Table 1.

Key themes and subthemes from religious leaders’ perspectives about hypertension in their communities

Themes	Frequency (n = 31)	Representative quotes
A. Perceptions of hypertension are influenced by religious beliefs
Perceptions of the causes of hypertension influenced by religion	19	i. “Maybe hypertension is caused by a lot of challenges. A person thinks a lot and a lot of problems have happened to him in his life. So, when he keeps on thinking about them, he gets hypertension.” (Muslim woman, age 38)   “[The source of hypertension] for how I understand, maybe it is just poverty or a difficult situation… I mean it results in a person having stress, thinking of what I can do when my income is low. Then it causes something like hypertension.” (Muslim woman, age 52) ii. “[I don’t plan to be tested for hypertension because] I believe in God, and I do not have depression.” (Christian woman, age 39)
Perceptions of hypertension treatment influenced by religion	10	iii. “Let me say that it can be treated when you first reduce stress… You have to agree with… the things that have already happened. First, you have to accept the sources which caused you to have that situation and leave it to God.” (Muslim man, age 40) iv. “For us who are teaching things about faith, we believe that through prayers and believing in God and praying to God [hypertension] can be treated.” (Christian man, age 42)   “What we are emphasizing is to pray to God so that he can help us with this problem of pressure” (Christian woman, age 44)
Perceptions of complications of hypertension influenced by religion	13	v. “When that situation happens during the mass, most [people] will interpret it as superstitious. And we always pray for them and some of them get better…. When you see that you are praying for him but there are no demons coming out, you then pour some water on him and place a fan near him.” (Christian man, age 50)   “I think most of the people will think that [an individual losing consciousness in church] is witchcraft.” (Christian woman, age 51) vi. “When my mosque members knew about [my hypertension], most of them thought that the demons might have attacked me, but the more I was explaining to them, they got to understand that was a problem of hypertension.” (Muslim man, age 64)
B. Religious beliefs can enable engagement with hypertension care
Religious texts relevant to hypertension	14	i. “The Bible has prophesized that Jesus Christ talked about diseases with no cure. Hypertension has the medicines of controlling it, but not a cure.” (Christian man, age 40)   “These scriptures were prophesized by the earlier prophets… even in the Qur’an they are there because these times were prophesied as the end times. That there will be different diseases and there will be no cure for them. One of the diseases is hypertension which has now arisen rapidly.” (Muslim woman, age 56)   “There are a lot of diseases mentioned in the Qur’an. Even that one [hypertension] is there.” (Muslim man, age 64)
Potential for religious beliefs to promote biomedical care	5	ii. “We should not put God far away; he should be the first one. We should pray to [God] to bless us, but the second step is to check our health.” (Christian man, age 42)  “Most of the scriptures encourage the use of medicine. Do not relax. And it is a very serious problem if you don’t use medicine.” (Muslim man, age 64)  “You can be prayed for so that God can make [bearing the illness] easier. When he goes to the hospital, God can just put him at ease until he has healed.” (Muslim man, age 40)
C. Religious leaders as potential partners for promoting hypertension control in communities
Religious leaders stated their knowledge of hypertension was incomplete and they could benefit from further education	11	i. “My understanding about blood pressure, it is a disease which I hear about it but I have never seen a patient with a problem like that. But from the explanations I am hearing, I hear that it is a disease which attacks old people. Now from there, I have not gotten any more explanation about what is the source and how does it affect people.” (Christian man, age 57)  “In the past I just knew that is only a fat person who gets pressure maybe because he has a lot of fats in his body… But after [I was diagnosed with hypertension], I had to ask myself depending on the body size I had, it was just a normal body size. So, I had to ask them why did I get pressure while I am not fat?” (Christian woman, age 48)
Religious leaders’ readiness to be educated and become educators	24	ii. “I have benefited to know what is hypertension, and I need enough education. More education so that I can go and be a leader to other people.” (Muslim woman, age 38)  “I can do it anywhere even in the church. After receiving the training, I will gather people of different kind and I will explain to them and also educate them.” (Christian woman, age 44)  “We pick a certain day and come to educate ourselves that there is this problem and get the knowledge and understand and also explain to other people about this information.” (Muslim man, age 41)  “I have gotten education that personally I am supposed to check my health. That means I will be a good ambassador to other people to make them also check their health and to protect themselves from these complications of hypertension because I have also seen a lot of complications here.” (Christian woman, age 38) iii. “I think as a leader; a perfect place is a place of worship because it is where a lot of people meet. It is easy for me to get them and educate them because it is a place where people come together more often than other places.” (Christian woman, age 38)
Congregants’ readiness to receive education about hypertension	21	iv. “From what I understand about mosque members, they will be grateful because [hypertension] has been a problem. It has killed a lot of our relatives. It has brought challenges because people connect it with witchcraft.” (Muslim woman, age 56)   “[Congregants] will feel good because I have given them knowledge about the disease of hypertension.” (Christian woman, age 32)   “I think they will receive this well because when you are educating someone to avoid something dangerous for his life. He will receive that very well” (Christian man, age 50)
Religious leaders’ influence as trusted community messengers	3	v. “When they have come to pray… then they will be told [about hypertension] because that is the place where a lot of people gather…everyone makes an effort to come on Friday, so you can explain to the ones who will be there. Then when they return home, they will also explain to the people who remained at home that there is this and this about hypertension.” (Muslim man, age 52) vi. “Religious leaders have a huge contribution to the society because they are the people with an influence… when they talk about something, it can be received quickly.” (Muslim man, age 40)   “But because I am a leader, I treated myself and I got better. They then believed that it can be treated.” (Muslim man, age 64)