Knowledge of Avoidable Risk Factors of Hypertension and Their Association with Hypertension Status Among University Students in The United Kingdom
Keywords:
Hypertension, avoidable risk factors, knowledge, university students, lifestyle behavioursAbstract
Hypertension remains a leading contributor to cardiovascular morbidity and premature mortality worldwide, with increasing prevalence observed among younger populations. Although avoidable lifestyle factors account for a substantial proportion of hypertension risk, prevention efforts depend heavily on adequate awareness and understanding of these factors. This study examines the level of knowledge of avoidable risk factors of hypertension among university students in England and evaluates the relationship between these factors and hypertension status. A cross-sectional quantitative design was employed using a structured questionnaire administered to students at a large English university. Descriptive statistics, chi-square analysis, and multinomial logistic regression were used to analyse the data. Findings indicate a high level of knowledge of avoidable risk factors, including alcohol consumption, obesity, high salt intake, and junk food consumption. Despite this, significant associations were observed between several avoidable risk factors and hypertension status, particularly alcohol use, body mass index, salt intake, and frequent consumption of junk food. The results highlight a clear disjunction between knowledge and health behaviour, suggesting that awareness alone is insufficient to reduce hypertension risk among university students. The study underscores the need for prevention strategies that extend beyond information provision to address behavioural, social, and environmental drivers of risk.
References
Adetunji, A., Uche Orji, C., Ezebialu, C., Adebayo, P. C., Sanusi, F., Imo, U., Adiat, T., & Ajala, T. (2025). The prevalence and risk factors of pre hypertension and hypertension among clinical students at the University of Ibadan, Nigeria. BMC Cardiovascular Disorders, 25, 393. https://doi.org/10.1186/s12872-025-04852-z
Alahmad, S. S., Samman, A. A., & Al Kayali, R. (2025). Unveiling the silent threat: Exploring hypertension prevalence and risk factors among university students in Syria. International Journal of Public Health, 70. https://doi.org/10.3389/ijph.2025.1607939
Almoraie, N. M., Alothmani, N. M., Alomari, W. D., & Al-Amoudi, A. H. (2024). Addressing nutritional issues and eating behaviours among university students: a narrative review. Nutrition research reviews, 1-16.
Alothman, S. A., Al Baiz, A. A., Alzaben, A. S., Khan, R., Alamri, A. F., & Omer, A. B. (2024, January). Factors associated with lifestyle behaviors among university students—a cross-sectional study. In Healthcare (Vol. 12, No. 2, p. 154). MDPI.
Aydin, N. (2025). Understanding of a healthy diet in relation to current guidelines: A case study of UK university students. Health Education Journal, 84(2), 125-134.
Bandura, A. (2001). Social cognitive theory: An agentic perspective. Annual review of psychology, 52(1), 1-26.
Carey, R. M., Muntner, P., Bosworth, H. B., & Whelton, P. K. (2018). Prevention and control of hypertension: JACC health promotion series. Journal of the American College of Cardiology, 72(11), 1278-1293.
Champion, V.L. and Skinner, C.S. (2008) The Health Belief Model. In: Glanz, K., Rimer, B.K. and Viswanath, K. Eds., Health behavior and health education: Theory, research, and practice. 4th Edition, Jossey-Bass, San Francisco, 189-193.
Datt, D., & Sharma, N. (2025). Prevalence of hypertension among young adults: A narrative review. International Journal of Health Sciences and Research, 15(12). https://doi.org/10.52403/ijhsr.20251222
Etikan, I., Musa, S. A., & Alkassim, R. S. (2016). Comparison of convenience sampling and purposive sampling. American Journal of Theoretical and Applied Statistics, 5(1), 1–4. https://doi.org/10.11648/j.ajtas.20160501.11
Evans, J. R., & Mathur, A. (2018). The value of online surveys: A look back and a look ahead. Internet Research, 28(4), 854–887. https://doi.org/10.1108/IntR-03-2018-0089
Faghy, M. A., Armstrong-Booth, K. E., Staples, V., Duncan, M. J., & Roscoe, C. M. (2021). Multi-component physical activity interventions in the UK must consider determinants of activity to increase effectiveness. Journal of Functional Morphology and Kinesiology, 6(3), 56.
Kario, K., Okura, A., Hoshide, S., & Mogi, M. (2024). The WHO global report 2023 on hypertension: Warning the emerging hypertension burden and its treatment strategy. Hypertension Research, 47, 1099–1102.
Kessler, T. A., & Rayman, L. (2024). Prevalence of high blood pressure, risk factors, and knowledge deficit in apparently healthy college students. Medical Research Archives, 12(6). https://doi.org/10.18103/mra.v12i6.5357
Kim, H. Y. (2017). Statistical notes for clinical researchers: Chi square test and Fisher’s exact test. Restorative Dentistry & Endodontics, 42(2), 152–155. https://doi.org/10.5395/rde.2017.42.2.152
Li, M., Cui, X., Meng, Y., Cheng, M., He, J., Yuan, W., Ni, J., & Liu, J. (2023). Prevalence of hypertension and its association with cardiovascular risk factors in college students in Hunan, China. International Journal of General Medicine, 16, 411–423. https://doi.org/10.2147/IJGM.S379957
Lopez, T., Shelby, L., Oguntuwase, Y., Sullivan, A., & Fergus, L. (2025). Hypertension in college students: Exploring the prevalence and risk factors. Food and Nutrition Sciences, 16(2). https://doi.org/10.4236/fns.2025.162011
Mahalakshmi, P. J., Valsaraj, S., Noufal, K. P., & Sudheesh. (2025). Hypertension among university students: A global and regional perspective review. World Journal of Biology Pharmacy and Health Sciences, 24(1), 126–134. https://doi.org/10.30574/wjbphs.2025.24.1.0889
Mills, K. T., Stefanescu, A., & He, J. (2020). The global epidemiology of hypertension. Nature Reviews Nephrology, 16, 223–237. https://doi.org/10.1038/s41581-019-0244-2
National Institute for Health and Care Excellence. (2023). Hypertension in adults: Diagnosis and management (NG136). Available at: https://www.nice.org.uk/guidance/ng136, (Accessed: 10 October 2025)
Niu, C., Zhang, P., Wei, L., Dong, J., Xu, C., Yang, Q., Lyu, D., Li, N., Li, M., & Zhang, L. (2025). The global burden of hypertension and its epidemiological impacts on adolescents and young adults: Projections to 2050. Frontiers in Cardiovascular Medicine, 12. https://doi.org/10.3389/fcvm.2025.1619445
Peltzer, K., & Pengpid, S. (2018). Prevalence, risk awareness and health beliefs of behavioural risk factors for cardiovascular disease among university students in nine ASEAN countries. BMC public health, 18(1), 237.
Piri, N., Moradi, Y., Gheshlagh, R. G., Abdullahi, M., Fattahi, E., Moradpour, F., (2023) Validity of self-reported hypertension and related factors in the adult population: Preliminary results from the cohort in the west of Iran. J Clin Hypertens (Greenwich). 2023 Feb;25(2):146-157. https://doi.org/10.1111/jch.14627.
Samakosky, M. J., Crouch, S. H., & Norris, S. A. (2025). “We don’t care because we are not sick”: understanding youths perceptions of hypertension in urban South Africa. BMC Public Health, 25(1), 2657.
Sax, L. J., Gilmartin, S. K., & Bryant, A. N. (2003). Assessing response rates and nonresponse bias in web and paper surveys. Research in higher education, 44(4), 409-432.
Setia, M. S. (2016). Methodology series module 3: Cross sectional studies. Indian Journal of Dermatology, 61(3), 261–264. https://doi.org/10.4103/0019-5154.182410
Sogari, G., Velez Argumedo, C., Gómez, M. I., & Mora, C. (2023). College Students and Eating Habits: A Study Using An Ecological Model for Healthy Behavior. Nutrients. 2018 Nov 23;10(12):1823. https://doi.org/10.3390/nu10121823.
Sprake, E., Lavin, J., Grabowski, P., Russell, J., Featherstone, M., & Barker, M. (2017). Eating habits associated with body weight gain in female university students: a UK-based study of Slimming World members. British Food Journal, 119(12), 2571-2582.
Steers, M. N., Neighbors, C., Wickham, R. E., Petit, W. E., Kerr, B., and Moreno, M. A. (2019) My friends, I'm #SOTALLYTOBER: A longitudinal examination of college students' drinking, friends' approval of drinking, and Facebook alcohol-related posts. Digit Health. 2019 May 6;5:2055207619845449. https://doi.org/10.1177/2055207619845449.
Stoltzfus, J. C. (2011). Logistic regression: a brief primer. Academic emergency medicine, 18(10), 1099-1104.
Tang, R., An, J., Bellows, B. K., Moran, A. E., & Zhang, Y. (2025). Trends in hypertension prevalence, awareness, treatment, and control among young adults, 2003–2023. American Journal of Hypertension, 38(8), 551–559. https://doi.org/10.1093/ajh/hpaf044
Tran, D. M. T., Dingley, C., & Arenas, R. (2021). Perception and beliefs regarding cardiovascular risk factors and lifestyle modifications among high-risk College students. Canadian Journal of Nursing Research, 53(2), 94-106.
Unger, T., Borghi, C., Charchar, F., Khan, N. A., Poulter, N. R., Prabhakaran, D., Ramirez, A., Schlaich, M., Stergiou, G. S., Tomaszewski, M., Wainford, R. D., Williams, B., & Schutte, A. E. (2020). International Society of Hypertension global hypertension practice guidelines. Hypertension, 75(6), 1334–1357. https://doi.org/10.1161/HYPERTENSIONAHA.120.15026
Wang, X., & Cheng, Z. (2020). Cross sectional studies: Strengths, weaknesses, and recommendations. Chest, 158(1), S65–S71. https://doi.org/10.1016/j.chest.2020.03.012
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., MacLaughlin, E. J., Muntner, P., Smith, S. C., Spencer, C. C., Stafford, R. S., & Wright, J. T. (2018). 2017 ACC/AHA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Journal of the American College of Cardiology, 71(19), e127–e248. https://doi.org/10.1016/j.jacc.2017.11.006
World Health Organization. (2023). Global report on hypertension: The race against a silent killer. WHO. https://www.who.int/publications/i/item/9789240081062
Zahid, Z., Shah, M. A., Tanvir, H., Amjad, A., Butt, N. S., & Asim, F. (2024). Prevalence and associated factors of hypertension in young adults: A cross sectional study. The Professional Medical Journal, 31(1). https://doi.org/10.29309/TPMJ/2024.31.01.7839
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Copyright (c) 2026 Freedom Nwakaego Igheghe, Kennedy Oberhiri Obohwemu,, Celestine Emeka Ekwuluo, Tina Puri, Gordon Mabengban Yakpir, Chika Oguguo, Kenneth Oshiokhayamhe Iyevhobu, Maame Ama Owusuaa-Asante, Efe Clement Abel, Kingsley Chike Madubuike, Mary Oluwayemisi Akadiri, Leonard Nnamdi Meruo, Chisom Lucky Emeka, Jennifer Adaeze Chukwu, Abba Sadiq Usman, Jerry Soni, Chinaza Amalachukwu Emegoakor, , Barth Onyekachi Nwokedi, David Samuel Otu, Tiphonas Moses Omale, Nneka Gloria Anazodo, Eke Desmond Onyebuchukwu, Ekenedilichukwu Anselem Odiegwu, Nwora Chinonso Oli, Orevaoghene Precious Edewor, Bassey Etim Ekpo-Bassey, Akeem Omokide

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