Characteristics and influencing factors of self-management behaviors of hypertensive patients in areas with concentrated ethnic minorities on plateau: a latent profile analysis

BACKGROUNDS: Hypertension remains a major public health challenge in China, especially in high-altitude ethnic minority areas where prevalence is high but awareness, treatment, and control rates remain low. Self-management is crucial for delaying complications and improving quality of life, yet previous studies have mainly focused on low-altitude areas and Han Chinese populations and have largely relied on total-score comparisons. Because self-management is multidimensional, such approaches may obscure population heterogeneity. Latent profile analysis (LPA) can identify subgroups with distinct behavior patterns, but evidence in hypertensive patients from high-altitude ethnic minority areas is scarce. This study aimed to identify latent profiles of self-management behaviors in this population and to examine factors associated with profile membership. METHODS: A cross-sectional study was conducted between December 2024 and May 2025 among hypertensive patients attending Gannan Tibetan Autonomous Prefecture People's Hospital. Latent profile analysis was performed to identify distinct self-management behavior profiles. Multinomial logistic regression was subsequently used to examine factors associated with profile membership, including self-efficacy, social support, chronic disease health literacy, age, ethnicity, smoking, and drinking. RESULTS: Three distinct profiles of self-management behaviors were identified: 1) a comprehensive management type, characterized by consistently good performance across all behavioral dimensions; 2) a low treatment management type, marked by poor medication adherence and inadequate blood pressure monitoring; and 3) a low risk factor management type, characterized by weak control of smoking, alcohol use, and work-related stress. Multiple logistic regression analyses demonstrated that self-efficacy played a role in each patient group, while social support, chronic disease-related health literacy, ethnicity, and dietary habits only exerted corresponding effects in specific patient subgroups. CONCLUSIONS: Self-management behaviors among patients with hypertension in high-altitude ethnic minority regions exhibited substantial heterogeneity, yielding three distinct latent profiles with clearly differentiated characteristics. The study found that self-efficacy played a role across all three behavioral categories, facilitating early identification of individuals who require intervention. Concurrently, clinical practice and public health interventions can implement stratified, precision-based management strategies tailored to the primary factors that influence different patient populations.