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. 2024 Oct 20;42(1):87–94. doi: 10.1111/phn.13465

Healthy Life Awareness, Blood Pressure Awareness and Insight Among Adult Individuals: A Population‐Based Cross‐Sectional Study

Handan Terzi 1,✉, Sultan Ayaz‐Alkaya 2, Eylül Yeşilyurt 3
PMCID: PMC11700936  PMID: 39428710

ABSTRACT

Objective

To measure healthy life awareness, blood pressure awareness and insight levels, along with their predisposing factors among adult individuals.

Design

A population‐based cross‐sectional study.

Sample

The population consisted of adult individuals in a rural district of a city in Türkiye. Voluntary individuals who visited the population screening, organized as the May Measurement Month activity, were invited to the study (n = 290).

Measurements

The data were collected by a questionnaire, the Healthy Life Awareness Scale (HeLAS), and the Blood Pressure Awareness and Insight Scale (BASIS). Descriptive statistics, Pearson Correlation, and multiple linear regression were used to analyze the data.

Results

The mean scores of the HeLAS and the BASIS were 49.62 ± 8.30 and 2.89 ± 1.43, respectively. Income level, regular physical activity habits, and formerly being diagnosed with hypertension were positively associated with a healthy life awareness level. Former diagnosis of hypertension, regular medication usage, and being unemployed were the significant predisposing factors of blood pressure awareness and insight level.

Conclusions

Most adult individuals displayed a moderate level of healthy life awareness and a low level of blood pressure awareness and insight. Nurses could take on the leading role in developing healthy lifestyle habits among individuals, ensure medication treatment adherence, and prevent hypertension prevalence.

Keywords: awareness, blood pressure, hypertension, middle‐aged, nursing, rural population, treatment adherence

1. Introduction

Hypertension, known as high blood pressure, is one of the most critical contributors to causes of premature deaths worldwide. According to a recent report from the World Health Organization (WHO), approximately 1.3 billion adult individuals aged between 30 and 79 have hypertension (WHO 2023). Despite all the proceeded global initiatives to control high blood pressure, hypertension prevalence is known to be still on the rise (Cífková et al. 2022; Pathak et al. 2022; Peng et al. 2024). Global prevalence of hypertension has been estimated among female and male adults as 32% and 34%, respectively (NCD‐RisC 2021). Nevertheless, 41% of females and 51% of males with hypertension are stated to be undiagnosed worldwide (NCD‐RisC 2021). It has been declared that approximately 46% of the hypertensive adult population in the world is unaware of having high blood pressure (WHO 2023). Therefore, countries are encouraged to take immediate action to reach the global hypertension controlling target, which is a 33% decrease by 2030 (WHO 2023). As a major public health priority, increasing awareness regarding the risks of high blood pressure and controlling strategies among the adult population via community‐based initiatives is thought to be of importance.

2. Background

Hypertension management and awareness augmentation campaigns are more successful in high‐income countries (NCD‐RisC 2019, 2021). In a study conducted in Australia, 49% of the social media posts regarding hypertension mainly were about increasing awareness (Dalli et al. 2024). In a Japan‐based study, a community‐based blood pressure measurement at‐home campaign was found to raise awareness among hypertensive and non‐hypertensive adults (Kabayama et al. 2023). Likely, several upper‐middle‐income countries, along with the central European countries, have shown remarkable improvement regarding the hypertension control issue (NCD‐RisC 2021). In the longitudinal studies, hypertension awareness among the community‐dwelling adult population was found to increase dramatically over time (Cífková et al. 2022; Sarebanhassanabadi et al. 2024). Therefore, awareness (Poulter and Lackland 2017) and insight on illness (Zhang et al. 2023) are considered as one of the influential factors in controlling chronic diseases.

Insight is a complicated and multifaceted term, that requires psychological and behavioral skills to cope with an illness, includes awareness, self‐consciousness, comprehension way of one's health status and diseases, acceptance of illness, and also relates to the understanding of how an individual's life is affected by health or disease (Marková and Berrios 2011). Awareness is essential to preventing lifestyle habits‐related diseases, such as hypertension (Del Pinto et al. 2024; Demir‐Doğan and Elik 2024; Pathak et al. 2022). Increasing blood pressure awareness among communities worldwide is crucial to ensure early diagnosis and treatment of hypertension (Dalli et al. 2024; Pathak et al. 2022). Therefore, the International World Hypertension Day, May 17th, was disseminated for the whole month of 2017 by the global authorities to accelerate the rise in blood pressure awareness among the general public (Poulter and Lackland 2017). According to the latest arterial hypertension management guideline of the European Society of Cardiology and the European Society of Hypertension, pharmacological treatment necessity can be reduced or prevented by modifying lifestyle habits among individuals early diagnosed (Williams et al. 2018). However, the efficacy of healthy habit‐gaining interventions in hypertension management is stated to decrease in the long term (Williams et al. 2018). Therefore, determination of the impact of awareness and insight on behavior change among individuals is thought to be remarkable in the success of proactive health status self‐promotion and hypertension prevention activities.

The worth of awareness and insight into illness control and health promotion activities regarding high blood pressure is assumed to be a featured issue of the community‐based primary care interventions of today's world (Zhang et al. 2023). Periodical screenings would make it easier to notice the symptoms at the early stages of unregulated blood pressure and help to control the severity of the related chronic diseases in community settings (WHO‐EMRO 2024). Therefore, nurses have a key role in high blood pressure management, early detection of its risk factors, and taking action as team leaders to apply the prevention strategies (Gomez del Pulgar et al. 2022).

Periodical blood pressure measurement is recommended to all adult individuals, either hypertensive or healthy, to promote illness and healthy life awareness and to increase the knowledge of cardiovascular diseases’ risk factors with the help of internationally accepted days (Del Pinto et al. 2024; Kabayama et al. 2023). Moreover, the relationship between a healthy life and chronic disease awareness needs to be uncovered (Şen et al. 2023). Nevertheless, a gap exists in the literature which investigates the healthy life and blood pressure awareness and insight specifically. The current study is thought to contribute to the global population‐based nursing actions, which aim to ensure individuals take control of their own health, make healthy choices, and make proper health decisions on high blood pressure lifelong prevention.

This study was performed to measure healthy life awareness, blood pressure awareness, insight levels, and their predisposing factors among adult individuals. The study hypothesis was that individual and health‐related characteristics might predict healthy life awareness, blood pressure awareness, and insight among adult individuals.

3. Methods

3.1. Study Design and Participants

A population‐based cross‐sectional study was conducted, and it was reported based on the STROBE checklist. The population consisted of adult individuals in a rural district of the capital city of Türkiye. The sample size was calculated as per the hypertension prevalence of similar research (Turé et al. 2022), with α = 0.05, 1−β = 0.95, and g = 0.1 at least 272. Individuals who visited the population screening, organized as the May Measurement Month activity, were invited to participate in the study (N = 356).

Adult individuals who (a) were 18 and over years old, (b) were permanent residents of the selected district, and (c) were voluntary to participate, were included in the study. Exclusion criteria were (a) being unable to understand the directions due to having any neuropsychiatric illnesses or disabilities and (b) speaking a mother language different from Turkish.

3.2. Setting

The selected district, where the present study was conducted is 41 km far from the city center. The district has one state hospital with 75 inpatient capacities for treatment services and six family health centers for preventive services. It is very close to the factory area, so most of the residents are proletarians.

3.3. Instruments

The data were collected by a questionnaire, the Healthy Life Awareness Scale (HeLAS), and the Blood Pressure Awareness and Insight Scale (BASIS). The questionnaire was constructed from the individual and health‐related characteristics, including age, sex, education level, income level, employment status, having any chronic diseases, having been diagnosed with hypertension, regular medication use, smoking habit, regular physical activity habit, and number of daily meals, according to the literature (NCD‐RisC 2021; Williams et al. 2018).

HeLAS was developed by Özer and Yılmaz to determine the healthy life awareness level among individuals (Özer and Yılmaz 2020). It is a 5‐point Likert‐type scale (1: totally disagree and 5: totally agree) with 15 items and 4 sub‐dimensions. The total score can be obtained from the scale ranges between 15 and 75. There is no cut‐off point; the higher the score, the more awareness of healthy life increases. The Cronbach's alpha of the total scale is 0.81 (Özer and Yılmaz 2020). In the present study, the Cronbach's alpha coefficient was 0.85.

BASIS was developed by Gerretsen et al. (2018) to comprehensively measure the main aspects of subjective hypertension awareness. The BASIS was adapted to Turkish community‐dwelling adults by Yılmaz et al. (2022). It is a one‐dimensional scale developed about the illness awareness model. It is constructed as three parts. The first part of the scale includes six questions to determine the laboratory test results. The second part includes eight items with a 10‐point Likert‐type assessment to measure hypertension awareness. Two items (fourth and sixth items) are reversely scored. The third part has the scoring principle of the scale. The second and the third parts of the scale were used within the scope of the current study. Scoring is performed according to the four sub‐categories of the illness awareness model (general illness awareness, symptom attribution, awareness of the need for treatment, and awareness of negative consequences). The total score of the scale is calculated as the arithmetic mean of the valid‐scored sub‐categories. Zero‐scored sub‐categories are excluded from the total score calculation. The total score of the scale is varied from 1 (low awareness) to 10 (high awareness). The Cronbach's alpha of the total scale is 0.75 (Yılmaz et al. 2022). In the present study, the Cronbach's alpha coefficient was 0.74.

3.4. Procedure

The population‐based blood pressure screening was planned as the May Measurement Month activity in a district of the capital city of Türkiye and conducted on Friday, May 20, 2022. The Directorate of the selected district was informed, and written permissions were gathered before the research. Three distinct and crowded areas were selected with the support of the Directorate of the district, and the screening caravans were constructed on the activity day. A stadiometer, a scale with 0.1 kg sensitivity, and ERKA‐brand sphygmomanometers were included in every screening caravan. The planned blood pressure screening campaign was advertised to the residents by the municipality of the district one week before the activity via SMS and public announcements. A reminder, including the research aim, scope, focused age groups, locations of the screening caravans, day, and time, was sent to the residents as SMS by the municipality one night before the field screening. Additionally, since height and weight measurements were going to be performed before blood pressure measurement, information was included in the sent SMS regarding loose clothes and easy‐to‐wear shoes that should be put on.

On the screening day, the municipality performed public announcements by car regarding the aim and blood pressure screening activity via touring the district during the day. Adult individuals who visited the screening caravans were informed thoroughly regarding the research aim, and written consents were gathered from the volunteered participants. Following, the height and weight of the individuals were measured, and individuals were encouraged to rest for a minimum of 15 min before checking their blood pressure. The data collection tools were handed to individuals who agreed to participate in the study during their resting time and requested to fill under the supervision of the responsible researcher of each screening caravan. Finally, their blood pressures were measured and recorded. Adult individuals were informed about their blood pressure measurements, guided, and counseled about their questions. Individuals whose systolic/diastolic blood pressure values were between unintentional values were referred to a healthcare facility immediately. The entire process took 25–35 min.

3.5. Data Analysis

The sample size was calculated on the G*Power v.3.1.9.4 (Heinrich Heine University, Germany) program. The data were analyzed using the IBM SPSS v.28.0 program (IBM Corp., Armonk, NY). The independent variables are the individual and health‐related characteristics of the adult individuals. Healthy life and blood pressure awareness and insight levels are the dependent variables. The normal distribution of the dataset was assessed via Skewness‐Kurtosis values (±2) (George and Mallery 2020). Descriptive statistics were described through numbers, percentages, mean, and standard deviation (SD). Since the data were normally distributed, the correlation between the scales was assessed via the Pearson Correlation coefficient. Multicollinearity and normality were assessed before performing the regression analysis and no violation was detected. Simple linear regression analysis was performed on each independent variable. Significant independent variables were included in multiple regression analysis with the backward method. The statistical significance level was accepted as p < 0.05.

3.6. Ethical Considerations

Ethical approval was gathered from the the Gazi University Ethical Committee (Approval date/Number: 10.05.2022/09), and written approval was gathered from the head of the district. After the explanation of the study aim, verbal approval and written informed consent of the voluntary adult individuals were obtained. Individuals were given the right of termination to the data collection process at any time that they wished. The anonymity was ensured by covering up the names and personal identifiers of the participants. The data collection forms that were included in the analysis were kept in a locked cupboard in the responsible researcher's office. The study was conducted by conforming to the principles of the Declaration of Helsinki, 2013.

4. Results

Of the screened individuals (N = 356), 14 were younger than 18 years old, 36 adult individuals refused to participate in the study, and 16 volunteered participants filled the data collection tools incompletely. The data of 290 adult individuals were analyzed within the scope of the study.

4.1. Individual and Health‐Related Characteristics

The mean age of the participants was 56.54 (SD = 14.6), and 65.2% were men. Of the participants, 58.3% were university and above graduates, 78.6% were employed, and 61.3% had equal expense income levels. Of the participants, 31% were obese, 46.9% had at least one chronic disease, 48.3% were regular medication users, 23.8% were diagnosed with hypertension formerly, 27.9% had a smoking habit, 50.7% had regular physical activity habits, and 50.3% had three and above meals daily (Table 1). The mean systolic blood pressure value was 132.63 (SD = 19.89), and the mean diastolic blood pressure value was 79.92 (SD = 11.39).

TABLE 1.

Individual and health‐related characteristics of the adults (n = 290).

Characteristics n %
Age groups
18–40 48 16.6
41–64 146 50.3
65 and older 96 33.1
Gender
Women 101 34.8
Men 189 65.2
Education level
Primary/secondary school 38 13.1
Highschool 83 28.6
University and above 169 58.3
Employment
Yes 228 78.6
No 62 21.4
Income level
Less than expense 48 16.6
Equal to expense 178 61.3
More than expense 64 22.1
Having any chronic disease
Yes 136 46.9
No 154 53.1
Regular medication use
Yes 140 48.3
No 150 51.7
Former diagnosis of hypertension
Yes 69 23.8
No 221 76.2
Smoking habit
Yes 81 27.9
No 209 72.1
Regular physical activity habit
Yes 147 50.7
No 143 49.3
Number of daily meals
Two 144 49.7
Three and above 146 50.3
BMI
Normal weight 86 29.7
Overweight 114 39.3
Obese 90 31.0
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4.2. Healthy Life Awareness and Associated Factors

The total mean score of the HeLAS was 49.62 (SD = 8.30). Each independent variable was evaluated initially using simple linear regression analysis for healthy life awareness among adult individuals (Table 2). Statistically significant variables, which were age, education level, income, former diagnosis of hypertension, and regular physical activity habits, were included in the multiple linear regression model. Income level, former diagnosis of hypertension, and regular physical activity habits in the constructed model explained about 6% of the variance for healthy lifestyle awareness (Adjusted R 2 = 0.06; F = 32.611; p < 0.001). The healthy life awareness was lower in adults who had low income (β = −0.121), those formerly diagnosed with hypertension (β = −0.127), and those who did not exercise regularly (β = −0.160).

TABLE 2.

Predisposing factors of healthy life awareness among adult individuals.

Variables Simple model Multiple models
(95% CI for B) (95% CI for B)
B Lower Upper β p B Lower Upper β p
Age groups (Ref: 65 and older) −2.84 −5.41 −0.28 −0.128 0.030
Gender (Ref: Men) −1.94 −3.95 0.06 −0.112 0.057
Employment (Ref: No) −1.46 −3.80 0.88 −0.072 0.219
Education level (Ref: Primary/secondary) 2.23 0.30 4.16 0.133 0.024
Income level (Ref: More than expense) −2.67 −4.97 −0.37 −0.133 0.023 −2.43 −4.69 −0.16 −0.121 0.036
Former diagnosis of hypertension (Ref: No) −2.47 −4.71 −0.23 −0.127 0.031 −2.48 −4.69 −0.27 −0.127 0.028
Having any chronic disease (Ref: No) −0.04 −1.97 1.88 −0.002 0.968
Regular medication use (Ref: No) −0.75 −2.67 1.17 −0.045 0.443
Regular physical activity habit (Ref: Yes) −2.60 −4.49 −0.70 −0.157 0.008 −2.65 −4.53 −0.77 −0.160 0.006
Number of daily meals (Ref: Two) −0.26 −2.18 1.66 −0.016 0.787
BMI (Ref: Normal weight) 0.33 −1.78 2.43 0.018 0.761
Smoking habit (Ref: No) 1.53 −0.60 3.67 0.083 0.159
Blood pressure awareness and insight 0.01 −0.08 0.03 0.071 0.226
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Notes: Ref: reference, B: unstandardized coefficient, β: standardized coefficient, CI: confidence interval.

R = 0.239, adjusted R 2 = 0.06, Durbin–Watson = 1.841, F = 5.800, p < 0.001.

4.3. Blood Pressure Awareness and Insight and Associated Factors

The total mean score of the BASIS was 2.89 (SD = 1.43). The mean score of general illness awareness was 2.32 (SD = 0.71), 2.12 (SD = 3.31) for symptom attribution, 1.45 (SD = 0.87) for the awareness of the need for treatment, and 5.75 (SD = 3.67) for the awareness of negative consequences. Each independent variable was first analyzed via simple linear regression analysis for blood pressure awareness and insight among adult individuals (Table 3). Statistically significant variables, which were age groups, employment status, former diagnosis of hypertension, having any chronic disease, and regular medication use were tested in the multiple linear regression model. Employment status, former diagnosis of hypertension, and regular medication use in the constructed model explained about 21% of the total variance for the blood pressure awareness and insight (Adjusted R 2 = 0.21; F = 26.983; p < 0.001). The blood pressure awareness and insight were higher in adult individuals who were formerly diagnosed with hypertension (β = 0.299), regular medication users (β = 0.196), and those who were unemployed (β = −0.141). There could not be found any statistically significant association between healthy lifestyle awareness and blood pressure awareness and insight levels among adult individuals.

TABLE 3.

Predisposing factors of blood pressure awareness and insight among adult individuals.

Variables Simple model Multiple model
(95% CI for B) (95% CI for B)
B Lower Upper β p B Lower Upper β p
Age groups (Ref: 18–40 years) 0.78 0.34 1.22 0.203 0.001
Gender (Ref: Men) 0.28 0.07 0.63 0.093 0.113
Employment (Ref: No) −0.60 −0.99 −0.20 −0.170 0.004 −0.49 −0.85 −0.13 −0.141 0.008
Education level (Ref: Primary/secondary) −0.25 −0.58 0.09 −0.084 0.152
Income level (Ref: More than expense) 0.26 −0.14 0.66 0.075 0.205
Former diagnosis of hypertension (Ref: No) 1.40 1.04 1.75 0.146 <0.001 1.01 0.59 1.42 0.299 <0.001
Having any chronic disease (Ref: No) 1.00 0.70 1.32 0.351 <0.001
Regular medication use (Ref: No) 1.05 0.74 1.36 0.367 <0.001 0.56 0.21 0.92 0.196 0.002
Physical activity habit (Ref: Yes) 0.09 −0.25 0.42 0.030 0.611
Number of daily meals (Ref: Two) −0.04 −0.37 0.30 −0.01 0.828
BMI (Ref: Normal weight) 0.30 −0.07 0.66 0.094 0.109
Smoking habit (Ref: No) −0.26 −0.63 0.11 −0.083 0.161
Healthy life awareness 0.01 −0.01 0.03 0.071 0.226
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Notes: Ref: reference, B: unstandardized coefficient, β: standardized coefficient, CI: confidence interval.

R = 0.470, adjusted R 2 = 0.21, F = 26.983, Durbin–Watson = 2.061, p < 0.001.

5. Discussion

The healthy life awareness, blood pressure awareness, insight levels, and their predisposing factors among adult individuals were sought within the scope of this population‐based study. Healthy life awareness was found as slightly above the moderate level in the present study. The higher the healthy life awareness, the more positive health attitudes among individuals (Demir‐Doğan et al. 2024; Şen et al. 2023). In the literature, healthy life awareness level was found to be slightly high in different samples (Demir‐Doğan and Elik 2024; Demir‐Doğan et al. 2024; Şen et al. 2023; Uyan et al. 2023). This difference can be accepted as the picture of the utilization differences of healthcare services between urban and rural areas. The participants of the present study were rural area residents, therefore, opportunities to access health‐related resources or comprehensive healthcare services may be lower compared to their urban counterparts. Accordingly, health‐seeking behavior among rural area residents may be lower. Thus, lower healthy life awareness may undesirably affect blood pressure awareness and insight among the rural adult population.

Increasing hypertension‐related public awareness and insight, especially in rural areas, is a necessity as a controlling activity (Fritz et al. 2024; Sarebanhassanabadi et al. 2024; Zhang et al. 2023). In the present study, the blood pressure awareness and insight level of the participants was quite low. Unlikely, blood pressure awareness and insight levels of hypertensive adult populations were found moderate in the literature (Gerretsen et al. 2018; Yılmaz et al. 2022). Indeed, increased blood pressure awareness and insight levels among individuals with hypertension are expected. When the global hypertension prevalence is considered, it is important to raise awareness and improve insight among the general population. In this context, low blood pressure awareness and insight levels among adult individuals, whether with hypertension or healthy, have been considered an innovative aspect of the present study. Thus, determination of blood pressure awareness and insight among individuals is thought to pave the way for improving hypertension prevention strategies.

Diagnosed with hypertension is known to increase the knowledge and awareness levels of individuals (Ofili et al. 2024). Similarly, the former diagnosis of hypertension was found to be one of the predictive factors of both healthy life awareness and blood pressure awareness and insight levels among the adult individuals in the present study. When the positive effect of health‐related awareness days and months on increasing knowledge among individuals is considered (Vernon et al. 2021), as a proactive approach, increasing health literacy levels regarding high blood pressure, its adverse outcomes, and prevention strategies, including lifestyle modifications, is thought to come to forth to reach the success in raising the overall awareness among both the patients and the general public.

Diagnosis of hypertension requires compliance with pharmacological treatment, along with healthy lifestyle behavior adoption (Pathak et al. 2022; WHO 2023). Adherence to medication regimens in the control of high blood pressure is stated to be vital for decreasing the global burden of hypertension and preventing cardiovascular diseases among adult individuals (Pathak et al. 2022). In the present study, regular medication usage was found to be the other significant predisposing factor of blood pressure awareness and insight level among adult individuals. This result is counted as the novice contribution of the present study to the literature. Therefore, increasing awareness regarding rational medication usage and the importance of treatment adherence among adult individuals is essential to high blood pressure management among individuals with hypertension. In this context, nurses can have the proper knowledge and skills to consider preparing individual‐centered care plans, acting mutually with the individuals, and improving the individuals’ lifestyle habits to ensure pharmacological treatment adherence at the optimal level (Cilluffo et al. 2024).

Healthy lifestyle habit modification among adult individuals at any age is an essential step in hypertension control, treatment, and prevention activities (Ofili et al. 2024; Pathak et al. 2022). Even though age was found to be a statistically significant factor both for healthy life awareness and blood pressure awareness and insight, regular physical activity habits significantly predicted healthy life awareness in the present study. The evidence regarding the predictive factors of healthy life awareness and blood pressure awareness and insight is scarce in the literature, yet the existing evidence differs (Demir‐Doğan et al. 2024; Jeong 2021; Lamelas et al. 2019). That is to say that the expectancy of adult individuals regarding being healthy with the increased age may have been negatively affected by the accompanying life‐threatening comorbidities, including hypertension. Therefore, raising health awareness among individuals is thought to help improve health‐seeking behavior and prevent higher prevalences of lifestyle‐related diseases across the world.

Socioeconomic level is associated with accessing healthcare services and health‐related knowledge which contribute to be improved health and disease awareness levels among individuals (Demir‐Doğan and Elik 2024; Şen et al. 2023). Likely to the literature (Demir‐Doğan and Elik 2024), income level was a significant predictive factor of healthy life awareness in the present study. Additionally, another novel contribution of the present study was that unemployment was a significant predisposing factor of blood pressure awareness and insight level among adult individuals. Unemployment was reported as an important contributor to hypertension occurred in adulthood in several studies (Adeke et al. 2024; Nygren et al. 2015). When unemployment is considered a communal problem (Nygren et al. 2015) and a significant stressor in a person's life, it is not surprising that the unemployed rural adult population is highly aware of its negative consequences on health, such as hypertension, in the adulthood. Considering the adverse effects of unemployment on the individual's and the family's income level, unemployment should be considered a critical global public health issue. Therefore, unemployed individuals should be the focus group of blood pressure awareness campaigns.

6. Implications for Nursing & Health Policy

Nurses could dynamically engage in health promotion activities to increase healthy life awareness and insight into illness among individuals. Nurses could take on the leading role in developing healthy lifestyle habits among individuals, encouraging them to maintain these habits lifelong, ensuring medication treatment adherence, using effective communication skills to understand the feelings of high‐risk populations, and preventing hypertension prevalence. Thus, they may be active agents in developing effective policy processes on health screenings in the future.

Moreover, the case manager role of nurses could be highlighted and improved during the undergraduate education period to raise awareness about the internationally accepted health‐related days and their effectiveness on community health. Therefore, nurse educators along with the nursing organizations, should encourage nursing students to be responsive and involved in both national and international proactive hypertension prevention and health promotion campaigns.

6.1. Strengths and Limitations

As far as our knowledge, healthy life awareness, blood pressure awareness, insight levels, and their predisposing factors among adult individuals via a population‐based screening activity have been sought for the first time in the literature. Moreover, being performed with the rural area residents is considered the other strength of the present study.

There are several limitations. Drawing the sample from one rural area should not be accepted that the results of the present study may reflect awareness levels of whole rural communities. The laboratory findings of the participants, which may be associated with high blood pressure or other comorbidities, could not be assessed. The present study is a snapshot of a particular period due to its cross‐sectional nature. As being a population‐based characteristic and adopting the cross‐sectional design, the confounding factors, including daily stressors, religious attitudes, and spiritual needs, cannot be controlled in investigating the causality. The self‐declaration of the data may have caused potential recall bias and a high inclination to socially desired responses. Future studies should compare rural and urban residents selecting larger samples with regard to increasing cumulative awareness and contributing to hypertension management activities.

7. Conclusion

The present population‐based study concluded that most of the adult individuals displayed a moderate level of healthy life awareness and a low level of blood pressure awareness and insight. Low income, not exercising regularly, and having a hypertension diagnosis were negatively associated with healthy life awareness. Former diagnosis of hypertension, regular medication usage, and being unemployed were the significant predisposing factors of blood pressure awareness and insight level among adult individuals. More comprehensive studies are recommended to be performed to reveal the effectiveness of the activities to raise public awareness and insight in hypertension management and the promotion of a healthy life.

Author Contributions

Study conception and design: H.T., S.A.A.; Data collection: H.T., E.Y.; Data analysis and interpretation: H.T., S.A.A.; Drafting of the article: H.T., S.A.A., E.Y.; Critical revision of the article: H.T., S.A.A.

Ethics Statement

It was gathered an ethical approval from the Gazi University Ethical Committee (date/number: 10.05.2022/09) before conducting the research. After the explanation of the study's aim, verbal approval and written informed consent of the voluntary adult individuals were obtained.

Consent

The verbal and written informed consent were obtained from the participants.

Conflicts of Interest

The authors declare no conflicts of interest.

Acknowledgments

The authors would like to thank the study participants who voluntarily participated in this study for their very valuable support.

Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not‐for‐profit sectors.

Data Availability Statement

Data can be obtained from the corresponding author upon a reasonable request.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

Data can be obtained from the corresponding author upon a reasonable request.

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