The association between blood pressure control and multiple self-management behaviors in elderly patients with hypertension: a study based on latent class analysis

Due to the aging of the population, the management of hypertension among older people has become a major challenge in China. However, studies on the self-management behaviors of older people with hypertension are lacking. Older people with hypertension constitute a unique group in which self-management behaviors are heterogeneous across different subgroups of individuals. The present study aimed to explore the latent class of self-management behaviors among older patients with hypertension and its association with blood pressure control. Elderly individuals with hypertension who participated in a community health examination in the lakeside community of Bengbu City were selected as research subjects and were asked to undergo a physical examination and participate in a questionnaire for data collection. Latent class analysis was performed to explore the self-management classes of older patients with hypertension; subsequently, the characteristics of these self-management classes were analyzed using a logistic regression model, and the relationship between self-management class and the level of blood pressure control was analyzed through multiple linear regression. A total of 3211 older patients with hypertension in the community were enrolled, and their self-management behaviors were divided into four classes: active management (23.70%), positive exercise management (16.29%), passive management (25.20%) and negative exercise management (34.81%). The results of the logistic regression analysis revealed that older age, male sex, widowhood, lower education level, rural residency, and limitations in terms of activities of daily living (ADLs) were strongly associated with the passive management class (P < 0.05). The results of the multiple linear regression analysis revealed that compared with patients who received passive management, patients who received positive exercise management or active management had better blood pressure control (positive exercise management: β = 0.059, t = 2.345, P = 0.019; active 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. Exercise-driven self-management behaviors are significantly positively correlated with better blood pressure control, indicating that its value lies in its “complementarity with drugs”. To improve exercise compliance among older adults in the community, intervention strategies should be used to improve people’s awareness of self-management behavior, change bad habits, and improve patients’ quality of life.