Determinants of Hypertension Prevention Practices Among Adults in a High-Density Residential Area in the Capital-City: A Cross-Sectional Study in Mtendere Compound, Lusaka, Zambia

Background: Hypertension is a growing contributor to morbidity and mortality in sub-Saharan Africa, yet many adults are still unaware of how to prevent it. In Zambia, preventive behaviours such as regular exercise, reduced salt intake, and routine blood pressure checks are underutilised. This study examined the factors associated with hypertension prevention practices among adults in Mtendere Compound, a high-density residential area in the capital city of Zambia, Lusaka. Methods: A cross-sectional study was conducted among 382 adults aged 18 to 65 years, selected through multistage random sampling. Data were collected using structured interviewer-administered questionnaires adapted from the WHO-STEPS tools. Key variables included demographic characteristics, knowledge of hypertension, health-seeking behaviour, and lifestyle factors. Descriptive statistics and logistic regression were used to analyse associations between independent variables and hypertension prevention practices as a compound outcome variable including low salt intake, regular exercises and check-ups. Results: Among participants, 58.6% showed adequate knowledge of hypertension prevention. However, only 41.1% reported practising at least three recommended behaviours. Receiving health advice at a facility (AOR: 3.09, 95% CI: 1.72-5.56), having good knowledge (AOR: 2.64, 95% CI: 1.46-4.75), and being employed (AOR: 1.78, 95% CI: 1.02-3.09) were independently associated with practising preventive behaviours. Age, sex, and education level were not statistically significant predictors. Conclusion: While the majority of the respondents had adequate knowledge of hypertension prevention, the actual practice was low. This study highlights the community-based reinforcement of social behavioural change (SBC) as a means to transform knowledge into practice among at-risk populations. Specifically, the study recommends tailoring interventions on hypertension prevention to reach unemployed and under-informed populations in informal settlements and other high-density settings in major towns and cities in sub-Saharan Africa.