Abstract 16702: Associations Between Knowledge, Attitudes, and Practices and Blood Pressure Control Among Iraqi and Syrian Refugees in the United States

Introduction: Displacement due to war or persecution has resulted in an unprecedented refugee crisis. Refugees face increased cardiovascular disease risk and poor blood pressure (BP) control. Yet, insights into their knowledge, attitudes, and practices (KAP) influencing BP management are limited.

Objective: To examine associations between KAP and BP control among Iraqi and Syrian refugees resettled in the United States. Method: Refugees from Iraq and Syria diagnosed with hypertension were recruited using a patient list at a federally qualified health center in San Diego. They completed a KAP survey and measured home BP (HMBP) using digital cuffs for at least 3 days/week for 4 weeks. Scores were computed for each KAP sub-scale; knowledge (0-16), attitude (1-20), and practice (1-8). Scores were categorized into quartiles (poor-excellent). The outcome was BP control calculated from an average of HMBP readings over 3 days for 4 weeks. Mixed effect logistic regression was used to assess the relationship between each KAP quartile and BP control (<130/80 mmHg).

Results: Final analysis included 95 refugees (79% Iraqis, 21% Syrians). Participants were male (56%), with mean age 58.4 (±16.34) years, 86% unemployed, 22% had at least a Bachelor's degree, 66% had limited English proficiency and only 3.6% had annual income ≥$35,000. The mean scores were as follows: BP 129/79 mmHg, with 61% having uncontrolled BP, knowledge 13.2 (± 2.37), attitude 14.6 (± 2.38), and practice 6.5 (± 1.17). Higher knowledge correlated with higher odds of BP control (adjusted Odds ratio (aOR): 1.89,95% Confidence Interval (CI): 1.39 - 2.55). Those who had fair and good attitude had lower odds of BP control (aOR: 0.63, 95% CI: 0.52 0.77; OR: 0.58, CI: 0.45 - 0.75) respectively (Table).

Conclusion: Findings suggest poorer BP knowledge correlates with BP control in Syrian and Iraqi refugees who are receiving BP care. Tailored health interventions for refugees are needed to promote cardiovascular health equity.