Disease risk perception, health intervention intention and their influencing factors among prehypertensive and hypertensive populations: a cross-sectional study with 1050 participants

BACKGROUND: Prehypertension and hypertension are major modifiable cardiovascular risk factors that impose a substantial global public health burden. Disease risk perception and health beliefs are critical determinants of health behaviors, yet few studies have compared the heterogeneous patterns influencing intervention intention between prehypertensive and hypertensive individuals. OBJECTIVE: To compare differences in health cognition, health beliefs, lifestyle behaviors, and intervention intention between prehypertensive and hypertensive groups, and to explore heterogeneous predictors of intervention intention to inform targeted prevention strategies. METHODOLOGY: A cross-sectional study enrolled 1050 adults (525 prehypertensive, 525 hypertensive) via convenience sampling from community centers and hypertension clinics (January-December 2025). Questionnaires included demographic characteristics, lifestyle behaviors, Health Belief Model (HBM) scales, and intervention intention. Data were analyzed using SPSS 25.0 with t-tests, χ² tests, correlation analyses, and multivariate logistic regression. RESULTS: Hypertensive patients were older, had more comorbidities, higher perceived severity, better lifestyle behaviors, and stronger intervention willingness (all P < 0.001). Lifestyle behaviors were positively correlated with intervention intention (r = 0.533, P < 0.01). Universal predictors included family history of hypertension, lifestyle behaviors, perceived severity, and health motivation (all P < 0.05). Prehypertensive individuals were primarily predicted by lifestyle behaviors (OR = 1.533, P < 0.001) and health motivation (OR = 1.398, P = 0.001); hypertensive patients by self-efficacy (OR = 1.464, P < 0.001), perceived susceptibility (OR = 1.163, P = 0.029), and lifestyle (OR = 1.089, P = 0.012). The prehypertension model had the highest explanatory power (Nagelkerke R²=0.849). CONCLUSIONS: Significant differences exist in health cognition, health beliefs, and intervention willingness between groups. Lifestyle behaviors serve as universal predictors of intervention intention, whereas disease perception factors play a more critical role among hypertensive patients. Targeted strategies-lifestyle optimization for prehypertension and self-efficacy enhancement for hypertension-are needed to improve self-management and reduce cardiovascular risk.