The Association between Blood Pressure Control and Multiple Self-Management Behaviors in Elderly Patients with Hypertension: A Study Based on Latent Class Analysis

Abstract

Abstract Background Hypertension in elderly people has become one of the major challenges in China due to the acceleration of population aging. There are few studies on the self-management behavior of elderly people with hypertension. Elderly people with hypertension are a unique group, and self-management behavior is heterogeneous among different groups of individuals. The present study explored the latent class of self-management behaviors in elderly patients with hypertension and its association with blood pressure control. Methods Elderly individuals with hypertension who participated in a community health examination in the lakeside community of Bengbu City were selected as research subjects, and a physical examination and questionnaire survey were carried out. Latent class analysis was used to explore the self-management class of elderly patients with hypertension; the characteristics of self-management class were analyzed by a logistic regression model; and the relationship between self-management class and blood pressure control level was analyzed by multiple linear regression. Results A total of 3211 elderly patients with hypertension in the community were enrolled, and their self-management behaviors could be divided into four classes: comprehensive positive management (23.70%), positive exercise management (16.29%), comprehensive negative management (25.20%) and negative exercise management (34.81%). Logistic regression results showed that older age, male sex, widowhood, lower education levels, rural residence, and ADL limitations had greater associations with comprehensive negative management (P < 0.05). The results of multiple linear regression analysis showed that compared with comprehensive negative management, patients with positive exercise management and comprehensive positive management had better blood pressure control (positive exercise management: β = 0.059, t = 2.345, P = 0. 019; comprehensive positive management: β = 0.073, t = 2.603, P = 0. 009), suggesting that exercise plays an important role in blood pressure control in elderly hypertensive patients. Conclusion There is significant heterogeneity in the self-management behavior of elderly patients with hypertension, and community workers should respond as follows: identify the self-management characteristics and risk factors for various classes of patients as early as possible; formulate different treatment plans for different classes of elderly patients with hypertension; and provide corresponding intervention strategies to help them improve their awareness of self-management behavior, change their bad habits, and improve their quality of life.