Dataset Information

Self-management and blood pressure control in China: a community-based multicentre cross-sectional study.

ABSTRACT:

Objectives

This study explored the relationship between self-management and blood pressure (BP) control in China.

Design

A cross-sectional study.

Setting

Eight community health centres from four cities in the Northeast (Shenyang), Northwest (Xi'an), Southwest (Chengdu) and South (Changsha) of China.

Participants

A total of 873 adults with hypertension, including 360 men and 513 women. Hypertension was defined as systolic BP ?140?mm Hg and/or?diastolic BP ?90?mm Hg.

Outcome measurements

BP control was the primary outcome variable. This was categorised as good control if individuals with hypertension reduced their BP to <140/90?mm Hg, otherwise, it was categorised as poor control. Secondary outcomes included self-management, defined as: (1) context or condition-specific factors or physical/social environments (eg, age, sex, marital status, education, personal income and health insurance) and (2) process or knowledge/beliefs, self-regulation skills/abilities and social facilitation (eg, treatment, diet, exercise and risk factor management). Data were analysed using logistic regression models using SPSS V.20.

Results

A total of 67.1% (n=586) participants had poor BP control. Limited outpatient care benefits in mainly rural residents (OR 2.26, 95%?CI 1.06 to 4.81) and longer disease duration (OR 1.03, 95%?CI 1.01 to 1.04) were associated with poor BP control. Self-management practices reduced the odds of having poor BP control (OR 0.98, 95%?CI 0.97 to 0.99).

Conclusions

The individual and family self-management theory can serve as an effective theory for understanding the key contexts, processes and outcomes essential for BP control in China. Future research should evaluate the effect of a self-management intervention (eg, self-monitoring, medication adherence, regular and routine doctor visits, and social supports) for BP control in China using a multisite cluster randomised controlled trial. Sex and gender difference, cost and patient-reported outcomes should also be examined.

SUBMITTER: Qu Z

PROVIDER: S-EPMC6528047 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Self-management and blood pressure control in China: a community-based multicentre cross-sectional study.

Qu Zhan Z Parry Monica M Liu Fang F Wen Xiulin X Li Jieqiong J Zhang Yanan Y Wang Duolao D Li Xiaomei X

BMJ open 20190320 3

<h4>Objectives</h4>This study explored the relationship between self-management and blood pressure (BP) control in China.<h4>Design</h4>A cross-sectional study.<h4>Setting</h4>Eight community health centres from four cities in the Northeast (Shenyang), Northwest (Xi'an), Southwest (Chengdu) and South (Changsha) of China.<h4>Participants</h4>A total of 873 adults with hypertension, including 360 men and 513 women. Hypertension was defined as systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg.<h ...[more]

PMID: 30898823

Similar Datasets

Project description:ImportanceIt is unclear whether mobile technology hypertension self-management programs are associated with blood pressure (BP) control.ObjectiveTo examine whether engagement with a hypertension self-management program with a BP monitor and connected smartphone application with clinically based digital coaching was associated with BP control during a follow-up period of as long as 3 years.Design, setting, and participantsThis cohort study enrolled US adults with elevated BP or hypertension between January 1, 2015, and July 1, 2020. The hypertension self-management program was provided through the participant's (or their spouse's) employer health plan.ExposuresProgram engagement, defined by average number of application sessions.Main outcomes and measuresSystolic and diastolic BP measured by a US Food and Drug Administration-cleared BP monitor, with categories defined as normal (systolic BP, <120 mm Hg), elevated (systolic BP, 120-129 mm Hg), stage 1 hypertension (systolic BP, 130-139 mm Hg), and stage 2 hypertension (systolic BP ≥140 mm Hg). Other measures included age, gender, depression, anxiety, diabetes, high cholesterol, smoking, geographic region, area deprivation index, self-reported weight, and device-measured physical activity (steps per day).ResultsAmong 28 189 participants (median [IQR] age, 51 [43-58] years; 9424 women [40.4%]; 13 902 men [59.6%]), median (IQR) baseline systolic BP was 129.5 mm Hg (120.5-139.6 mm Hg) and diastolic BP was 81.7 mm Hg (75.7-88.4 mm Hg). Median systolic BP at 1 year improved at least 1 category for 495 of 934 participants (53.0%) with baseline elevated BP, 673 of 966 (69.7%) with baseline stage 1 hypertension, and 920 of 1075 (85.7%) with baseline stage 2 hypertension. Participants in the program for 3 years had a mean (SEM) systolic BP reduction of 7.2 (0.4), 12.2 (0.7), and 20.9 (1.7) mm Hg compared with baseline for those starting with elevated, stage 1 hypertension, and stage 2 hypertension, respectively. Greater engagement was associated with lower systolic BP over time (high-engagement group: 131.2 mm Hg; 95% CI, 115.5-155.8 mm Hg; medium-engagement group: 133.4 mm Hg; 95% CI 116.3-159.5 mm Hg; low-engagement group: 135.5 mm Hg; 95% CI, 117.3-164.8 mm Hg; P < .001); these results persisted after adjusting for age, gender, depression, anxiety, diabetes, high cholesterol, smoking, area deprivation index rank, and US region, which was partially mediated by greater physical activity. A very high BP (systolic BP >180 mm Hg) was observed 11 637 times from 3778 participants. Greater engagement was associated with lower risk of very high BP; the estimated probability of a very high BP was greater in the low-engagement group (1.42%; 95% CI, 1.26%-1.59%) compared with the medium-engagement group (0.79%; 95% CI, 0.71%-0.87%; P < .001) and the high-engagement group (0.53%; 95% CI, 0.45%-0.60%; P < .001 for comparison with both groups).Conclusions and relevanceThe findings of this study suggest that a mobile technology hypertension self-management program can support long-term BP control and very high BP detection. Such programs may improve real-world BP monitoring and control.

Dataset Information

Self-management and blood pressure control in China: a community-based multicentre cross-sectional study.

Objectives

Design

Setting

Participants

Outcome measurements

Results

Conclusions

Publications

Self-management and blood pressure control in China: a community-based multicentre cross-sectional study.

Similar Datasets

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