u003e\n\u003cli\u003eFinger CE, Moreno-Gonzalez I, Gutierrez A, Moruno-Manchon JF, McCullough LD. Age-related immune alterations and cerebrovascular inflammation. Molecular psychiatry. 2022;27(2):803-18.\u003c/li\u003e\n\u003cli\u003eBoehme AK, Esenwa C, Elkind MS. Stroke risk factors, genetics, and prevention. Circulation research. 2017;120(3):472-95.\u003c/li\u003e\n\u003cli\u003eLi C, Engström G, Hedblad B, Berglund Gr, Janzon L. Blood pressure control and risk of stroke: a population-based prospective cohort study. Stroke. 2005;36(4):725-30.\u003c/li\u003e\n\u003cli\u003eBushnell CD, Col\u0026oacute;n-Emeric CS. Secondary stroke prevention strategies for the oldest patients: possibilities and challenges. Drugs \u0026amp; aging. 2009;26:209-30.\u003c/li\u003e\n\u003cli\u003eMiller TA. Health literacy and adherence to medical treatment in chronic and acute illness: a meta-analysis. Patient education and counseling. 2016;99(7):1079-86.\u003c/li\u003e\n\u003cli\u003eGaffari-Fam S, Babazadeh T, Oliaei S, Behboodi L, Daemi A. Adherence to a health literacy and healthy lifestyle with improved blood pressure control in Iran. Patient preference and adherence. 2020:499-506.\u003c/li\u003e\n\u003cli\u003eViinikainen J, Bryson A, B\u0026ouml;ckerman P, Kari JT, Lehtim\u0026auml;ki T, Raitakari O, et al. Does better education mitigate risky health behavior? A mendelian randomization study. Economics \u0026amp; Human Biology. 2022;46:101134.\u003c/li\u003e\n\u003cli\u003eNg R, Sutradhar R, Yao Z, Wodchis WP, Rosella LC. Smoking, drinking, diet and physical activity\u0026mdash;modifiable lifestyle risk factors and their associations with age to first chronic disease. International journal of epidemiology. 2020;49(1):113-30.\u003c/li\u003e\n\u003cli\u003eKalita J, Bharadwaz MP, Aditi A. Prevalence, contributing factors, and economic implications of strokes among older adults: a study of North-East India. Scientific Reports. 2023;13(1):16880.\u003c/li\u003e\n\u003cli\u003eFenny AP, Enemark U, Asante FA, Hansen KS. Patient satisfaction with primary health care\u0026ndash;a comparison between the insured and non-insured under the National Health Insurance Policy in Ghana. Global journal of health science. 2014;6(4):9.\u003c/li\u003e\n\u003cli\u003eBittoni MA, Wexler R, Spees CK, Clinton SK, Taylor CA. Lack of private health insurance is associated with higher mortality from cancer and other chronic diseases, poor diet quality, and inflammatory biomarkers in the United States. Preventive medicine. 2015;81:420-6.\u003c/li\u003e\n\u003cli\u003eGoal 6: Ensure access to water and sanitation for all.\u003c/li\u003e\n\u003cli\u003eSirisha S, Jala S, Vooturi S, Yada PK, Kaul S. Awareness, recognition, and response to stroke among the general public\u0026mdash;an observational study. Journal of Neurosciences in Rural Practice. 2021;12(04):704-10.\u003c/li\u003e\n\u003cli\u003eSur NB, Kozberg M, Desvigne-Nickens P, Silversides C, Bushnell C. Improving stroke risk factor management focusing on health disparities and knowledge gaps. Stroke. 2024;55(1):248-58.\u003c/li\u003e\n\u003cli\u003eKernan WN, Viera AJ, Billinger SA, Bravata DM, Stark SL, Kasner SE, et al. Primary care of adult patients after stroke: a scientific statement from the American Heart Association/American Stroke Association. Stroke. 2021;52(9):e558-e71.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Stroke, Prevalence, Older patients, Hypertension, Uganda","lastPublishedDoi":"10.21203/rs.3.rs-5867126/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5867126/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eGlobally, stroke is one of the top three leading causes of death and disability. Although several stroke risk factors are modifiable, including hypertension, factors associated with stroke among older patients with hypertension in Uganda remain underexplored. This study assessed the prevalence and factors associated with stroke among older patients with hypertension in public healthcare facilities in the Greater Kampala Metropolitan Area, Uganda.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA cross-sectional study was conducted among 383 older patients with hypertension. Systematic sampling was used to recruit study participants, and STATA 15.0 was used for analysis. Descriptive statistics were used to present continuous variables, while frequencies and proportions were used to present categorical data. Bivariate analyses identified associations between independent variables and stroke. Multivariable analyses controlled for confounders. A modified Poisson regression analysis with robust standard errors estimated prevalence ratios.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eOf the 383 respondents, 71.0% (272/383) were aged 60\u0026ndash;69 years (mean age 66.8\u0026thinsp;\u0026plusmn;\u0026thinsp;7.1), 80.9% (310/383) were female, and 42.8% (164/383) had a primary education level (1\u0026ndash;7 years). About 31.9% (122/383) exercised regularly, 94.8% (363/383) consumed carbohydrates frequently, 5.2% (20/383) had ever smoked, and 42.0% (151/383) had ever consumed alcohol. The prevalence of stroke was 18.3% (70/383). The factors associated with stroke included being aged 80 years and above (APR\u0026thinsp;=\u0026thinsp;2.68, 95% CI: 1.59\u0026ndash;4.51), having 8\u0026ndash;13 years of formal education (secondary education)(APR\u0026thinsp;=\u0026thinsp;0.37, 95% CI: 0.14\u0026ndash;0.98), possessing health insurance (APR\u0026thinsp;=\u0026thinsp;3.34, 95% CI: 1.19\u0026ndash;9.37), having high knowledge of stroke (APR\u0026thinsp;=\u0026thinsp;24.72, 95% CI: 6.20-98.55), and receiving stroke-related health information (APR\u0026thinsp;=\u0026thinsp;1.78, 95% CI: 1.05\u0026ndash;3.02).\u003c/p\u003e\u003ch2\u003eConclusion and recommendation:\u003c/h2\u003e \u003cp\u003eThis study demonstrated a high prevalence of stroke among older patients with hypertension. Public health education and community outreach should be expanded to underserved populations, while age-specific hypertension management and affordable healthcare services are essential. Engaging men and leveraging stroke survivors as peer educators can further strengthen prevention efforts. Future research should explore barriers to prevention and develop tailored interventions for diverse populations\u003c/p\u003e","manuscriptTitle":"Stroke prevalence and associated factors among older patients with hypertension attending public healthcare facilities in Greater Kampala Metropolitan Area, Uganda","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-02-03 08:46:44","doi":"10.21203/rs.3.rs-5867126/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5ce637fd-3ad0-4e0d-be22-a9a56c49e61a","owner":[],"postedDate":"February 3rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-02-04T07:24:12+00:00","versionOfRecord":[],"versionCreatedAt":"2025-02-03 08:46:44","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5867126","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5867126","identity":"rs-5867126","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}