Hypertension knowledge gaps: A patient-caregiver comparison from a tertiary care centre in Northern India.

Background: Hypertension is the leading modifiable risk factor for cardiovascular disease, yet awareness and control remain low, particularly in low- and middle-income countries (LMICs). In India, caregivers play a central role in patient support, but their comparative knowledge has been underexplored. This study assessed hypertension-related knowledge among patients and caregivers in a tertiary care setting in Northern India. Methods: A cross-sectional study was conducted over 7 months (October 2024-April 2025) in the cardiology out-patient department of a tertiary hospital in Punjab, India. Adults living with hypertension and their accompanying caregivers were consecutively enrolled. A structured questionnaire assessed sociodemographic factors and blood pressure (BP) monitoring practices, and the knowledge scores were compared between patients and caregivers, and associations with sociodemographic variables were examined. Results: Of 3,501 participants, 2,032 (58%) were patients, and 1,469 (42%) were caregivers. The cohort was predominantly male (56.6%), urban (69%) and educated up to the 12th grade (69%). Only 22.5% reported regular BP monitoring. Awareness of the hypertension definition (50.2%), the normal BP range (67%) and key risk factors, such as alcohol (41.2%), obesity (37%) and smoking (34.2%), was limited. Caregivers consistently demonstrated higher knowledge than patients (mean score: 8.7 versus 8.5/15; p=0.004), with better performance associated with higher education, urban residence and skilled occupations. Conclusions: Caregivers demonstrated greater knowledge of hypertension than patients, underscoring their potential as partners in disease management. Persistent gaps in awareness of risk factors, complications and follow-up emphasize the need for family-centred education, caregiver-focused counselling and accessible self-monitoring to strengthen hypertension control in LMICs.